Nokea
A client who is prescribed an iron preparation for treating iron deficiency anemia tells the nurse that she has also been taking ascorbic acid. The nurse would assess the client for which of the following?
- A. An increase in seizure activity
- B. Signs of vitamin B12 deficiency
- C. Increased absorption of iron
- D. Signs of folate deficiency
Correct Answer: C
Rationale: The nurse should monitor for an increased absorption of iron in the client due to the interaction of ascorbic acid with the iron preparation. An increase in seizure activity may occur when folic acid is administered with the hydantoins. Signs of folate deficiency may occur when sulfasalazine is administered concurrently. Vitamin B12 deficiency is a rare deficiency caused by a low dietary intake.
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Based on the nurse's understanding of epoetin alfa, the nurse would expect to administer the drug cautiously to a client with a history of which of the following? Select all that apply.
- A. Diabetes
- B. Renal failure
- C. History of seizures
- D. Congestive heart failure
- E. Hypotension
Correct Answer: C,D
Rationale: Epoetin alfa (Procrit) is used cautiously in clients with hypertension, heart disease, congestive heart failure, or a history of seizures.
The nurse is preparing to administer vitamin B12 to a client. The nurse would administer the drug cautiously if the client had which condition?
- A. Pulmonary disease
- B. Hypertension
- C. Heart disease
- D. Seizures
Correct Answer: A
Rationale: Vitamin B12 is cautiously administered to clients with pulmonary disease. Epoetin alfa and darbepoetin alfa are administered cautiously to clients with hypertension, heart disease, and a history of seizures.
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 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 who was treated for anemia is being discharged. The client has been instructed to continue with epoetin alfa for a week. Which of the following points should the nurse include in the teaching plan to educate the client about the therapy when caring for the client on an outpatient basis?
- A. Avoid use of multivitamin preparations.
- B. Report signs of joint pain to the primary health care provider.
- C. Follow the recommended diet provided by the primary health care provider.
- D. Take the drug on an empty stomach or with water.
Correct Answer: B
Rationale: When caring for a client who is to take epoetin alfa for anemia, the nurse should instruct the client to report any signs of joint pain, dizziness, headache, fatigue, nausea, vomiting, or diarrhea to the primary health care provider. The nurse should instruct the client to avoid taking multivitamin preparations and to follow the diet recommended by the primary health care provider when caring for a client who has to take folic acid. The nurse should instruct the client to take the drug on an empty stomach or with water when caring for a client who has to take iron supplements on an outpatient basis.