Nokea
A client is prescribed oprelvekin. The nurse would administer the drug cautiously to the client if he had a history of which of the following? Select all that apply.
- A. Diabetes
- B. Renal failure
- C. Peptic ulcer disease
- D. Heart failure
- E. Atrial fibrillation
Correct Answer: B,D,E
Rationale: Oprelvekin (Neumega) is used cautiously in clients with renal failure, heart failure, or atrial arrhythmias.
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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.
A nurse identifies a nursing diagnosis of Constipation for a client receiving iron supplements. Which of the following would be appropriate to promote resolution of this problem?
- A. Increase the intake of milk and dairy products.
- B. Consume a diet high in fiber.
- C. Take antacids after consuming meals.
- D. Perform vigorous exercises.
Correct Answer: B
Rationale: When caring for a client with constipation, the nurse should instruct the client to consume a high-fiber diet, increase fluid intake to 10 to 12 glasses of water daily, and increase activity. Increased activity can include exercise, however, the client does not need to engage in vigorous exercise. Increasing the intake of milk and dairy products or taking antacids after meals will not help reduce the constipation or the discomfort caused due to it.
Prior to administering a drug used to treat anemia, the nurse should assess a client's vital signs, ability to carry out activities of daily living, and general appearance, and for the presence of which of the following other general symptoms? Select all that apply.
- A. Fatigue
- B. Pallor
- C. Headache
- D. Shortness of breath
- E. Sore tongue
Correct Answer: A,B,C,D,E
Rationale: Prior to administering a drug used to treat anemia, the nurse should assess a client's vital signs, client's ability to carry out activities of daily living, and client's general appearance, and for the presence of other general symptoms including fatigue, shortness of breath, sore tongue, headache, and pallor.
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.