Nokea
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.
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A client with iron deficiency anemia is prescribed iron supplements. After administering the drug, the nurse would assess the client for which of the following as a possible adverse reaction related to gastrointestinal function?
- A. Headache
- B. Darker stools
- C. Soreness
- D. Backache
Correct Answer: B
Rationale: The nurse needs to closely monitor the client for darker stools as an adverse gastrointestinal reaction to iron supplements. Headache and backache are the generalized system reactions to iron supplements. Soreness is a generalized system reaction to the administration of iron when given though the parenteral route.
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 with iron deficiency anemia who is receiving iron supplements. What information should the nurse include in the teaching plan for this client?
- A. Frequency of urination will increase.
- B. Soreness of throat might occur.
- C. Itching of throat might occur.
- D. Color of stools will become darker.
Correct Answer: D
Rationale: The nurse should inform the client receiving oral iron supplements that the color of stools will become darker. Frequency of urination is not known to increase with the oral administration of iron supplements. Similarly, soreness of the throat and itching of the throat are also not known to occur with the oral administration of iron supplements.
A client receives filgrastim to treat neutropenia associated with chemotherapy. The nurse monitors the client's absolute neutrophil count (ANC). The nurse anticipates stopping the drug when the ANC reaches which level?
- A. 2500/mm³
- B. 5000/mm³
- C. 7500/mm³
- D. 10000/mm³
Correct Answer: D
Rationale: Injections of the CSF filgrastim are started at least 24 hours after the completion of a cycle of chemotherapy. The absolute neutrophil count (ANC) is monitored and therapy is continued until an ANC count of at least 10,000/mm³ is achieved.
A client is prescribed vitamin B12 for vitamin B12 deficiency anemia. After teaching the client about the drug, the nurse determines that the teaching was successful when the client states that which of the following can decrease the absorption of oral vitamin B12? Select all that apply.
- A. Alcohol
- B. Calcium
- C. Neomycin
- D. Colchicine
- E. Phenytoin
Correct Answer: A,C,D
Rationale: Alcohol, neomycin, and colchicine may decrease the absorption of oral vitamin B12.