Anemia Meds

A patient received desmopressin preoperatively to maintain hemostasis during a surgical procedure. Which postoperative assessment finding indicates the patient has experienced an adverse effect of the drug? 1 +2 edema of the extremities 2 Blood glucose level of 220 mg/dL 3 Serum sodium level of 150 mEq/L 4 Serum potassium level of 5.5 mEq/L

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Hemophilia is a genetically based bleeding disorder seen almost exclusively in which patients? 1 Males 2 Females 3 Hispanics 4 Caucasians

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The nurse is caring for a patient with anemia related to chronic renal failure. Which agent might be used to treat the anemia? 1 Epoetin alfa [Procrit] 2 Filgrastim [Neupogen] 3 Oprelvekin [Neumega] 4 Sargramostim [Leukine]

1

Which nursing action should prevent an adverse effect of a liquid iron preparation? 1 Administer the iron preparation through a dropper. 2 Administer the liquid iron preparation along with vitamin C. 3 Administer the liquid buccally to delay absorption and lessen adverse effects. 4 Mix the liquid iron preparation with an antacid for patients with underlying peptic ulcer disease.

1

Which statement indicates that a pregnant patient has understood the nurse's discharge teaching regarding folic acid? 1 "Folic acid deficit can cause spina bifida." 2 "Anemia is the only risk from no folic acid." 3 "Folic acid does not absorb without vitamin B12." 4 "I will double my dose if I forget to take it the day before."

1

A large number of megaloblasts are seen in the patient's lab results. What should the nurse teach the patient? 1 This is a normal finding. 2 This is a result of B12 deficiency. 3 Megaloblasts are oversized white cells. 4 This could be caused by chronic kidney disease.

2

A maintenance dose of epoetin alfa [Epogen] is ordered for a patient undergoing dialysis for chronic renal failure. The nurse should anticipate administering which dosage of epoetin alfa [Epogen]? 1 40,000 units subQ weekly 2 75 units/kg IV 3 times/week 3 100 units/kg IV 3 times/week 4 150 units/kg subQ 3 times/week

2

A patient with hemophilia has complained of severe pain. Which is the most effective treatment? 1 Aspirin therapy 2 Administration of morphine sulfate 3 Administration of meperidine [Demerol] IM 4 Administration of acetaminophen [Tylenol]

2

A patient with hemophilia is frightened about contracting human immunodeficiency virus (HIV) from therapy. How should the nurse respond to the patient? 1 "This is a risk." 2 "All blood is screened for viruses." 3 " Why do you think this is possible?" 4 " I will call the healthcare provider, so you can discuss this."

2

The nurse is administering iron dextran [INFeD] by intravenous (IV) infusion to a patient with iron deficiency. Which is the priority nursing action during the administration of this drug? 1 Assess the lung sounds and respiratory rate. 2 Ensure that epinephrine is available as needed. 3 Monitor the blood urea nitrogen and creatinine levels. 4 Use Y-connector tubing to connect to the primary line.

2

The nurse is evaluating the effectiveness of the drug oprelvekin [Neumega] in a patient undergoing cancer chemotherapy. Which finding is most indicative that this drug is having its intended effect? 1 Hemoglobin level of 13.2 g/dL 2 Platelet count of 150 × 103/mm3 3 White blood cell count of 5500/mm3 4 Total lymphocyte count of 1000/mm3

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The nurse teaches a patient about therapy for hemophilia. What should be included in the plan? 1 Treatment can cure the disease. 2 Treatment with factor VIII or IX is preferred. 3 Antifibrinolytic drugs are the mainstay of therapy. 4 Replacement therapy should only occur during acute episodes.

2

What condition increases the patient's risk for the development of myocardial infarction (MI) and disseminated intravascular coagulation (DIC) when receiving anti-inhibitor coagulant complex (AICC)? 1 Diabetes 2 Liver disease 3 Hypothyroidism 4 Chronic renal disease

2

Which statement is true concerning factor VIII administration for hemophilia A treatment? 1 Medication is given by Z track. 2 Medication is given intravenously. 3 Medication is given subcutaneously. 4 Medication is prescribed in oral form.

2

A patient is ordered desmopressin [DDAVP] 0.3 mcg/kg. The patient weighs 150 pounds. What dose should the nurse administer? Record your answer using two decimal places. _____ mcg

20.45 150 pounds divided by 2.2 = 68.18 kg; 68.18 x 0.3 mcg = 20.45 mcg dose

A patient has been diagnosed with intrinsic factor deficiency. What is the resulting patient diagnosis? 1 Allergic anemia 2 Chronic anemia 3 Pernicious anemia 4 Iron deficiency anemia

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A patient is diagnosed with hemophilia. Which is an essential intervention? 1 Daily administration of vitamin K 2 Administration of 81 mg aspirin daily 3 Administration of recombinant factors 4 Administration of warfarin [Coumadin] daily

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A patient is diagnosed with sprue. What should the nurse teach the patient? 1 This condition has no treatment. 2 The cause of this condition is not known. 3 This condition decreases folic acid uptake. 4 Folic acid deficit injures the nervous system

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A patient is prescribed aminocaproic acid. Which statement is true concerning this therapy? 1 This medication is only given orally. 2 This medication is only used in adults. 3 This medication is for serious bleeding. 4 This medication is only given intravenously.

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The nurse is caring for a patient with iron deficiency anemia. What should the nurse teach this patient? 1 This is a very rare anemia. 2 There are no risks from this deficit. 3 This disease is caused by a nutritional deficit. 4 There is no treatment needed for this condition.

