# 一位服用clozapine的個案致電診所，主訴發燒、寒顫和喉嚨痛。下一劑藥物即將服用。護理師應提供哪項指示？ > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=497751&lang=zh-tw > language: zh-TW > subject: Adverse Effects/Contraindications/Interactions > category: PPT ## 題目 一位服用clozapine的個案致電診所，主訴發燒、寒顫和喉嚨痛。下一劑藥物即將服用。護理師應提供哪項指示？ ## 選項 1. 暫停服藥，並立即接受感染和嗜中性白血球低下症的臨床評估 **✔ 正確答案** 2. 服用acetaminophen退燒，並按原定時程繼續服用clozapine 3. 將下一劑clozapine劑量加倍，因為感染可能降低藥物吸收 4. 永久停用clozapine，並在未進一步評估的情況下丟棄藥物 **正確答案: 1** ## 解析 發燒、寒顫和喉嚨痛可能表示因clozapine相關的嚴重嗜中性白血球低下症而導致的感染。個案需要立即接受臨床評估和ANC檢測，才能服用下一劑藥物。現行FDA指引不再要求REMS登錄，但嗜中性白血球低下症的監測仍很重要。 ## 深入解析 快速解答 暫停即將服用的劑量，並安排立即評估感染和嗜中性白血球低下症。發燒、寒顫和喉嚨痛是需要評估的警示症狀，才能繼續暴露於clozapine。 為什麼這是正確的 Clozapine可能顯著降低嗜中性白血球數量，減弱身體對抗感染的能力。症狀可能在個案得知血球計數偏低前出現，因此臨床評估和ANC有助於指導治療是否暫停、調整或安全繼續。 簡單比喻或心智圖像 嗜中性白血球就像感染的第一線應變人員。Clozapine可能縮減這批人員，因此發燒是需要清點人數的警報；此比喻不代表每次發燒都是由嗜中性白血球低下症引起。 記憶掛鉤 Clozapine加上感染症狀，表示暫停下一劑並檢查抗感染細胞。 NCLEX 決策規則 對於可能抑制骨髓的藥物，將發燒、寒顫、喉嚨痛、口腔潰瘍或異常虛弱與可能的嗜中性白血球低下症連結。暫停立即服用的劑量，並及時取得臨床和實驗室指引，而非掩蓋症狀。 為什麼其他選項是錯的 Acetaminophen可能掩蓋發燒，而嚴重感染持續進展。加倍clozapine劑量無治療依據且增加毒性，而未經評估即永久停藥可能導致復發，且忽略以ANC為基礎的個別化計畫。參考文獻 - [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing - [2]FDA: Clozapine REMS Removal and Continuing ANC MonitoringU.S. Food and Drug Administration, 2025 ## 相同主題題目 - [A nurse is reviewing the morning lab results for an adult client receiving warfarin for at…](https://mymerci.kr/pages/nclex_q.php?qn_id=360515&lang=zh-tw) - [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=zh-tw) - [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=zh-tw) - [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=zh-tw) - [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=zh-tw) - [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=zh-tw) - [An 80-year-old male with heart failure is prescribed digoxin 0.125 mg daily. During mornin…](https://mymerci.kr/pages/nclex_q.php?qn_id=372686&lang=zh-tw) - [A 38-year-old female with rheumatoid arthritis is being discharged with a new prescription…](https://mymerci.kr/pages/nclex_q.php?qn_id=372687&lang=zh-tw) ## 以其他語言閱讀 - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=497751&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=497751&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=497751&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=497751&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=497751&lang=vi) --- More free questions: [NCLEX-RN 題庫](https://mymerci.kr/pages/nclex_bank.php?lang=zh-tw) _僅供學習參考。實際臨床請遵循最新指引與所屬機構規範。_