Nokea
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.
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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.
A patient is to receive iron dextran injections. Which technique is appropriate when the nurse is administering this medication?
- A. Intravenous administration mixed with 5% dextrose
- B. Intramuscular injection in the upper arm
- C. Intramuscular injection using the Z-track method
- D. Subcutaneous injection into the abdomen
Correct Answer: C
Rationale: Intramuscular iron is given using the Z-track method deep into a large muscle mass. If given intravenously, it is given with normal saline, not 5% dextrose.
A 2-year-old child will be receiving ferrous sulfate oral drops (Fer-Iron) 5 mg/kg/day in three divided doses. The child weighs 30 pounds. Identify how many milligrams the nurse will administer per dose. (Record answer using one decimal place.)
Correct Answer: 22.7 mg
Rationale: Convert pounds to kilograms: 30 ?· 2.2 = 13.6 kg. Calculate the total dose per day: 5 mg/kg/day ?? 13.6 kg = 68 mg/day. Divide into 3 doses: 68 mg/day ?· 3 doses/day = 22.67, rounded to 22.7 mg/dose.
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.
A patient has been receiving epoetin alfa for severe iron-deficiency anemia. Today, the provider changed the order to darbepoetin. The patient questions the nurse, 'What is the difference in these drugs?' Which response by the nurse is correct?
- A. There is no difference in these two drugs.
- B. Aranesp works faster than Epogen to raise your red blood cell count.
- C. Aranesp is given by mouth, so you will not need to have injections.
- D. Aranesp is a longer-acting form, so you will receive fewer injections.
Correct Answer: D
Rationale: Darbepoetin (Aranesp) is longer-acting than epoetin alfa (Epogen); therefore, fewer injections are required.