Ferrous sulfate is prescribed for a client. She returns to t...

Ferrous sulfate is prescribed for a client. She returns to the clinic in two weeks. Which assessment by the nurse indicates that she has NOT been taking iron as ordered?

A. The client's cheeks are flushed.
B. The client reports having more energy.
C. The client complains of nausea.
D. The client's stools are light brown.

Correct Answer: D

Rationale: Iron turns stool black. Light brown stools indicate the client has not been taking iron as prescribed. Flushed cheeks, increased energy, and nausea can be associated with iron therapy compliance.

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The charge nurse is making assignments on a medical floor. Which client should be assigned to the most experienced nurse?

A. The client diagnosed with iron-deficiency anemia who is prescribed iron supplements.
B. The client diagnosed with pernicious anemia who is receiving vitamin B12 intramuscularly.
C. The client diagnosed with aplastic anemia who has developed pancytopenia.
D. The client diagnosed with renal disease who has a deficiency of erythropoietin.

Correct Answer: C

Rationale: Aplastic anemia with pancytopenia (C) is complex, risking bleeding/infection, requiring experienced care. Iron (A), B12 (B), and renal anemia (D) are more stable.

The nurse identifies a concept of hematologic regulation for a client diagnosed with leukemia. Which clinical manifestations support the concept?

A. The client has petechiae on the trunk and extremities.
B. The client complains of pain and swelling in the joints.
C. The client has an Hbg of 9.7 and Hct of 32%.
D. The client complains of a headache and slurred speech.

Correct Answer: A,C

Rationale: Petechiae (A) and low Hb/Hct (C) reflect leukemia’s impact on hematologic regulation (thrombocytopenia, anemia). Joint pain (B) is less common, and headache/slurred speech (D) suggest stroke.

The nurse is assessing a client diagnosed with acute myeloid leukemia. Which assessment data support this diagnosis?

A. Fever and infections.
B. Nausea and vomiting.
C. Excessive energy and high platelet counts.
D. Cervical lymph node enlargement and positive acid-fast bacillus.

Correct Answer: A

Rationale: AML causes neutropenia, leading to fever/infections (A). Nausea (B) is nonspecific, high platelets/energy (C) are incorrect (AML causes thrombocytopenia/fatigue), and acid-fast bacillus (D) indicates TB, not AML.

The nurse writes a diagnosis of 'activity intolerance' for a client diagnosed with anemia. Which intervention should the nurse implement?

A. Encourage isometric exercises.
B. Assist the client with activities of daily living (ADLs).
C. Provide a high-protein diet.
D. Refer to the physical therapist.

Correct Answer: B

Rationale: Assisting with ADLs (B) conserves energy in anemia-related activity intolerance. Isometric exercises (A) strain oxygen capacity, diet (C) is medical, and PT (D) is collaborative.

The nurse is administering a transfusion of packed red blood cells to a client. Which interventions should the nurse implement? List in order of performance.

A. Start the transfusion slowly.
B. Have the client sign a permit.
C. Assess the IV site for size and patency.
D. Check the blood with another nurse at the bedside.
E. Obtain the blood from the laboratory.

Correct Answer: E,C,B,D,A

Rationale: 1. Obtain blood (E): Retrieve from lab. 2. Assess IV site (C): Ensure 18-gauge patency. 3. Sign permit (B): Obtain consent. 4. Check blood (D): Verify with another nurse. 5. Start slowly (A): Infuse at 10–15 mL/hr initially.