Nokea
Epoetin alfa (Epogen) is prescribed for a client who is on dialysis. When teaching the client about the drug, the nurse should plan to include which information about the drug?
- A. The drug is given to help the kidneys produce urine.
- B. The drug is given because the kidneys can no longer get rid of waste products.
- C. The drug replaces natural erythropoietin, which can no longer be produced when the kidney is in failure.
- D. The drug is given to the client to improve athletic ability.
Correct Answer: C
Rationale: Epoetin alfa replaces erythropoietin, deficient in kidney failure, to stimulate red blood cell production, correcting anemia. It does not affect urine production, waste removal, or athletic performance.
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The wife of a man who is comatose following a head injury asks the nurse if she should visit him since he is unresponsive. How should the nurse reply initially?
- A. Explain that since he is unresponsive there is no need for her to be here
- B. Tell her that the nurse will call if there is any change
- C. Suggest that her presence is important even though he seems unaware
- D. Recommend that she ask his coworkers to visit
Correct Answer: C
Rationale: Presence of loved ones may provide comfort and stimulate awareness in comatose patients, supporting family involvement. Other responses discourage visitation.
The incidence of Sickle Cell Anemia is higher among black American babies.
The symptoms of sickle cell anemia are not evident until later during infancy because
- A. The baby is fed with milk formula, which is rich in ironbfb.
- B. The infant has a much higher RBC count than children and adult.
- C. Maternal iron is depleted later in infancy.
- D. Infants have more body fluids than any age group.
Correct Answer: C
Rationale: High levels of fetal hemoglobin prevent sickling of red blood cells. The newborn has from 44% to 89% fetal hemoglobin, but this rapidly decreases during the first year, making symptoms evident later.
Teaching about the need to avoid foods high in potassium is most important for which client?
- A. a client receiving diuretic therapy
- B. a client with an ileus
- C. a client with metabolic alkalosis
- D. a client with renal disease
Correct Answer: D
Rationale: Renal disease impairs potassium excretion, leading to hyperkalemia, so avoiding high-potassium foods is critical. The other conditions are more associated with hypokalemia. Physiological Adaptation
While assessing an Rh positive newborn whose mother is Rh negative, the nurse recognizes the risk for hyperbilirubinemia. Which of the following should be reported immediately?
- A. Jaundice evident at 26 hours
- B. Hematocrit of 55%
- C. Serum bilirubin of 12 mg
- D. Positive Coombs' test
Correct Answer: C
Rationale: The elevated bilirubin is in the range that requires immediate intervention, such as phototherapy. At a serum bilirubin of 12 mg, the neonate is at risk for the development of kernicterus, or bilirubin encephalopathy. The provider determines the therapy appropriate after reviewing all laboratory findings.
A patient with borderline personality disorder is exhibiting self-harming behaviors. Which of the following interventions is most appropriate?
- A. Ignore the self-harming behaviors
- B. Provide immediate medical care for injuries
- C. Punish the patient for self-harming
- D. Encourage the patient to discuss their feelings
Correct Answer: B
Rationale: Providing immediate medical care for injuries ensures safety and addresses physical harm, the priority in self-harming behaviors. Ignoring, punishing, or only discussing feelings delays critical intervention.