Nokea
The client diagnosed with iron-deficiency anemia is prescribed ferrous gluconate orally. Which should the nurse teach the client?
- A. Take Imodium, an antidiarrheal, over-the-counter (OTC) for diarrhea.
- B. Limit exercise for several weeks until a tolerance is achieved.
- C. The stools may be very dark, and this can mask blood.
- D. Eat only red meats and organ meats for protein.
Correct Answer: C
Rationale: Ferrous gluconate darkens stools (C), potentially masking GI bleeding. Imodium (A) is premature, exercise (B) is encouraged, and diet (D) should be varied, not meat-only.
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The nurse knows that infectious mononucleosis is caused by which of the following?
- A. Cytomegalovirus
- B. Beta-hemolytic Streptococcus
- C. Epstein-Barr virus
- D. Herpes simplex virus I
Correct Answer: C
Rationale: Infectious mononucleosis is caused by the Epstein-Barr virus.
Which action should the nurse expect to perform after a client has a bone marrow biopsy taken from the iliac crest?
- A. Apply pressure to the site for one minute
- B. Administer a narcotic analgesic
- C. Apply an adhesive bandage to the site
- D. Place the client in a recumbent position
Correct Answer: C
Rationale: Applying an adhesive bandage to the site after a bone marrow biopsy prevents bleeding and protects the area. Pressure is typically applied for longer, narcotics are not routine, and recumbent positioning is not required.
The client diagnosed with leukemia is scheduled for bone marrow transplantation. Which interventions should be implemented to prepare the client for this procedure? Select all that apply.
- A. Administer high-dose chemotherapy.
- B. Teach the client about autologous transfusions.
- C. Have the family members' HLA typed.
- D. Monitor the complete blood cell count daily.
- E. Provide central line care per protocol.
Correct Answer: A,C,D,E
Rationale: High-dose chemotherapy (A) ablates marrow, HLA typing (C) identifies donors, CBC monitoring (D) tracks counts, and central line care (E) prevents infection. Autologous transfusions (B) are irrelevant (donor marrow used).
The nurse is collecting data from the client undergoing testing for possible basal cell carcinoma (BCC). Which information in the client’s health history should the nurse identify as risk factors for BCC?
- A. Taking immune-suppressing medications
- B. 10-pack-year history of cigarette smoking
- C. Has fair skin color, red hair, and blue eyes
- D. Had bone exposure to high radon gas levels
- E. Works as a laborer in road construction
Correct Answer: A, C, E
Rationale: Immune-suppressing drugs weaken the immune system, and cellular changes can occur more aggressively. B. Smoking history is a risk factor for lung cancer, not BCC. C. Persons with fair skin, blond or red hair, and blue, green, or gray eyes have a higher risk for BCC due to the ease of sunburn with sun exposure if the skin is not protected. D. Exposure to indoor radon gas is a risk factor for lung cancer, not BCC. Radon is a radioactive colorless, odorless, tasteless, and chemically inert gas. It is formed by the natural radioactive decay of uranium in rock, soil, and water. E. Frequent participation in outdoor activities with exposure to sunlight is a risk for BCC due to the damage caused by UV light. UV light damages DNA.
The client is diagnosed with severe iron-deficiency anemia. Which statement is the scientific rationale regarding oral replacement therapy?
- A. Iron supplements are well tolerated without side effects.
- B. There is no benefit from oral preparations; the best route is IV.
- C. Oral iron preparations cause diarrhea if not taken with food.
- D. Very little of the iron supplement will be absorbed by the body.
Correct Answer: D
Rationale: Oral iron has low absorption (D), requiring high doses. Side effects (A) include GI upset, IV (B) is for severe cases, and diarrhea (C) is not primary (constipation is common).