An older female adult patient who has been treated with clozapine (Clozaril) for 9 months calls to cancel a clinic appointment because of flulike symptoms, including a sore throat, fever, and tiredness. Which statement shows the best understanding regarding the management of the patient’s symptoms?

Correct Answer: B

Rationale: Step-by-step rationale for answer B: 1. Clozapine can cause agranulocytosis, a serious side effect characterized by a low white blood cell count. 2. The patient's symptoms of sore throat, fever, and tiredness may indicate a potential infection or agranulocytosis. 3. Blood work is necessary to monitor the patient's white blood cell count to rule out agranulocytosis. 4. Keeping the appointment and arranging for blood work allows for timely assessment and appropriate management. Summary of other choices: A: Incorrect. Advising the patient to drink juices and water and rest without further assessment may delay necessary medical intervention. C: Incorrect. Merely acknowledging flu season without taking proactive steps to assess the patient's condition is inadequate. D: Incorrect. Jumping to conclusions about the seriousness of the symptoms without proper evaluation through blood work is premature and may cause unnecessary alarm.

Correct Answer: C

Rationale: The correct answer is C: Decreased weight. Orlistat works by inhibiting the absorption of dietary fats in the intestines, leading to reduced calorie intake and ultimately weight loss. This is the intended therapeutic effect of orlistat. A: Increased wakefulness - Orlistat does not affect wakefulness. B: Increased appetite - Orlistat actually helps reduce appetite by promoting a feeling of fullness. D: Decreased hyperactivity - Orlistat does not have any direct impact on hyperactivity.

Correct Answer: A

Rationale: The correct answer is A: Potassium level 2.8 mEq/L. Low potassium levels can increase the toxicity of cardiac glycosides as they compete for the same binding sites on cardiac cells leading to enhanced drug effects. Potassium plays a crucial role in cardiac function, and low levels can potentiate the risk of cardiac glycoside toxicity. This can result in serious cardiac arrhythmias and even cardiac arrest. Summary: - Choice B: Potassium level 4.9 mEq/L is within normal range and would not increase toxicity. - Choice C: Sodium level 140 mEq/L is not directly related to cardiac glycoside toxicity. - Choice D: Calcium level 10 mg/dL is not typically associated with increased toxicity of cardiac glycosides.

Correct Answer: D

Rationale: Step 1: Diuretics can cause orthostatic hypotension, leading to a drop in blood pressure upon standing. Step 2: Orthostatic hypotension increases the risk of falling and injury, especially in older adults. Step 3: By instructing the patient to take extra precautions when standing up, the nurse helps prevent falls and injuries. Step 4: This teaching point is crucial for promoting the patient's safety and independence at home. Summary: Choice A is incorrect because the timing of diuretic intake with meals is not as critical as preventing falls. Choice B is incorrect as skipping doses can lead to uncontrolled hypertension. Choice C is incorrect because stopping the medication abruptly can have negative consequences and potassium supplements may not be necessary. Choice D is correct as it addresses the potential side effect of orthostatic hypotension and emphasizes safety measures.

Correct Answer: D

Rationale: The correct answer is D because active transport involves the movement of molecules against their concentration gradient, requiring energy expenditure. This process is crucial for maintaining cellular homeostasis and ensuring proper functioning of cells. Options A, B, and C are incorrect because active transport is not based on diffusion, does require energy consumption, and does not involve engulfing of molecules by vesicle formation. It is important to understand the fundamental concept of active transport to differentiate it from passive transport mechanisms.