A nurse working in a community health center is speaking with a client who has a serious mental illness. The client states that they are unable to find employment and they do not understand why. Which of the following questions should the nurse ask? (Select all that apply.)
"What is your expected salary range?"
"Have you served time in prison?"
"What type of vehicle do you drive?"
"Do you use drugs?"
"Are you taking antipsychotic medication?"
Correct Answer : B,D,E
Rationale:
A. Asking about salary range is not directly relevant to the client’s mental health condition and would not help in understanding the barriers to employment.
B. Inquiring if the client has served time in prison may reveal a history that could impact their employability, as some employers may have restrictions on hiring individuals with criminal records.
C. Asking about the type of vehicle the client drives is not directly related to the client’s mental health or barriers to employment, and it would not provide insight into why the client is struggling to find work.
D. Asking about drug use is pertinent as substance abuse can interfere with employment opportunities and overall functioning.
E. Knowing whether the client is taking antipsychotic medication is important because adherence to treatment can significantly affect the client’s ability to function in a work environment.
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Correct Answer is A
Explanation
Rationale:
A. Sore throat and muscle aches are common symptoms of agranulocytosis, a serious side effect of clozapine, indicating a potentially dangerous drop in white blood cells.
B. Severe restlessness is not a primary indicator of agranulocytosis but could be related to other side effects or symptoms.
C. Increased anxiety and suicidal ideations are not specific symptoms of agranulocytosis but can be related to psychiatric conditions or medication effects.
D. Respiratory depression and a comatose state are not typical signs of agranulocytosis and would indicate a more severe, different medical emergency.
Correct Answer is D
Explanation
Rationale:
A. The medication administration record is important for verifying the order but should be used in conjunction with the patient’s identification.
B. The order sheet provides the details of the blood product to be administered but is not the primary source for verifying patient identity.
C. The chart includes medical history and orders but does not provide direct patient identification for blood administration.
D. The identification wristband is the primary and most direct method for verifying the patient’s identity to ensure that the correct blood product is administered to the correct patient.