A 33-year-old woman with schizophrenia comes in for a refill of clozapine (Clozaril). Her most recent lab report shows an absolute neutrophil count (ANC) of 1,100/μL. What action should the psychiatric mental health nurse practitioner (PMHNP) take?

Choice A reason: While a hematology consultation may be appropriate in severe or persistent cases, the immediate action required at an ANC of 1,100/μL is to interrupt clozapine therapy due to the risk of agranulocytosis. This value falls below the threshold for safe continuation. Choice B reason: Continuing treatment at an ANC of 1,100/μL is contraindicated. Clozapine carries a risk of severe neutropenia, and guidelines recommend interruption of therapy when ANC drops below 1,500/μL, with more urgent action below 1,000/μL. Choice C reason: Interrupting treatment is the correct action. An ANC of 1,100/μL indicates moderate neutropenia, and clozapine should be paused to prevent progression to agranulocytosis. Monitoring and potential re-initiation may follow depending on recovery. Choice D reason: Suspending treatment implies a more permanent cessation. While this may be necessary if neutropenia worsens or recurs, the initial step at this ANC level is interruption, not full suspension.