Registered Practical Nurse (RPN) Practice Test

A client has been taking clozapine (Clozaril) and reports a sore throat and weakness. What should the nurse do?

1. Administer an over-the-counter pain reliever

2. Notify the physician for a white blood cell count

3. Monitor for signs of infection

4. Schedule the client for routine blood work

The correct answer is: Notify the physician for a white blood cell count

When a client on clozapine reports symptoms such as a sore throat and weakness, it is crucial for the nurse to act swiftly due to the potential risk of agranulocytosis, a serious side effect associated with clozapine. This condition involves a dangerously low white blood cell count, which significantly increases the risk of infections. By notifying the physician for a white blood cell count, the nurse ensures that appropriate laboratory testing can be conducted to assess the client's white blood cell levels immediately. This step is essential in determining whether the client is experiencing a serious adverse effect from the medication, which requires timely intervention. While monitoring for signs of infection and scheduling routine blood work are important components of overall patient care, the immediate priority in this situation should be to confirm or rule out agranulocytosis by measuring the white blood cell count. Additionally, administering an over-the-counter pain reliever may provide symptomatic relief, but it does not address the underlying concern of the potential side effects related to clozapine usage. Thus, notifying the physician for a white blood cell count is the most appropriate response in this scenario.