A) Consult with hematologist to determine appropriate antibiotic regimen and monitor closely.
B) Institute twice-weekly complete blood count with differentials and monitor closely.
C) Discontinue clozapine, initiate alternative antipsychotic medication and monitor closely.
D) Institute daily complete blood count with differentials and monitor closely.
- ANSWER>>B) Institute twice-weekly complete blood count with differentials and monitor closely.
The recommended cut-points for discontinuation of clozapine are WBC of 2,000 to 3,000 or granulocytes of 1,000 to 1,500 for agranulocytosis and severely compromised immune system. At a WBC of 4,000, the recommendation is to closely monitor CBC with differential twice a week while patient may continue clozapine in the absence of any other signs or symptoms.
A patient with a diagnosis of schizophrenia has a history of suicidal ideation and suicide attempts. The PMHNP should consider which antipsychotic medication that is the only antipsychotic to reduce the risk of suicide in schizophrenia?
A) Abilify (aripriprazole)
B) Latuda (lurasidone)
C) Invega (iloperidone)
D) Clozaril (clozapine)
- ANSWER>>D) Clozaril (clozapine) is the only known antipsychotic medication that had been shown to reduce the risk of suicide in patients diagnosed with schizophrenia.
A patient being treated for major depressive disorder and on sertraline (Zoloft), 150 mg po daily for the past 16 years, presents to the psychiatric mental health practitioner for an outpatient follow-up visit. During the visit she states that she has not been feeling well, reporting the flu. She also states she has not taken her medication in the last five days. Which of the following symptoms would she be describing if you suspect selective serotonin reputable inhibitors (SSRIs) discontinuation syndrome?
A) Agitation, nausea, dysphoria, and diequilibrium
B) Agitation, nausea, tremor, and ataxia.
C) Restlessness, tremor, fever, and shivering.
D) Restlessness, headache, increased heart rate, and diarrhea.
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