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The nurse is to administer 900 mg ferrous iron salts. The nurse has 320 mg tablets. What is the nurse's best action? 1 Administer two tablets. 2 Administer three tablets. 3 Call the healthcare provider. 4 Obtain a different iron preparation.

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The nurse reviews the prescribed medication for a patient with hemophilia who complains of bleeding-related pain. Which medication should the nurse question if ordered for this patient? 1 Codeine 2 Tylenol (acetaminophen) 3 Percodan (oxycodone/aspirin) 4 MS Contin (time released morphine sulfate)

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What is the primary reason for neurologic damage with pernicious anemia? 1 Headaches 2 Decreased oxygenation 3 Demyelination of neurons 4 Increased red blood cell size

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Which finding indicates a positive outcome from treatment with filgrastim [Neupogen]? 1 Bone pain is eliminated. 2 The cancer goes into remission. 3 The neutrophil count increases. 4 The red blood cell count increases.

3

Which medication promotes hemostasis in hemophilia A and hemophilia B by inhibition of fibrinolysis? 1 Celecoxib [Celebrex] 2 Desmopressin [DDAVP] 3 Aminocaproic acid [Amicar] 4 Diphenhydramine [Benadryl]

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Which patient is contraindicated for therapy with iron dextran? 1 A teenager 2 An elderly patient 3 A patient with hypotension 4 A patient who can tolerate oral iron

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Which patient will benefit most from prophylactic iron therapy? 1 A teenage girl 2 An elderly patient 3 A pregnant woman 4 An adolescent boy

3

A patient being treated for pernicious anemia with cyanocobalamin, the patient reports new onset of muscle weakness and states, "My heart is skipping beats." Which laboratory value most likely is contributing to these new symptoms? 1 Serum chloride level of 98 mEq/L 2 Serum sodium level of 133 mEq/L 3 Serum glucose level of 185 mg/dL 4 Serum potassium level of 2.3 mEq/L

4

A patient cannot take oral cyanocobalamin. Which is an appropriate intervention? 1 Administer an antidote. 2 Administer an antihistimine. 3 Prepare the patient for surgery. 4 Administer intranasal cyanocobalamin.

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A patient is receiving cyanocobalamin for the treatment of pernicious anemia. Which electrolyte should the nurse monitor as a result of this treatment? 1 Sodium 2 Calcium 3 Chloride 4 Potassium

4

A patient takes megadoses of vitamins and folic acid daily. Which is essential for the nurse to teach the patient? 1 B12 is not taken with folic acid. 2 Oral folic acid is not absorbed well. 3 Blood levels should be drawn weekly. 4 Large doses, taken long term, can increase cancer risk.

4

A patient who has a vitamin B12 deficiency wants to know about the cause. What should the nurse teach the patient about the likely cause? 1 Too few vitamins in the diet. 2 Calcium gluconate administration 3 Dietary deficiency of intrinsic factor 4 Decreased absorption of vitamin B12.

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A patient who has received iron dextran is complaining of chest pain. What is the nurse's best action? 1 Call a code. 2 Administer an antacid. 3 Administer a respiratory treatment. 4 Consult with the healthcare provider to assess the ECG.

4

On-demand therapy is indicated for which type of patient? 1 A patient with mild hemophilia 2 A patient with severe hemophilia 3 A patient who is allergic to factor VIII [Bioclate] 4 A patient who is bleeding or about to undergo surgery

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The nurse is caring for a patient who is receiving sodium-ferric gluconate complex. What is the most likely reason for this administration? 1 The patient is pregnant. 2 The patient has hypertension. 3 The patient has two types of anemia. 4 The patient has chronic kidney disease.

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The nurse is monitoring a patient receiving ferrous sulfate for treatment of iron deficiency anemia. Which finding indicates that the therapy is effective? 1 Black stools 2 Decrease in energy 3 Absence of emesis 4 Increased hemoglobin

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The nurse is teaching the parent of a young child about administering ferrous sulfate to the child at home. Which teaching point should receive the highest priority? 1 "Do not give iron with any other medications or vitamins." 2 "Give the liquid iron with a straw to reduce tooth staining." 3 "This medicine may cause the child's stool to look dark green or black." 4 "Store the ferrous sulfate in a childproof container and keep it out of the child's reach."

4

The nurse knows that which statement is most accurate? 1 Antibodies to factor VIII develop after 20 to 30 treatments. 2 The risk of inhibitor development is higher in Caucasians than in Hispanics. 3 Individuals with severe hemophilia A have less of a risk of developing inhibitors than those with the mild form. 4 Immune tolerance therapy is more successful in eliminating inhibitor production in hemophilia A than in hemophilia B.

4

What should the nurse recommend in relation to immunizations for a child with hemophilia? 1 Start immunizations as an adult. 2 Administer only inhaled immunizations. 3 Avoid immunization due to the risk of bleeding. 4 Have immunizations administered intramuscularly.

4

Which instructions should the nurse include in the plan of care for a patient receiving ferrous sulfate therapy? 1 "Iron does not absorb." 2 "Iron should only be taken at night." 3 "Iron compounds are not taken orally." 4 "Antacids should not be taken with iron."

4

Which treatment should be included in a plan for a patient with mild joint pain related to hemophilia? 1 Administration of aspirin 2 Administration of narcotics 3 Administration of ibuprofen [Motrin] 4 Administration of acetaminophen [Tylenol]

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