Nokea
The nurse is discussing vitamin replacement with a client in the clinic. Which vitamin should the nurse discuss with the client in order to increase the absorption of folic acid and iron?
- A. Vitamin Bâ??â??
- B. Vitamin C
- C. Vitamin B6
- D. Vitamin E
Correct Answer: B
Rationale: Vitamin C enhances the absorption of folic acid and iron. Vitamin Bâ??â?? and folic acid are essential for the maturation of red blood cells. Vitamin B6 serves as a coenzyme in hemoglobin formation. Vitamin E protects blood cells from vitamin E-deficient hemolytic anemia.
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A client is brought to the emergency department with suspected bleeding esophageal varices. Which hemoglobin level should the nurse immediately report to the physician?
- A. 13.0 g/dL
- B. 10.2 g/dL
- C. 5.0 g/dL
- D. 11.4 g/dL
Correct Answer: C
Rationale: The nurse should immediately report a 5.0 g/dL, which is a critical low level. A 13.0 g/dL is a normal level, 11.4 is slightly low, and 10.2 is low.
The nurse is assisting the physician with obtaining a sample to determine the status of blood cell formation. What type of procedure will the nurse have prepared the client for?
- A. A bone marrow aspiration
- B. A Schilling test
- C. A thoracentesis
- D. A urine sample
Correct Answer: A
Rationale: A bone marrow aspiration is performed to determine the status of blood cell formation. In this procedure, the physician applies local anesthesia and removes bone marrow from the posterior iliac crest or the sternum. The marrow is examined for the types and percentage of immature and maturing blood cells.
The nurse is caring for a client who is undergoing bone marrow aspiration to determine the blood cell formation status. What nursing intervention should the nurse provide to the client during the test?
- A. Administer oral radioactive vitamin Bâ??â?? to the client.
- B. Administer a nonradioactive Bâ??â?? injection.
- C. Collect urine for 24 to 48 hours after the client receives the nonradioactive Bâ??â??.
- D. Support the client and monitor the status.
Correct Answer: D
Rationale: When a client undergoes a bone marrow aspiration, the nurse assists the physician, supports the client during the procedure, and monitors the condition afterward. The client needs to be administered oral radioactive vitamin Bâ??â?? or a nonradioactive Bâ??â?? injection in case of the Schilling test, which helps in determining pernicious anemia and macrocytic anemia. Collecting urine for 24 to 48 hours after administering nonradioactive Bâ??â?? is also applicable to the Schilling test.
The nurse is observing the skin of a client who is taking medications that depress the hematopoietic system and notices multiple areas of ecchymosis on the arms; bleeding for a prolonged period after an IV was started; and reports of black, tarry stool. What does the nurse understand may be a side effect of this medication that the client displays?
- A. Leukocytosis
- B. Leukopenia
- C. Thrombocytopenia
- D. Neutropenia
Correct Answer: C
Rationale: Signs of thrombocytopenia include unusual or easy bleeding; oozing from injection sites; bleeding gums; and dark, tarry stools. Leukocytosis would cause fever as well as other signs and symptoms of infection. Leukopenia symptoms are fever, sore throat, and chills. Neutropenia reduces the client's ability to fight infection and makes susceptible to microorganisms.
The nurse is reviewing laboratory studies that determine a client is deficient in copper. What does the nurse understand is the importance of copper in the body?
- A. Essential for the maturation of red blood cells
- B. Basic nutritional component of heme in hemoglobin
- C. Involved in the transfer of iron from storage to plasma
- D. Serves as a coenzyme in hemoglobin formation
Correct Answer: C
Rationale: Copper is involved in the transfer of iron from storage to plasma. Folic acid and Bâ??â?? are essential for the maturation of red blood cells. Iron is the basic nutritional component of heme in hemoglobin. Vitamin B6 serves as a coenzyme in hemoglobin formation.