A patient who has been taking clozapine for 6 weeks visits the clinic complaining of fever, sore throat, and mouth sores. The nurse notifies the patient's physician because the nurse suspects which of the following?

Correct Answer: D

Rationale: The correct answer is D: Agranulocytosis. Clozapine is known to cause agranulocytosis, a serious condition characterized by a decrease in white blood cells, leading to increased susceptibility to infections. The symptoms of fever, sore throat, and mouth sores are indicative of an infection, which could be a result of agranulocytosis. The physician should be notified immediately for further evaluation and management. A: Severe anemia is not typically associated with the symptoms described and is not a common side effect of clozapine. B: Neuroleptic malignant syndrome presents with symptoms such as muscle rigidity, fever, and altered mental status, which are different from the symptoms described. C: Encephalitis is inflammation of the brain and is not directly related to the symptoms reported by the patient.

Correct Answer: A

Rationale: The correct answer is A: It is episodic in nature. Schizoaffective disorder is characterized by a combination of schizophrenia symptoms and mood disorder symptoms. One key difference between schizoaffective disorder and schizophrenia is that schizoaffective disorder is episodic, meaning the individual experiences periods of mood symptoms alongside psychotic symptoms. This episodic nature distinguishes it from schizophrenia, where symptoms are typically more continuous. Choices B, C, and D are incorrect as they do not accurately reflect a defining characteristic of schizoaffective disorder. Schizoaffective disorder can still involve difficulties with self-care, severe hallucinations, and a high risk of suicide, so these options are not specific enough to differentiate it from schizophrenia.

Correct Answer: C

Rationale: The correct answer is C because it demonstrates active listening, empathy, and encourages further exploration of the patient's experience without dismissing or invalidating their feelings. By asking James to share more about his experience, it shows that you are engaged, caring, and willing to understand his perspective. This approach can help build trust and rapport with the patient, which is important in therapeutic communication. Option A is incorrect because it denies the patient's experience and may lead to feelings of invalidation. Option B is incorrect as it dismisses the patient's feelings of fear and may come across as patronizing. Option D is incorrect as it focuses more on reassurance rather than addressing the patient's emotional distress and exploring their experience.

Correct Answer: B

Rationale: The correct answer is B: Empowerment. Empowerment refers to the level of choice, influence, and control that users of mental health services can exercise over events in their lives. It involves empowering individuals to make decisions and take actions that enhance their well-being. Emotional regulation (A) refers to the ability to manage and control emotions. Mutual negotiation (C) involves reaching agreements through discussion and compromise. Self-determination (D) is the right of individuals to make choices about their own lives. However, empowerment specifically focuses on giving individuals the ability to exert influence and control over their circumstances, making it the most appropriate term in this context.

Correct Answer: D

Rationale: The correct answer is D because NGRI clients are treated in a hospital setting due to their mental illness, and their discharge is determined by the courts based on their mental state at that time. GBMI clients, on the other hand, are usually treated in a hospital setting but their discharge is typically handled through the correctional system, not the courts. Therefore, D is the most appropriate choice as it accurately distinguishes the discharge process for NGRI clients from GBMI clients. Choices A, B, and C are incorrect because they do not accurately depict the differences in treatment and discharge processes between NGRI and GBMI clients.