Question 1

A client who had gastric bypass six months ago is profoundly anemic.The client has memory loss and periodic hallucinations.A diagnosis of folate deficiency has been proposed.Why would the nurse provisional diagnosis?

Accepted Answer

Folate-deficiency anemia typically does not produce neurological symptoms, which are more commonly associated with vitamin B12 deficiency.

Question 2

The nurse is caring for an ambulatory client who requires treatment for pernicious anemia on a medical unit.The client is weak and short of breath,and recently has become confused.Vital signs at rest are temperature 98.0°F,pulse 98 BPM,respirations 22/minute,blood pressure 96/60,and pulse oximetry 95%.Which nursing diagnosis has the highest priority?

Accepted Answer

The nursing diagnosis with the highest priority is falls, risk for related to confusion, weakness, and an unfamiliar environment. The client is short of breath, weak, and confused, putting them at risk for falls. It is the nurse's responsibility to assess and ensure that the client is in a safe environment to prevent falls. While the other nursing diagnoses are also important, they are not as high of a priority as preventing falls.

Question 3

A client is admitted with pernicious anemia.The nurse understands that therapy will include medication to address the client's lack of intrinsic factor.Which drug would the nurse anticipate administering?

Accepted Answer

Pernicious anemia is a type of anemia that occurs when the body is unable to absorb vitamin B12 due to a lack of intrinsic factor. Cyanocobalamin is a form of vitamin B12 that can be injected subcutaneously to treat pernicious anemia. Intravenous iron and oral iron salts are used to treat iron-deficiency anemia, not pernicious anemia. Epoetin alfa is a medication used to stimulate the production of red blood cells and is also not effective in addressing the lack of intrinsic factor seen in pernicious anemia.

Question 4

A client who is a strict vegetarian is prescribed cyanocobalamin (Nascobal)for vitamin B₁₂deficiency.Which information should the nurse provide for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of A client who is a strict vegetarian...

Question 5

A client received a first dose of cyanocobalamin (Nascobal)2 days ago.The nurse is monitoring the client's electrolytes because of the possibility of which clinical manifestation?

Accepted Answer

Cyanocobalamin can cause hypokalemia (a marked decrease in potassium), which can lead to dangerous dysrhythmias. Therefore, the nurse should monitor electrolytes in the client who has received this medication. A decrease in serum osmolality (choice A) and sodium (choice D) may not necessarily be caused by administration of cyanocobalamin. While cyanocobalamin is involved in one-carbon metabolism and can affect the metabolism of calcium, it is unlikely to cause a marked decrease in calcium (choice B).

Question 6

A client is prescribed a dose of oprelvekin.Prior to administration of the drug,which nursing assessment should trigger a telephone call to the provider who wrote the order?

Accepted Answer

Oprelvekin is contraindicated in patients with a history of myelogenous leukemia because it can stimulate the proliferation of malignant cells.

Question 7

The nurse is developing teaching materials on managing the side effects of oral iron salts for distribution in a free clinic.Which information should be included?

Accepted Answer

The answer of The nurse is developing teaching materials on...

Question 8

A client is receiving the first dose of sargramostim (Leukine).Which assessment findings should the nurse evaluate as indicating a possible serious adverse effect of this drug? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of A client is receiving the first dose...

Question 9

The nurse is reviewing lab work prior to administering a client's regularly scheduled subcutaneous injection of epoetin alfa.The nurse notes that the client's hematocrit has dropped from the last time lab was drawn.Which action by the nurse is the most appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is reviewing lab work prior...

Question 10

A client with severe pernicious anemia tells the nurse,"I do not understand why everyone is so excited about a little anemia.Lots of people are anemic." The nurse responds that long-term pernicious anemia can cause severe damage to the tissues of the system?

Accepted Answer

Pernicious anemia can cause severe damage to the nervous system, as it leads to a deficiency in Vitamin B12, which is essential for the functioning of nerve cells. Over time, this can lead to irreversible nerve damage and neurological symptoms. While anemia itself can occur in many people, pernicious anemia is a specific type that requires treatment to prevent long-term damage.

Question 11

The nurse is delivering care to a dialysis client who received epoetin alfa during the previous visit.Which nursing intervention is most important during this treatment?

