Nokea
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.
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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 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.
A client is receiving a colony-stimulating factor and experiences dilutional anemia secondary to fluid retention associated with drug therapy. The nurse would most likely identify which nursing diagnosis?
- A. Fatigue
- B. Constipation
- C. Imbalanced Nutrition: Less Than Body Requirements
- D. Anxiety
Correct Answer: A
Rationale: During administration of the CSF drugs, the patient may experience fluid retention. The increase in fluid volume makes the ratio of cells to fluid in the blood less, which results in a dilutional anemia. The patient may experience fatigue due to this anemia. Constipation is more likely when iron supplements are used. Imbalanced Nutrition: Less Than Body Requirements would be more likely if the client was experiencing anemia. There is no evidence to suggest Anxiety as a nursing diagnosis.
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 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.