Nokea
The client is diagnosed with pernicious anemia. Which health-care provider order should the nurse anticipate in treating this condition?
- A. Subcutaneous iron dextran.
- B. Intramuscular vitamin B12.
- C. Intravenous folic acid.
- D. Oral thiamine medication.
Correct Answer: B
Rationale: Pernicious anemia results from B12 deficiency; IM B12 is standard treatment due to absorption issues. Iron, folic acid, or thiamine do not address the primary cause.
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A client is receiving external beam radiation to the mediastinum for treatment of bronchial cancer. Addressing which of the following should take priority in planning care?
- A. Esophagitis
- B. Leukopenia
- C. Fatigue
- D. Skin irritation
Correct Answer: B
Rationale: Leukopenia. Clients develop leukopenia due to the depressant effect of radiation therapy on bone marrow function. Infection is the most frequent cause of morbidity and death in clients with cancer.
An adult client had an abdominal hysterectomy this morning. Meperidine HCl (Demerol) 75 mg IM q3-4h PRN for pain is ordered. At 9:00 P.M., she complains of lower abdominal pain. She was last medicated at 5:45 P.M. What is the most appropriate initial action for the nurse to take?
- A. Offer her a bed pan and a back rub
- B. Reposition her
- C. Administer meperidine HCl 75 mg IM
- D. Encourage her to perform relaxation and breathing exercises
Correct Answer: C
Rationale: The last dose was over 3 hours ago, within the PRN order. Administering meperidine is appropriate for pain relief.
A young woman delivered a 7-lb, 8-oz baby boy spontaneously. Ergotrate 0.4 mg q6h for five days is ordered. A half-hour after the nurse administers the first dose, she complains of abdominal cramping. The nurse's best response is based on which understanding?
- A. Cramping indicates a serious adverse reaction.
- B. Cramping can be reduced by abdominal breathing.
- C. The medication is having the desired effect.
- D. The dosage needs to be reduced.
Correct Answer: C
Rationale: Ergotrate causes uterine contractions, leading to cramping, which is the intended effect to prevent postpartum hemorrhage.
An adult client is being treated for genital herpes with acyclovir (Zovirax) tablets. Which statement she makes indicates that she understands her therapy?
- A. It is safe now to have sexual relations.
- B. I will stay home from work until the blisters are gone.
- C. This medicine will cure the herpes infection.
- D. If the blisters come back, I will start taking the pills immediately.
Correct Answer: D
Rationale: Acyclovir reduces symptoms and recurrence of herpes but does not cure it. Starting treatment at recurrence is appropriate.
The nurse is providing education for a client with newly diagnosed tuberculosis. Which statement should be included in the information that is given to the client?
- A. Isolate yourself from others until you are finished taking your medication.'
- B. Follow up with your primary care provider in 3 months.'
- C. Continue to take your medications even when you are feeling fine.'
- D. Continue to get yearly tuberculin skin tests.'
Correct Answer: C
Rationale: The most important piece of information the tuberculosis client needs is to understand the importance of medication compliance, even if no longer experiencing symptoms. Clients are most infectious early in the course of therapy. The numbers of acid-fast bacilli are greatly reduced as early as 2 weeks after therapy begins.