Nokea
The nurse is preparing to administer vitamin B12 to a client. The nurse would administer the drug cautiously if the client had which condition?
- A. Pulmonary disease
- B. Hypertension
- C. Heart disease
- D. Seizures
Correct Answer: A
Rationale: Vitamin B12 is cautiously administered to clients with pulmonary disease. Epoetin alfa and darbepoetin alfa are administered cautiously to clients with hypertension, heart disease, and a history of seizures.
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A nurse is caring for a client with hypertension who is prescribed epoetin alfa for anemia. Which of the following would the nurse include in the plan of care when administering this drug to the client?
- A. Report 10 mm Hg rise in systolic blood pressure to primary health care provider.
- B. Note the hematocrit value before each dose during therapy.
- C. Shake the drug well before it is administered to the client.
- D. Administer the drug once every 3 weeks through IV route.
Correct Answer: B
Rationale: When caring for a client who is prescribed epoetin alfa, the nurse should measure the hematocrit before each dose during the drug therapy. The nurse should monitor the blood pressure of a client with hypertension when he is receiving epoetin alfa and report any rise of 20 mm Hg or more in the systolic or diastolic pressure to the primary health care provider. The drug is given three times weekly IV or SC. If the client is receiving dialysis, the drug is administered into the venous access line. The drug is mixed gently during preparation for administration. Shaking may denature the glycoprotein.
A nurse identifies a nursing diagnosis of Constipation for a client receiving iron supplements. Which of the following would be appropriate to promote resolution of this problem?
- A. Increase the intake of milk and dairy products.
- B. Consume a diet high in fiber.
- C. Take antacids after consuming meals.
- D. Perform vigorous exercises.
Correct Answer: B
Rationale: When caring for a client with constipation, the nurse should instruct the client to consume a high-fiber diet, increase fluid intake to 10 to 12 glasses of water daily, and increase activity. Increased activity can include exercise, however, the client does not need to engage in vigorous exercise. Increasing the intake of milk and dairy products or taking antacids after meals will not help reduce the constipation or the discomfort caused due to it.
A client is prescribed ferrous sulfate (Feosol). Which of the following adverse reactions should the nurse discuss with a client prior to the administration of this drug? Select all that apply.
- A. Constipation
- B. Fluid retention
- C. Nausea
- D. Fatigue
- E. Dark stools
Correct Answer: A,C,E
Rationale: GI irritation, nausea, vomiting, constipation, diarrhea, darker stools, headache, backache, and allergic reactions are adverse reactions the nurse should discuss with a client prior to the administration of ferrous sulfate (Feosol).
After reviewing information about colony-stimulating factors, a group of nursing students demonstrate understanding of the information when they identify which of the following as true about filgrastim (Neupogen)? Select all that apply.
- A. Is a glycoprotein
- B. Promotes proliferation of leukocytes
- C. Stimulates differentiation of erythrocytes
- D. Stimulates maturation of megakaryocytes
- E. Is used to treat chemotherapy-induced neutropenia
Correct Answer: A,B,E
Rationale: Colony-stimulating factors such as filgrastim (Neupogen) are glycoproteins used to stimulate proliferation, differentiation, and maturation of leukocytes. They are used to treat chemotherapy-induced neutropenia.
A client is prescribed vitamin B12 for vitamin B12 deficiency anemia. After teaching the client about the drug, the nurse determines that the teaching was successful when the client states that which of the following can decrease the absorption of oral vitamin B12? Select all that apply.
- A. Alcohol
- B. Calcium
- C. Neomycin
- D. Colchicine
- E. Phenytoin
Correct Answer: A,C,D
Rationale: Alcohol, neomycin, and colchicine may decrease the absorption of oral vitamin B12.