Question 1

A woman who is planning to become pregnant should ensure that she receives adequate levels of which supplement to reduce the risk for fetal neural tube defects?

Accepted Answer

It is recommended that administration of folic acid be begun at least 1 month before pregnancy and continue through early pregnancy to reduce the risk for fetal neural tube defects.

Question 2

The nurse is administering folic acid to a patient with a new diagnosis of anemia. Which statement about treatment with folic acid is true?

Accepted Answer

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. The other options are incorrect.

Question 3

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?

Accepted Answer

Orange juice contains ascorbic acid, which enhances the absorption of oral iron forms; antacids, milk, and yogurt may interfere with absorption.

Question 4

The nurse will teach a patient who is receiving oral iron supplements to watch for which expected adverse effects?

Accepted Answer

Black, tarry stools and other gastrointestinal disturbances may occur with the administration of iron preparations. The other options are incorrect.

Question 5

The nurse is reviewing the medical record of a patient before giving a new order for iron sucrose (Venofer). Which statement regarding the administration of iron sucrose is correct?

Accepted Answer

Iron sucrose (Venofer) is an injectable iron product indicated for the treatment of iron-deficiency anemia in patients with chronic renal disease. It is also used for patients without kidney disease. Its risk of precipitating anaphylaxis is much less than that of iron dextran, and a test dose is not required. Hypotension is the most common adverse effect and appears to be related to infusion rate. Low-weight elderly patients appear to be at greatest risk for hypotension.

Question 6

The nurse is administering liquid oral iron supplements. Which intervention is appropriate when administering this medication?

Accepted Answer

Liquid oral forms of iron need to be taken through a plastic straw to avoid discoloration of tooth enamel. Milk may decrease absorption.

Question 7

During therapy with the hematopoietic drug epoetin alfa (Epogen), the nurse instructs the patient about adverse effects that may occur, such as:

Accepted Answer

Hypertension is an adverse effect of hematopoietic drugs, along with headache, fever, pruritus, rash, nausea, vomiting, arthralgia, cough, and injection site reaction. The other options are incorrect.

Question 8

A patient is to receive iron dextran injections. Which technique is appropriate when the nurse is administering this medication?

Accepted Answer

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.

Question 9

A patient will be taking oral iron supplements at home. The nurse will include which statements in the teaching plan for this patient?

Accepted Answer

Iron tablets need to be taken with meals to reduce gastrointestinal distress, but antacids and milk interfere with absorption. Orange juice enhances the absorption of iron. Stools may become black and tarry in patients who are on iron supplements. Tablets need to be taken whole, not crushed, and the patient needs to be encouraged to eat foods high in iron.

Question 10

A nurse is giving instructions to a patient who will be receiving oral iron supplements. Which instructions will be included in the teaching plan?

Accepted Answer

Although taking iron tablets with food may decrease absorption, doing so helps to reduce gastrointestinal distress. Antacids and milk may cause decreased iron absorption; iron tablets must be taken whole and not crushed. Black, tarry stools are expected adverse effects of oral iron supplements.

Question 11

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? _______

Accepted Answer

The answer of A patient will be receiving epoetin alfa...

Question 12

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?

Accepted Answer

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. The other options are incorrect.

Question 13

A patient has been receiving epoetin alfa (Epogen) for severe iron-deficiency anemia. Today, the provider changed the order to darbepoetin (Aranesp). The patient questions the nurse, "What is the difference in these drugs?" Which response by the nurse is correct?

Accepted Answer

Darbepoetin (Aranesp) is longer-acting than epoetin alfa (Epogen); therefore, fewer injections are required. The other options are incorrect.

Question 14

A patient with end-stage renal failure has been admitted to the hospital for severe anemia. The patient is refusing blood transfusions. The nurse anticipates drug therapy with which drug to stimulate the production of red blood cells?

Accepted Answer

Epoetin alfa is a colony-stimulating factor that is responsible for erythropoiesis, or formation of red blood cells. The other options are incorrect.

Question 15

An oral iron supplement is prescribed for a patient. The nurse would question this order if the patient's medical history includes which condition?

Accepted Answer

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.

Question 16

A cancer patient is receiving drug therapy with epoetin alfa (Epogen). The nurse knows that the medication must be stopped if which laboratory result is noted?

Accepted Answer

If epoetin is continued when hemoglobin levels are above 11 g/dL, patients may experience serious adverse events, including heart attack, stroke, and death. Guidelines now recommend that the drug be stopped when the hemoglobin level reaches 10 g/dL for cancer patients. For renal patients, the target hemoglobin level is 11 g/dL for patients on dialysis and 10 g/dL for chronic renal patients not on dialysis.

Question 17

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 26 pounds. Identify how many milligrams the nurse will administer per dose. (record answer using one decimal place) _______

Accepted Answer

The answer of A 2-year-old child will be receiving ferrous...

Question 18

A patient has been taking iron supplements for anemia for 2 months. During a follow-up assessment, the nurse will observe for which therapeutic response?

Accepted Answer

Absence of fatigue, increased activity tolerance and well-being, and improved nutrition status are therapeutic responses to iron supplementation. The other options are incorrect.

Quiz 54: Anemia Drugs