Nokea
A client is prescribed ferrous sulfate. Before administering the drug, the nurse reviews the client's medical record. The nurse would withhold the drug and contact the primary health care provider if the client's history revealed which of the following? Select all that apply.
- A. Hemolytic anemia
- B. Vitamin B12 deficiency anemia
- C. Anemia of chronic kidney disease
- D. Hemochromatosis
- E. Hypertension
Correct Answer: A,D
Rationale: The use of iron supplements is contraindicated in clients with hemochromatosis or hemolytic anemia.
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A nursing instructor is conducting a class on the different types of blood cells. Which of the following would the instructor include as the correct function? Select all that apply.
- A. Erythrocytes supply our cells with oxygen from the lungs to the tissues.
- B. Erythrocytes control bleeding from microscopic to major tears in our tissues.
- C. Leukocytes supply our cells with oxygen from the lungs to the tissues.
- D. Leukocytes protect the body from dangerous organisms.
- E. Megakaryocytes control bleeding from microscopic to major tears in our tissues.
Correct Answer: A,D,E
Rationale: Erythrocytes supply our cells with oxygen from the lungs to the tissues; leukocytes protect the body from dangerous organisms; and megakaryocytes control bleeding from microscopic to major tears in our tissues.
A client has a hypersensitivity reaction to pegfilgrastim (Neufasta). The nurse would expect to administer which of the following to treat the hypersensitivity reaction and maintain the use of colony-stimulating factors? Select all that apply.
- A. Prednisone
- B. Diphenhydramine
- C. Albuterol
- D. Naproxen
- E. Hydrocodone
Correct Answer: A,B,C
Rationale: Colony-stimulating factors, like pegfilgrastim (Neulasta), can cause hypersensitivity reactions and should be treated with antihistamines (diphenhydramine), steroids (prednisone), and bronchodilators (albuterol) to maintain their use.
A nurse is caring for a client who has been prescribed iron dextran. The nurse understands that which information is used to calculate the drug dosage?
- A. Client's age
- B. Client's height
- C. Hemoglobin level
- D. Platelet count
Correct Answer: C
Rationale: Hemoglobin level and body weight of the client are important information the nurse requires to calculate the drug dosage for administering iron dextran. The client's age, height, and platelet count are not essential information when calculating drug dosage for iron dextran.
A client is prescribed vitamin B12 for his pernicious anemia following gastric bypass surgery. The nurse would be alert for which of the following as a possible adverse reaction?
- A. Urticaria
- B. Dyspnea
- C. Pulmonary edema
- D. Joint pain
Correct Answer: C
Rationale: The nurse needs to closely monitor the client for pulmonary edema, an adverse reaction to vitamin B12. The other adverse reactions to the administration of vitamin B12 include increased RBC production, acne, peripheral vascular thrombosis, heart failure, mild diarrhea, and itching. Urticaria and dyspnea are caused when iron is administered parenterally. Joint pain is an adverse reaction to epoetin alfa.
A client with chronic kidney disease is prescribed epoetin alfa (Procrit). Which of the following would be appropriate for the nurse to do when administering this drug to promote optimal response? Select all that apply.
- A. Shake the vial vigorously prior to administration.
- B. Use the vial for multiple doses.
- C. Discard any unused portion after administration.
- D. Administer the drug either intravenously or subcutaneously.
- E. Avoid using the drug if the client is receiving dialysis.
Correct Answer: C,D
Rationale: When administering epoetin alfa (Procrit) to a client with chronic kidney disease, the following apply: the drug is given three times weekly IV or subcutaneously, if the client is receiving dialysis, the drug is administered into the venous access line, the drug is mixed gently during preparation for administration; shaking may denature the glycoprotein; and the vial is used for only one dose and any remaining or unused portion is discarded.