Nokea
Which of the following menu choices indicate that the patient understands the nurse's teaching about best dietary choices for iron-deficiency anemia?
- A. Omelet and whole wheat toast
- B. Cantaloupe and cottage cheese
- C. Strawberry and banana fruit plate
- D. Cornmeal muffin and orange juice
Correct Answer: A
Rationale: Eggs and whole grain breads are high in iron. The other choices are appropriate for other nutritional deficiencies, but are not the best choice for a patient with iron-deficiency anemia.
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The nurse is caring for a patient with polycythemia vera. Which of the following actions should the nurse implement during treatment?
- A. Place the patient on bed rest.
- B. Administer iron supplements.
- C. Avoid use of aspirin products.
- D. Monitor fluid intake and output.
Correct Answer: D
Rationale: Monitoring hydration status is essential in polycythemia vera to prevent thrombosis due to increased blood viscosity. Aspirin therapy is used to decrease risk for thrombosis. The patient should be encouraged to ambulate to prevent deep vein thrombosis (DVT). Iron is contraindicated in patients with polycythemia vera.
Which of the following newly admitted patients should the nurse assign as a roommate for a patient who has aplastic anemia?
- A. A patient with severe heart failure
- B. A patient who has viral pneumonia
- C. A patient who has right leg cellulitis
- D. A patient with multiple abdominal drains
Correct Answer: A
Rationale: Patients with aplastic anemia are at risk for infection because of the low white blood cell production associated with this type of anemia, so the nurse should avoid assigning a roommate with any possible infectious process.
Which of the following nursing actions should the nurse include in the plan of care for a patient admitted with multiple myeloma?
- A. Monitor fluid intake and output.
- B. Administer calcium supplements.
- C. Assess lymph nodes for enlargement.
- D. Limit weight bearing and ambulation.
Correct Answer: A
Rationale: A high fluid intake and urine output helps prevent the complications of kidney stones caused by hypercalcemia and renal failure caused by deposition of Bence Jones protein in the renal tubules. Weight bearing and ambulation are encouraged to help bone retain calcium. Lymph nodes are not enlarged with multiple myeloma. Calcium supplements will further increase the patient's calcium level and are not used.
All of these patients are waiting to be admitted by the emergency department nurse. Which one of the following requires the most rapid assessment and care by the nurse?
- A. The patient with hemochromatosis who has symptoms of abdominal pain
- B. The patient with thrombocytopenia who has blood oozing after having a tooth extracted
- C. The patient with chemotherapy-induced neutropenia who has a temperature of 38.2°C (100.8°F)
- D. The patient with a history of sickle cell anemia who has had nausea and diarrhea for 24 hours
Correct Answer: C
Rationale: A neutropenic patient with a fever is assumed to have an infection and developing sepsis. Rapid assessment, cultures, and initiation of antibiotic therapy are needed. The other patients also require rapid assessment and care but not as urgently as the neutropenic patient.
The nurse is caring for a patient with myelodysplastic syndrome who has 20% blasts in marrow and the health care provider has prescribed high-intensity treatment. Which of the following treatments should the nurse prepare the patient to receive?
- A. Antibiotics
- B. Antifungals
- C. Chemotherapy
- D. A blood transfusion
Correct Answer: C
Rationale: Low-risk patients (<5% blasts in marrow) can often be treated with transfusions, antibiotics, antifungals, EPO, and hematopoietic growth factors. High-risk patients (<5% blasts in marrow) may be treated with single-agent chemotherapy (e.g., hydroxyurea) or intensive chemotherapy as in AML.