Nokea
An oral iron supplement is prescribed for a patient. The nurse would question this order if the patient's medical history includes which condition?
- A. Decreased hemoglobin
- B. Hemolytic anemia
- C. Weakness
- D. Concurrent therapy with erythropoietics
Correct Answer: B
Rationale: Iron supplements are contraindicated in anemias that are not caused by iron-deficiency, such as hemolytic anemia. Decreased hemoglobin and weakness are related to iron-deficiency anemia. Iron supplements are given with erythropoietic drugs to aid in the production of red blood cells.
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A woman who is planning to become pregnant should ensure that she receives adequate levels of which supplement to reduce the risk for fetal neural tube defects?
- A. Vitamin B12
- B. Vitamin D
- C. Iron
- D. Folic acid
Correct Answer: D
Rationale: It is recommended that administration of folic acid be begun at least 1 month before pregnancy and continue through early pregnancy to reduce the risk for fetal neural tube defects.
A cancer patient is receiving drug therapy with epoetin alfa. The nurse knows that the medication must be stopped if which laboratory result is noted?
- A. White blood cell count of 550 cells/mm?³
- B. Hemoglobin level of 12 g/dL
- C. Potassium level of 4.2 mEq/L
- D. Glucose level of 78 mg/dL
Correct Answer: B
Rationale: If epoetin is continued when hemoglobin levels are above 11 g/dL, patients may experience serious adverse events, including heart attack, stroke, and death. Caution must be used when hemoglobin levels are above 10 g/dL for cancer patients and 11 g/dL for renal patients.
A 2-year-old child will be receiving ferrous sulfate oral drops (Fer-Iron) 5 mg/kg/day in three divided doses. The child weighs 30 pounds. Identify how many milligrams the nurse will administer per dose. (Record answer using one decimal place.)
Correct Answer: 22.7 mg
Rationale: Convert pounds to kilograms: 30 ?· 2.2 = 13.6 kg. Calculate the total dose per day: 5 mg/kg/day ?? 13.6 kg = 68 mg/day. Divide into 3 doses: 68 mg/day ?· 3 doses/day = 22.67, rounded to 22.7 mg/dose.
The nurse is teaching a patient with iron-deficiency anemia about foods to increase iron intake. Which food may enhance the absorption of oral iron forms?
- A. Milk
- B. Yogurt
- C. Antacids
- D. Orange juice
Correct Answer: D
Rationale: Orange juice contains ascorbic acid, which enhances the absorption of oral iron forms; antacids, milk, and yogurt may interfere with absorption.
The nurse will teach a patient who is receiving oral iron supplements to watch for which expected adverse effects?
- A. Palpitations
- B. Drowsiness and dizziness
- C. Black, tarry stools
- D. Orange-red discoloration of the urine
Correct Answer: C
Rationale: Black, tarry stools and other gastrointestinal disturbances may occur with the administration of iron preparations.