Accepted Answer

The answer of The nurse is delivering care to a...

Question 12

A client with preexisting bipolar disorder is receiving filgrastim (Neupogen)for the management of neutropenia following chemotherapy treatments for lymphocytic leukemia.The oncology nurse recognizes that which preparation for bipolar disorder could complicate the management of the client's leukemia?

Accepted Answer

Lithium carbonate is known to decrease the effectiveness of cancer treatments, including chemotherapy. Its use in patients with leukemia receiving chemotherapy could compromise the effectiveness of the treatment and worsen the outcome. Therefore, the oncology nurse should closely monitor the client's medications and consult with the prescribing physician before administering any drugs that may affect the course of chemotherapy. Clonazepam, valproic acid, and carbamazepine do not interfere with the management of leukemia or neutropenia.

Question 13

The nurse completes an assessment of a client who is prescribed filgrastim after a bone marrow transplant.The nurse would attend most closely to which parameters on the complete blood count?

Accepted Answer

Filgrastim is a drug that stimulates the production of neutrophils, so the nurse would attend most closely to the total white cell count and neutrophil count on the complete blood count for this client. Platelet count and reticulocyte count are not directly affected by filgrastim, and hemoglobin/hematocrit and band count are not as relevant to monitoring the effects of filgrastim in this situation.

Question 14

A client says to the nurse,"My sister's doctor told her to start taking ferrous sulfate tablets.Do you think that would help me feel better?" Which client history would be of concern to the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of A client says to the nurse,"My sister's...

Question 15

Which client is most likely to require a folic acid supplement to treat anemia?

Accepted Answer

Chronic heavy alcohol intake can lead to folic acid deficiency anemia. Folic acid is needed for the production of red blood cells, and alcohol can interfere with the absorption and utilization of this vitamin. The other clients mentioned are not as likely to require a folic acid supplement to treat anemia. The forearm arterial-venous shunt and dialysis would not directly affect folic acid levels, chronic heart failure may lead to anemia due to decreased oxygen delivery, and type 2 diabetes mellitus may cause anemia due to kidney disease or other factors, but not specifically a deficiency of folic acid.

Question 16

Mild folate deficiency can be managed with dietary interventions.Which foods would the nurse recommend?

Accepted Answer

Bread and pastas, dried beans, and fresh greens are good sources of folate, which can help manage mild folate deficiency. Lean meat, cheese, and milk may be high in protein and other nutrients, but they are not particularly good sources of folate. Strawberries, melon, and blueberries contain some folate, but not enough to be considered a significant source compared to the other options. Fresh citrus fruits are not particularly high in folate either.

Question 17

The nurse is planning care for a client who will be administering injections of cyanocobalamin once a month.Which goal is most appropriate?

Accepted Answer

The most appropriate goal for a client who will be administering injections of cyanocobalamin once a month is that the client will safely self-administer cyanocobalamin as ordered every 4 weeks. This goal ensures that the client is able to properly and safely administer the medication, which is crucial for their health outcome. The other goals (B, C and D) are also important, but not as appropriate as the goal A for the client's safety and well-being.

Question 18

The nurse has instructed a client on the self-administration of oral iron tablets.Which client statement indicates the need for further clarification?

Accepted Answer

Iron tablets should not be taken with milk or any other dairy products as they can interfere with the absorption of iron. They should be taken on an empty stomach or with a small amount of juice rich in vitamin C to enhance absorption.

Question 19

The health care provider has ordered darbepoetin alfa (Aranesp)for a client who has anemia secondary to chemotherapy.What teaching should the nurse provide to the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of The health care provider has ordered darbepoetin...

Question 20

The nurse is preparing a dose of parenteral iron (iron dextran)for a client with severe resistant anemia.The nurse is aware of the major adverse reaction that can accompany intravenous ferric gluconate.Which assessment parameters will the nurse attend to most closely?

Accepted Answer

The major adverse reaction of intravenous iron preparations is anaphylaxis, which can present with respiratory distress and hypotension. Therefore, the nurse should closely monitor respiratory status and blood pressure during administration.

