Nokea
A nurse is teaching a client about taking ferrous sulfate to treat iron deficiency anemia. Which of the following instructions should the nurse include? (Select All)
- A. Eat iron-enriched foods.
- B. Spread the dosage across each day.
- C. Take the drug on an empty stomach.
- D. Report dark green or black stools.
Correct Answer: A
Rationale: The correct answer is A: Eat iron-enriched foods. Iron-enriched foods help increase iron levels in the body, aiding in treating iron deficiency anemia. Consuming these foods along with ferrous sulfate can enhance the effectiveness of the treatment.
B: Spreading the dosage across each day is important to maintain consistent iron levels but is not the most crucial aspect of treatment.
C: Taking the drug on an empty stomach may enhance absorption but can also lead to stomach upset, so it is not necessary for all clients.
D: Reporting dark green or black stools is important to monitor for gastrointestinal bleeding, but it is not an instruction related to taking ferrous sulfate.
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The nurse is reviewing the parts of the complete blood count and differential with a patient. Where should the nurse state that neutrophils, eosinophils, and basophils are produced?
- A. Spleen
- B. Thymus
- C. Lymph nodes
- D. Red bone marrow
Correct Answer: D
Rationale: The correct answer is D: Red bone marrow. Neutrophils, eosinophils, and basophils are all types of white blood cells that are produced in the red bone marrow through a process called hematopoiesis. The red bone marrow is a primary site for the production of blood cells, including these specific types of white blood cells. Neutrophils are important for fighting bacterial infections, eosinophils are involved in allergic reactions and parasitic infections, and basophils play a role in allergic responses. Therefore, it is crucial for the nurse to inform the patient that these cells are produced in the red bone marrow. The other choices (A: Spleen, B: Thymus, C: Lymph nodes) are incorrect as these organs do not play a primary role in the production of these specific types of white blood cells.
A 20-month-old otherwise healthy male presents late for his 18-month well child check. During his first year of life, he took iron-fortified formula and had a point-of-care hemoglobin (Hgb) of 12 g/dL at his 1-year well child check. His mother reports that he is a picky eater but loves milk and has recently become obsessive about chewing the corners of his cardboard books. Physical examination is normal except for a flow murmur. Which combination of laboratory test results listed below would most likely characterize this patient?
- A. Hgb 8.7 g/dL, mean corpuscular volume (MCV) 60 fL, serum ferritin 2 ng/mL
- B. Hgb 12.0 g/dL, MCV 80 fL, serum ferritin 30 ng/mL
- C. Hgb 9.2 g/dL, MCV 60 fL, serum ferritin 30 ng/mL
- D. Hgb 11.2 g/dL, MCV 90 fL, serum ferritin 7 ng/mL
Correct Answer: A
Rationale: The correct answer is A because it reflects iron deficiency anemia in a 20-month-old child who is a picky eater and has pica behavior. The low hemoglobin level of 8.7 g/dL indicates anemia. The MCV of 60 fL suggests microcytic anemia, typical of iron deficiency. The serum ferritin level of 2 ng/mL confirms low iron stores.
Choice B is incorrect as the hemoglobin level is normal, MCV is higher, and serum ferritin is not indicative of iron deficiency anemia.
Choice C is incorrect as the hemoglobin level is higher, and the MCV is not consistent with iron deficiency anemia.
Choice D is incorrect as the hemoglobin level is higher, MCV is too high for iron deficiency anemia, and the serum ferritin level does not support iron deficiency.
Which statement is correct regarding lymphocyte counts in infants versus adults?
- A. NK-cell numbers are lowest at birth and increase with age.
- B. B-cell numbers are highest at birth and decline with age.
- C. T-cell numbers in infants are higher than in adults.
- D. Infants have low lymphocyte counts that increase with age.
Correct Answer: C
Rationale: The correct answer is C: T-cell numbers in infants are higher than in adults. This is because infants have a relatively higher proportion of T-cells compared to adults due to their underdeveloped immune system. T-cell numbers decrease with age as the immune system matures and adapts to the environment.
Rationale:
1. T-cells play a crucial role in the immune response, especially in infants who rely heavily on cellular immunity.
2. NK-cell numbers do not follow the pattern described in option A, as they are important in early immune responses.
3. B-cell numbers do not decline with age as stated in option B, as they are responsible for antibody production throughout life.
4. Option D is incorrect as infants actually have higher lymphocyte counts compared to adults due to their developing immune system.
A nurse is reviewing the medication record of a client who is receiving alteplase following an acute myocardial infarction (MI). Which of the following medications should the nurse expect the client to be taking in addition to the alteplase?
- A. Protamine
- B. Desmopressin
- C. Ferrous sulfate
- D. Heparin
Correct Answer: D
Rationale: The correct answer is D: Heparin. Following an acute MI, a client receiving alteplase may also be prescribed heparin to prevent re-thrombosis and further clot formation. Alteplase is a thrombolytic agent that works by breaking down clots, while heparin is an anticoagulant that helps prevent new clots from forming. Protamine (choice A) is used to reverse the effects of heparin, not typically administered alongside alteplase. Desmopressin (choice B) is used for conditions like diabetes insipidus, unrelated to MI treatment. Ferrous sulfate (choice C) is an iron supplement, not indicated in this scenario.
A laboratory finding of granulocytosis
- A. Complete absence of peripheral blood granulocytes and their precursors in the bone marrow
- B. Acute bacterial infections
- C. Myeloproliferative disorders
- D. Increased numbers of granulocytes in blood and bone marrow
Correct Answer: D
Rationale: The correct answer is D because granulocytosis refers to an increased number of granulocytes in both blood and bone marrow. This finding is commonly associated with conditions such as infections, inflammation, and certain hematologic disorders. Other choices are incorrect because A describes a condition of granulocytopenia, B is associated with acute bacterial infections but not specific to granulocytosis, and C refers to myeloproliferative disorders which may involve other cell types besides granulocytes.