Nokea
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.
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The nurse will teach a patient who is receiving oral iron supplements to watch for which expected adverse effects?
- A. Palpitations
- B. Drowsiness and dizziness
- C. Black, tarry stools
- D. Orange-red discoloration of the urine
Correct Answer: C
Rationale: Black, tarry stools and other gastrointestinal disturbances may occur with the administration of iron preparations.
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.
A patient will be receiving epoetin alfa (Epogen) 8000 units IV three times a week. The medication is available in a vial that contains 10,000 units/mL. How many milliliters will the nurse draw up for this dose?
Correct Answer: 0.8 mL
Rationale: Calculate volume: 10,000 units:1 mL::8000 units:x mL. (10,000 ?? x) = (1 ?? 8000); 10,000x = 8000; x = 0.8 mL.
An oral iron supplement is prescribed for a patient. The nurse would question this order if the patient's medical history includes which condition?
- A. Decreased hemoglobin
- B. Hemolytic anemia
- C. Weakness
- D. Concurrent therapy with erythropoietics
Correct Answer: B
Rationale: Iron supplements are contraindicated in anemias that are not caused by iron-deficiency, such as hemolytic anemia. Decreased hemoglobin and weakness are related to iron-deficiency anemia. Iron supplements are given with erythropoietic drugs to aid in the production of red blood cells.
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.