Which of the following antipsychotic agents is most associated with the possibility of a hematological dyscrasia such as agranulocytosis in a patient being treated for schizophrenia?

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Question 1 of 5

Which of the following antipsychotic agents is most associated with the possibility of a hematological dyscrasia such as agranulocytosis in a patient being treated for schizophrenia?

Correct Answer: D

Rationale: Clozapine, a second-generation antipsychotic, is highly effective for treatment-resistant schizophrenia but carries a 1-2% risk of agranulocytosis, a severe drop in neutrophils, necessitating regular blood monitoring. Chlorpromazine causes rare leukopenia, not agranulocytosis prominence. Buspirone, an anxiolytic, lacks hematological risks. Lithium may increase leukocytes, not decrease them. Asenapine has minimal blood dyscrasia association. Clozapine's unique efficacy comes with this rare but serious side effect, distinguishing it and requiring strict oversight, per FDA guidelines.

Question 2 of 5

A 28-year-old woman presents to the emergency department in an acute asthma exacerbation. Her asthma developed in her 20s after she had recurrent upper respiratory infections. She was doing well, but she twisted her ankle yesterday and was taking aspirin to reduce the inflammation. She is diagnosed with aspirin-induced asthma. What is the most appropriate long-term treatment for her condition?

Correct Answer: D

Rationale: Aspirin-induced asthma (AIA) involves leukotriene overproduction. Zafirlukast , a leukotriene receptor blocker-prevents attacks long-term. Albuterol and Ipratropium treat acutely. Cromolyn stabilizes mast cells but is less specific. Theophylline (E) is outdated. Zafirlukast targets AIA's pathophysiology.

Question 3 of 5

A male patient is to begin therapy with isotretinoin and asks, 'What do I have to remember to do while taking this medicine?' How would the nurse respond? (Select all that apply.)

Correct Answer: B

Rationale: Isotretinoin is a potent medication with significant side effects and precautions. Patients should avoid sunlight (A) due to increased photosensitivity. Regular laboratory tests (C) are necessary to monitor liver function and lipid levels. Two forms of contraceptives (D) are required for females due to the high risk of teratogenicity. Monitoring weight (B) is not typically associated with isotretinoin use.

Question 4 of 5

Atropine:

Correct Answer: A

Rationale: Atropine, a muscarinic antagonist, causes bronchodilation by relaxing bronchial smooth muscle, a true statement used in asthma or COPD. It produces mydriasis (pupil dilation), not miosis (constriction), making that false, as it blocks parasympathetic tone. It's highly lipid-soluble, crossing the blood-brain barrier, so that's false. It doesn't block acetylcholine (ACh) reuptake (there's no such mechanism) but competitively inhibits muscarinic receptors, so that's incorrect. It reduces, not increases, salivary secretions. Bronchodilation is a primary therapeutic effect, reflecting atropine's anticholinergic action, critical for respiratory applications and distinguishing it from sympathomimetics.

Question 5 of 5

An HIV-positive client who has been started on highly active antiretroviral therapy (HAART) came back for a follow-up checkup. Which of the following will be the most helpful in determining the response to the therapy?

Correct Answer: C

Rationale: The most helpful test in determining the response to highly active antiretroviral therapy (HAART) in an HIV-positive client is the viral load test. This test measures the amount of HIV in a person's blood, indicating how well the medication is working to suppress the virus. A decrease in the viral load over time signifies a positive response to the treatment, while an increase may indicate treatment failure or drug resistance development. Monitoring the viral load is crucial in managing HIV and making informed decisions about the continuation or modification of the antiretroviral therapy regimen. Rapid HIV antigen tests, Western Blot analysis, and white blood cell count do not directly assess the response to HAART in the same way that viral load testing does.

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