A nurse is educating a client who is prescribed clozapine. Which of the following findings should the nurse identify as consistent with agranulocytosis and instruct the client to report to their provider?

Choice A reason: Sore throat and malaise are hallmark early signs of agranulocytosis, a potentially life-threatening adverse effect of clozapine. Agranulocytosis involves a dangerously low neutrophil count, impairing the body’s ability to fight infection. These symptoms suggest infection and warrant immediate evaluation and blood work. Choice B reason: While increased anxiety and suicidal ideations are serious psychiatric symptoms, they are not specific to agranulocytosis. These may be related to underlying mental illness or other medication effects but do not indicate neutropenic risk. Choice C reason: Respiratory depression and coma are not associated with agranulocytosis. These symptoms may occur with overdose or CNS depressants, but clozapine-induced agranulocytosis presents with infection-like symptoms, not respiratory failure. Choice D reason: Severe restlessness may be indicative of akathisia or agitation, which are extrapyramidal symptoms or side effects of antipsychotics, but not agranulocytosis. It does not reflect the immunosuppressive risk that clozapine poses.