Chapter 21-agents used to treat anemia

Question 1

The nurse would anticipate the use of what medication in the treatment of anemia associated with chronic renal failure?

Answer 1

epoetin alfa recombinant

Question 2

The nurse understands that the reason U.S. food manufacturers of flours and certain other grain products are required to add folic acid to their product is because folic acid:

Answer 2

deficiencies may cause neural tube defects during pregnancy.

Question 3

The client with megaloblastic anemia asks the nurse what causes this disorder. The nurse’s best response is:

Answer 3

“Megaloblastic anemia results from vitamin B12 or folic acid deficiency, or both.”

Question 4

The client who has megaloblastic anemia will usually have red blood cells that are

Answer 4

macrocytic.

Question 5

The client with anemia asks the nurse what usually causes anemia. The nurse’s best reply is:

Answer 5

“Although anemia can have several causes, the most common is nutritional deficits.”

Question 6

The nurse is providing education for the client who must take iron therapy. Which of the following statements by the nurse should be included in the teaching?

Answer 6

“Taking iron with vitamin C increases the absorption of the iron.”

Question 7

The nurse is interviewing a client on iron therapy. Which of the client statements best indicates client compliance with therapy:

Answer 7

“My stools are darker than usual.”

Question 8

The nurse is caring for a client with a toxic level of iron. The nurse anticipates administering:

Answer 8

deferoxamine mesylate.

Question 9

The nurse caring for a client with vitamin B12 deficiency secondary to impaired B12 absorption anticipates the client will receive:

Answer 9

intramuscular cyanocobalamin.

Question 10

Which of the following should the nurse include in teaching a client who is taking a liquid oral iron preparation?

Answer 10

intramuscular cyanocobalamin.

Question 11

To optimally treat an adult client with iron deficiency anemia, what daily dose of elemental iron is required?

Answer 11

200 mg

Question 12

The nurse asked, “Which of the following substances may increase absorption of iron?” Her answer should be:

Answer 12

ascorbic aci

Question 13

While taking a client’s history, the nurse recognizes the client has been taking a drug that, with prolonged use, may cause anemia due to blood loss. The nurse would expect to see a prescription for which of the following?

Answer 13

indomethacin- Indomethacin can cause GI bleeding, especially with prolonged use.

Question 14

Which of the following clients are at risk for folic acid deficiency?

Answer 14

23-year-old woman taking oral contraceptives

Question 15

When assessing a client receiving intravenous iron therapy, the nurse should:

Answer 15

monitor the IV site for phlebitis.

Question 16

The nurse would monitor erythropoietin levels for which of the following client?

Answer 16

oncology client receiving Procrit

This client requires erythropoietin levels monitored.

Question 17

The nurse is caring for a client with a history of gastrectomy for gastric cancer. The nurse should:

Answer 17

monitor for vitamin B12 deficiency.

Question 18

The nurse is caring for a client receiving Epogen for chemotherapy-induced anemia. The nurse should:

Answer 18

monitor the client for hypertension.

Epogen can cause hypertension and is contraindicated in clients with uncontrolled hypertension

Question 19

The nurse is aware that which of the following groups is at greatest risk for anemia?

Answer 19

nursing mothers- Lactating mothers lose approximately 2 mg of iron/day.

Question 20

The nurse anticipates that the urine of a client receiving treatment for iron toxicity will appear:

Answer 20

red in color. When deferoxamine mesylate is excreted, it colors the urine red.

Question 21

The nurse preparing to administer a dose of Epogen must be aware to:

Answer 21

not shake the drug solution, which will deactivate it.

Question 22

The nurse is evaluating the client’s understanding of how to take her iron supplements. Which statement demonstrates client understanding?

Answer 22

“I take one pill 3 times a day, rather than one large dose, to increase absorption of the iron.”

Question 23

When teaching a client receiving cyanocobalamin for pernicious anemia, the nurse should instruct the client:

Answer 23

that damage to the nervous system may occur if the client stops the therapy abruptly
.The nurse must stress compliance with cyanocobalamin therapy to avoid CNS damage.

Question 24

The nurse is aware that a deficiency of what vitamin may cause anemia?

Answer 24

vitamin E- Because of vitamin E’s role in stabilizing the membrane of the red blood cells, a deficiency could lead to anemia.

Question 25

Which of the following clients should be monitored because of risk for folic acid deficiency? Select all that apply.

Answer 25

a. a 30-year-old man taking phenytoin for seizures
b. a 45-year-old man who has ingested three cans of beer a day for 20 years
d. a 25-year-old woman taking trimethoprim for a urinary tract infection

Question 26

The nurse assesses a client at risk for nutritional anemia for which of the following manifestations? Select all that apply.

Answer 26

a. fatigue
b. tachycardia
d. vertigo
e. pallor

Question 27

The client is receiving Feosol. The nurse would monitor for which of the following? Select all that apply.

Answer 27

b. staining of teeth
e. nausea and vomiting
c. dyspepsia
f. tarry stools

Question 28

The client receiving Mircera would be monitored for which of the following? Select all that apply

Answer 28

d. nasopharyngitis
b. headache
e. seizures
f. diarrhea

Question 29

The nurse recruit is correct when he provides which of the following information concerning iron dextran? Select all that apply.

Answer 29

a. It should not be mixed with any other drug for IV infusion.
b. No more than 100 mg should be administered daily.
c. Clients receiving iron dextran who also have RA should be monitored for acute exacerbation of RA.
d. Iron dextran may cause false elevated levels of bilirubin and calcium.
e. It may cause a metallic taste.

Question 30

Which of the following are dietary sources of folic acid? Select all that apply.

Answer 30

a. turnips
c. rice
d. citrus fruits