Quiz 39: Pharmacotherapy of Hematopoietic Disorders

A client who had gastric bypass six months ago is profoundly anemic.The client has memory loss and periodic hallucinations.A diagnosis of folate deficiency has been proposed.Why would the nurse provisional diagnosis?

A client is admitted with pernicious anemia.The nurse understands that therapy will include medication to address the client's lack of intrinsic factor.Which drug would the nurse anticipate administering?

A client who is a strict vegetarian is prescribed cyanocobalamin (Nascobal) for vitamin B₁₂deficiency.Which information should the nurse provide for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A client received a first dose of cyanocobalamin (Nascobal) 2 days ago.The nurse is monitoring the client's electrolytes because of the possibility of which clinical manifestation?

A client is prescribed a dose of oprelvekin.Prior to administration of the drug,which nursing assessment should trigger a telephone call to the provider who wrote the order?

The nurse is developing teaching materials on managing the side effects of oral iron salts for distribution in a free clinic.Which information should be included?

A client with severe pernicious anemia tells the nurse,"I do not understand why everyone is so excited about a little anemia.Lots of people are anemic." The nurse responds that long-term pernicious anemia can cause severe damage to the tissues of the system?

The nurse is delivering care to a dialysis client who received epoetin alfa during the previous visit.Which nursing intervention is most important during this treatment?

The nurse completes an assessment of a client who is prescribed filgrastim after a bone marrow transplant.The nurse would attend most closely to which parameters on the complete blood count?

Which client is most likely to require a folic acid supplement to treat anemia?

Mild folate deficiency can be managed with dietary interventions.Which foods would the nurse recommend?

The nurse is planning care for a client who will be administering injections of cyanocobalamin once a month.Which goal is most appropriate?

The nurse has instructed a client on the self-administration of oral iron tablets.Which client statement indicates the need for further clarification?

The nurse is preparing a dose of parenteral iron (iron dextran) for a client with severe resistant anemia.The nurse is aware of the major adverse reaction that can accompany intravenous ferric gluconate.Which assessment parameters will the nurse attend to most closely?

Quiz 39: Pharmacotherapy of Hematopoietic Disorders

A client who had gastric bypass six months ago is profoundly anemic.The client has memory loss and periodic hallucinations.A diagnosis of folate deficiency has been proposed.Why would the nurse provisional diagnosis?

A client is admitted with pernicious anemia.The nurse understands that therapy will include medication to address the client's lack of intrinsic factor.Which drug would the nurse anticipate administering?

A client who is a strict vegetarian is prescribed cyanocobalamin (Nascobal) for vitamin B12 deficiency.Which information should the nurse provide for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A client received a first dose of cyanocobalamin (Nascobal) 2 days ago.The nurse is monitoring the client's electrolytes because of the possibility of which clinical manifestation?

A client is prescribed a dose of oprelvekin.Prior to administration of the drug,which nursing assessment should trigger a telephone call to the provider who wrote the order?

The nurse is developing teaching materials on managing the side effects of oral iron salts for distribution in a free clinic.Which information should be included?

A client with severe pernicious anemia tells the nurse,"I do not understand why everyone is so excited about a little anemia.Lots of people are anemic." The nurse responds that long-term pernicious anemia can cause severe damage to the tissues of the system?

The nurse is delivering care to a dialysis client who received epoetin alfa during the previous visit.Which nursing intervention is most important during this treatment?

The nurse completes an assessment of a client who is prescribed filgrastim after a bone marrow transplant.The nurse would attend most closely to which parameters on the complete blood count?

Which client is most likely to require a folic acid supplement to treat anemia?

Mild folate deficiency can be managed with dietary interventions.Which foods would the nurse recommend?

The nurse is planning care for a client who will be administering injections of cyanocobalamin once a month.Which goal is most appropriate?

The nurse has instructed a client on the self-administration of oral iron tablets.Which client statement indicates the need for further clarification?

The nurse is preparing a dose of parenteral iron (iron dextran) for a client with severe resistant anemia.The nurse is aware of the major adverse reaction that can accompany intravenous ferric gluconate.Which assessment parameters will the nurse attend to most closely?

A client who is a strict vegetarian is prescribed cyanocobalamin (Nascobal) for vitamin B₁₂deficiency.Which information should the nurse provide for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.