Nokea
A woman who is in her third trimester of pregnancy has been experiencing an exacerbation of iron deficiency anemia in recent weeks. When providing the patient with nutritional guidelines and meal suggestions, what foods would be most likely to increase the woman's iron stores?
- A. Salmon accompanied by whole milk
- B. Mixed vegetables and brown rice
- C. Beef liver accompanied by orange juice
- D. Yogurt, almonds, and whole grain oats
Correct Answer: C
Rationale: Food sources high in iron include organ meats, other meats, beans (e.g., black, pinto, and garbanzo), leafy green vegetables, raisins, and molasses. Taking iron-rich foods with a source of vitamin C (e.g., orange juice) enhances the absorption of iron. All of the listed foods are nutritious, but liver and orange juice are most likely to be of benefit.
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A patient's absolute neutrophil count (ANC) is 440/mm3. But the nurse's assessment reveals no apparent signs or symptoms of infection. What action should the nurse prioritize when providing care for this patient?
- A. Meticulous hand hygiene
- B. Timely administration of antibiotics
- C. Provision of a nutrient-dense diet
- D. Maintaining a sterile care environment
Correct Answer: A
Rationale: Providing care for a patient with neutropenia requires that the nurse adhere closely to standard precautions and infection control procedures. Hand hygiene is central to such efforts. Prophylactic antibiotics are rarely used and it is not possible to provide a sterile environment for care. Nutrition is highly beneficial, but hand hygiene is the central aspect of care.
A patient with a history of atrial fibrillation has contacted the clinic saying that she has accidentally overdosed on her prescribed warfarin (Coumadin). The nurse should recognize the possible need for what antidote?
- A. IVIG
- B. Factor X
- C. Vitamin K
- D. Factor VIII
Correct Answer: C
Rationale: Vitamin K is administered as an antidote for warfarin toxicity.
A patient with renal failure has decreased erythropoietin production. Upon analysis of the patients complete blood count, the nurse will expect which of the following results?
- A. An increased hemoglobin and decreased hematocrit
- B. A decreased hemoglobin and hematocrit
- C. A decreased mean corpuscular volume (MCV) and red cell distribution width (RDW)
- D. An increased MCV and RDW
Correct Answer: B
Rationale: The decreased production of erythropoietin will result in a decreased hemoglobin and hematocrit. The patient will have normal MCV and RDW because the erythrocytes are normal in appearance.
The nurse is assessing a new patient with complaints of overwhelming fatigue and a sore tongue that is visibly smooth and beefy red. This patient is demonstrating signs and symptoms associated with what form of what hematologic disorder?
- A. Sickle cell anemia
- B. Hemophilia
- C. Megaloblastic anemia
- D. Thrombocytopenia
Correct Answer: C
Rationale: A red, smooth, sore tongue is a symptom associated with megaloblastic anemia. Sickle cell disease, hemophilia, and thrombocytopenia do not have symptoms involving the tongue.
An adult human patient has been diagnosed with anemia from iron deficiency anemia. What nursing diagnosis would be the most likely to be applicable to this patient's condition?
- A. Risk for deficient vascular volume related to low red blood cell production
- B. Risk for infection susceptibility related to low oxygen levels in tissue
- C. Anemia-related acute pain
- D. Fatigue from low oxygen transport capacity
Correct Answer: D
Rationale: Fatigue is the major assessment finding common to all forms of anemia. Anemia does not usually result in acute pain or fluid volume deficit. The patient may have an increased risk of infection due to impaired immune function, but fatigue is more likely.