Nokea
The nurse is administering folic acid to a patient with a new diagnosis of anemia. Which statement about treatment with folic acid is true?
- A. Folic acid is used to treat any type of anemia.
- B. Folic acid is used to treat iron-deficiency anemia.
- C. Folic acid is used to treat pernicious anemia.
- D. The specific cause of the anemia needs to be determined before treatment.
Correct Answer: D
Rationale: Folic acid should not be used to treat anemias until the underlying cause and type of anemia have been identified. Administering folic acid to a patient with pernicious anemia may correct the hematologic changes of anemia, but the symptoms of pernicious anemia (which is due to a vitamin B12 deficiency, not a folic acid deficiency) may be deceptively masked.
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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.
During therapy with the hematopoietic drug epoetin alfa, the nurse instructs the patient about adverse effects that may occur, such as
- A. Anxiety
- B. Drowsiness
- C. Hypertension
- D. Constipation
Correct Answer: C
Rationale: Hypertension is an adverse effect of hematopoietic drugs, along with headache, fever, pruritus, rash, nausea, vomiting, arthralgia, cough, and injection site reaction.
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 is administering liquid oral iron supplements. Which intervention is appropriate when administering this medication?
- A. Have the patient take the liquid iron with milk.
- B. Instruct the patient to take the medication through a plastic straw.
- C. Have the patient sip the medication slowly.
- D. Have the patient drink the medication, undiluted, from the unit-dose cup.
Correct Answer: B
Rationale: Liquid oral forms of iron need to be taken through a plastic straw to avoid discoloration of tooth enamel. Milk may decrease absorption.
The nurse is administering intravenous iron dextran for the first time to a patient with anemia. After giving a test dose, how long will the nurse wait before administering the remaining portion of the dose?
- A. 30 minutes
- B. 1 hour
- C. 6 hours
- D. 24 hours
Correct Answer: B
Rationale: Although anaphylactic reactions usually occur within a few moments after the test dose, it is recommended that a period of at least 1 hour elapse before the remaining portion of the initial dose is given.