Nokea
A client has had heavy menstrual bleeding for 6 months. Her gynecologist diagnoses microcytic hypochromic anemia and prescribes ferrous sulfate (Feosol), 300mg PO daily. Before initiating iron therapy, the nurse reviews the client's medical history. Which condition would contraindicate the use of ferrous sulfate?
- A. Pregnancy
- B. Ulcerative colitis
- C. Asthma
- D. Severely impaired liver function
Correct Answer: D
Rationale: Severely impaired liver function is a contraindication for the use of ferrous sulfate. In patients with liver disease, iron metabolism can be affected, leading to potential toxicity from iron accumulation. Ferrous sulfate is primarily metabolized by the liver, so in cases of severely impaired liver function, the metabolism of the drug may be altered, leading to potential adverse effects. It is important to consider alternative iron therapy options in patients with severe liver impairment to avoid potential complications.
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A nurse is assessing for jaundice in a dark-skinned newborn. Where is the best place to assess for jaundice in this newborn?
- A. Buttocks
- B. Tip of nose and sclera
- C. Sclera, conjunctiva, and oral mucosa
- D. Palms of hands and soles of feet
Correct Answer: C
Rationale: The best place to assess for jaundice in a dark-skinned newborn is in the sclera, conjunctiva, and oral mucosa. Jaundice, which is caused by elevated levels of bilirubin in the blood, is more easily seen in these areas compared to the skin. While jaundice is commonly assessed on the skin in light-skinned individuals, it may not be as readily apparent in dark-skinned newborns. Therefore, examining the sclera, conjunctiva, and oral mucosa for a yellowish discoloration provides a more reliable indication of jaundice in dark-skinned infants. This approach ensures that healthcare providers can accurately detect and monitor jaundice in newborns of all skin tones.
A client has been scheduled for a Schilling test. What instruction will the nurse give the client?
- A. Take nothing mouth fro 12 hours prior to the test
- B. Collect his urine for 12 hours
- C. Administer a fleet enema the evening before the test
- D. Empty his bladder immediately before the test
Correct Answer: B
Rationale: The correct instruction the nurse will give to the client scheduled for a Schilling test is to collect his urine for 12 hours. The Schilling test is a diagnostic test used to assess the body's ability to absorb vitamin B12. The test involves collecting urine samples over a period of 24 hours after the client ingests a small amount of radioactive vitamin B12. By collecting urine for 12 hours, the healthcare provider will be able to analyze the excretion of the vitamin and determine the client's ability to absorb vitamin B12. Instructions such as fasting, enema administration, or emptying the bladder before the test are not typically associated with the Schilling test procedure.
Which bite causes Rocky Mountain spotted fever?
- A. Flea
- B. Tick
- C. Mosquito
- D. Mouse or rat
Correct Answer: B
Rationale: Rocky Mountain spotted fever is caused by the bite of an infected tick. The bacterium Rickettsia rickettsii is transmitted to humans through the bite of the American dog tick, the Rocky Mountain wood tick, or the brown dog tick. These ticks are commonly found in wooded areas and attach themselves to the skin of humans or animals, transmitting the bacteria responsible for Rocky Mountain spotted fever. It is important to take precautions to prevent tick bites, such as using insect repellent, wearing long sleeves and pants when in wooded areas, and conducting thorough tick checks after being outdoors.
Nurse Norma's discharge teaching for Mr. Aurelio, diagnosed with heart failure, should stress the significance of:
- A. maintaining a sedentary lifestyle most of the day
- B. obtain daily weights at the same time
- C. walking 2 miles daily
- D. maintaining a high fiber die
Correct Answer: B
Rationale: Nurse Norma's discharge teaching for Mr. Aurelio, diagnosed with heart failure, should stress the significance of obtaining daily weights at the same time. Daily weights help monitor fluid retention, a key indicator of worsening heart failure. Sudden weight gain may signal fluid buildup in the body, while weight loss may indicate dehydration or treatment effectiveness. By obtaining daily weights at the same time each day, Mr. Aurelio can track changes and provide valuable information for his healthcare team to adjust his treatment plan accordingly. This practice is crucial in managing heart failure and preventing exacerbations.
Primary amenorrhea should be considered for any female adolescent who has not reached menarche by
- A. 13 years or has not done so within 3 years of thelarche
- B. 14 years or has not done so within 2 years of thelarche
- C. 14 years or has not done so within 3 years of thelarche
- D. 15 years or has not done so within 3 years of thelarche
Correct Answer: D
Rationale: Primary amenorrhea is suspected if menarche has not occurred by age 15 or within 3 years of thelarche.