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A nurse is providing education to a patient with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education?
- A. Take the iron with dairy products to enhance absorption.
- B. Increase the intake of vitamin E to enhance absorption.
- C. Iron will cause the stools to darken in color.
- D. Limit foods high in fiber due to the risk for diarrhea.
Correct Answer: C
Rationale: The nurse will inform the patient that iron will cause the stools to become dark in color. Iron should be taken on an empty stomach, as its absorption is affected by food, especially dairy products. Patients should be instructed to increase their intake of vitamin C to enhance iron absorption. Foods high in fiber should be consumed to minimize problems with constipation, a common side effect associated with iron therapy.
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A nurse is a long-term care facility is admitting a new resident who has a bleeding disorder. When planning this resident's care, the nurse should include which of the following?
- A. Housing the resident in a private room
- B. Implementing a passive ROM program to compensate for activity limitation
- C. Implementing of a plan for fall prevention
- D. Providing the patient with a high-fiber diet
Correct Answer: C
Rationale: To prevent bleeding episodes, the nurse should ensure that an older adult with a bleeding disorder does not suffer a fall. Activity limitation is not necessarily required, however. A private room is not necessary and there is no reason to increase fiber intake.
The nurse on the pediatric unit is caring for a patient with a diagnosis of hemophilia. The patient is a childâ??a 10-year-old boy. The nurse knows that a priority nursing diagnosis for this patient would be what?
- A. Hypothermia
- B. Diarrhea
- C. Ineffective coping
- D. Imbalanced nutrition
Correct Answer: C
Rationale: Most patients with hemophilia are diagnosed as children. They often require assistance in coping with the condition because it is chronic, places restrictions on their lives, and is an inherited disorder that can be passed to be passed to future generations. Children with hemophilia are not at risk of hypothermia, diarrhea or imbalanced nutrition.
A patient with Von Willebrand disease (vWD) has experienced recent changes in bowel function that suggest the need for a screening colonoscopy. What intervention should be performed in anticipation of this procedure?
- A. The patient should not undergo the normal bowel cleansing protocol prior to the procedure.
- B. The patient should receive a unit of fresh-frozen plasma 48 hours before the procedure.
- C. The patient should be admitted to the surgical unit on the day before the procedure.
- D. The patient should be given necessary clotting factors before the procedure.
Correct Answer: D
Rationale: A goal of treating vWD is to replace the deficient protein (e.g., vWF or factor VIII) prior to an invasive procedure to prevent subsequent bleeding. Bowel cleansing is not contraindicated and FFP does not reduce the patient's risk of bleeding. There may or may not be a need for preprocedure hospital admission.
A patients blood work reveals a platelet level of 17,000/mm3. When inspecting the patients integumentary system, what finding would be most consistent with this platelet level?
- A. Dermatitis
- B. Petechiae
- C. Urticaria
- D. Alopecia
Correct Answer: B
Rationale: When the platelet count drops to less than 20,000/mm?³, petechiae can appear. Low platelet levels do not normally result in dermatitis, urticaria (hives), or alopecia (hair loss).
A patient with a history of cirrhosis is admitted to the ICU with a diagnosis of bleeding esophageal varices; an attempt to stop the bleeding has been only partially successful. What would the critical care nurse expect the care team to order for this patient?
- A. Packed red blood cells (PRBCs)
- B. Vitamin K
- C. Oral anticoagulants
- D. Heparin infusion
Correct Answer: A
Rationale: Patients with liver dysfunction may have life-threatening hemorrhage from peptic ulcers or esophageal varices. In these cases, replacement with fresh frozen plasma, PRBCs, and platelets is usually required. Vitamin K may be ordered once the bleeding is stopped, but that is not what is needed to stop the bleeding of the varices. Anticoagulants would exacerbate the patient's bleeding.