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1. A nurse is caring for a client with schizophrenia who has been
prescribed clozapine. The nurse should monitor the client for which of the
following adverse effects?
a) Agranulocytosis
b) Tardive dyskinesia
c) Neuroleptic malignant syndrome
d) Extrapyramidal symptoms
Answer: A. Agranulocytosis is a potentially life-threatening condition that
can occur with clozapine use. It is characterized by a severe reduction in
white blood cells, which increases the risk of infection. The nurse should
monitor the client's blood counts regularly and report any signs of
infection, such as fever, sore throat, or mouth ulcers.
2. A nurse is conducting a mental status examination on a client with
schizophrenia who exhibits loose associations. Which of the following
statements by the client is an example of loose associations?
a) "I like to watch TV, but the news is always bad. Bad news makes me
sad. Sadness is a feeling that I don't like."
b) "The sky is blue today. Blue is my favorite color. I have a blue shirt
that I got from my mother. She is in heaven now."
c) "You are wearing a white coat. White is the color of snow. Snow is cold
and wet. Wet is what you get when you swim."
d) "I need to take my medication. Medication helps me think clearly.
Clearly, you are a good nurse. Nurse rhymes with purse."
Answer: C. Loose associations are a form of disorganized thinking that
involves a shift from one topic to another without any logical connection
or coherence. The client's statement about white, snow, wet, and swim
demonstrates loose associations.
3. A nurse is teaching a client with schizophrenia and his family about
relapse prevention. Which of the following information should the nurse
include in the teaching?
a) Relapse can be prevented by taking medication as prescribed and
avoiding stress.
b) Relapse can be predicted by the presence of prodromal symptoms, such
as anxiety, insomnia, or social withdrawal.
c) Relapse can be managed by increasing the dose of medication and
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