Nokea
A nurse should encourage a client with megaloblastic anemia to eat which of the following foods, as they are rich in folate? Select all that apply.
- A. Collard greens
- B. Grapes
- C. Wheat bread
- D. Salmon
- E. Chicken
Correct Answer: A,C,D,E
Rationale: A deficiency of folic acid (folate) results in megaloblastic anemia, and the nurse should encourage a client to eat foods rich in folic acid including leafy green vegetables (collard greens), fish (salmon), meat, poultry (chicken), and whole grains (wheat bread).
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A client with megaloblastic anemia is prescribed leucovorin. The nurse would identify which of the following as a contraindication for this drug?
- A. Pernicious anemia
- B. Hemochromatosis
- C. Uncontrolled hypertension
- D. Hypersensitivity to human albumin
Correct Answer: A
Rationale: Leucovorin is contraindicated in clients with pernicious anemia or other anemias in which vitamin B12 is deficient. Leucovorin is not contraindicated in clients with hemochromatosis, uncontrolled hypertension, and hypersensitivity to human albumin. Epoetin alfa is contraindicated in clients with uncontrolled hypertension and hypersensitivity to human albumin. Iron compounds are contraindicated in clients with hemochromatosis or hemolytic anemia.
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 client with chronic kidney disease is prescribed epoetin alfa (Procrit). Which of the following would be appropriate for the nurse to do when administering this drug to promote optimal response? Select all that apply.
- A. Shake the vial vigorously prior to administration.
- B. Use the vial for multiple doses.
- C. Discard any unused portion after administration.
- D. Administer the drug either intravenously or subcutaneously.
- E. Avoid using the drug if the client is receiving dialysis.
Correct Answer: C,D
Rationale: When administering epoetin alfa (Procrit) to a client with chronic kidney disease, the following apply: the drug is given three times weekly IV or subcutaneously, if the client is receiving dialysis, the drug is administered into the venous access line, the drug is mixed gently during preparation for administration; shaking may denature the glycoprotein; and the vial is used for only one dose and any remaining or unused portion is discarded.
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 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.