A nurse in a pediatric clinic is caring for a child who has iron deficiency anemia and a new prescription for ferrous sulfate tablets. Which of the following instructions should the nurse provide the parents regarding the administration of this medication?

Iron (Ferrous Sulfate) may turn stools tarry green.

Administer at bedtime.

Give with a 240 mL (8 oz) glass of milk.

Administer at mealtimes.

Answer and Explanation

The Correct Answer is A

Choice A: This instruction is correct, as iron supplements can cause a change in the color and consistency of stools, making them dark, green, or black. This is not a sign of bleeding or infection, but a normal side effect of iron therapy. The parents should be informed of this possibility and reassured that it is harmless.

Choice B: This instruction is incorrect, as iron supplements should not be administered at bedtime, but rather one hour before or two hours after meals. This is because iron absorption is reduced by food, especially dairy products, antacids, or calcium supplements. The parents should be instructed to give the medication on an empty stomach or with a small amount of food if it causes nausea.

Choice C: This instruction is incorrect, as iron supplements should not be given with milk, as milk contains calcium, which can interfere with iron absorption and reduce its eﬀectiveness. The parents should be instructed to avoid giving milk or other dairy products within two hours of the medication.

Choice D: This instruction is incorrect, as iron supplements should not be administered at mealtimes, but rather one hour before or two hours after meals. This is because iron absorption is reduced by food, especially dairy products, antacids, or calcium supplements. The parents should be instructed to give the medication on an empty stomach or with a small amount of food if it causes nausea.

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Correct Answer is B

Explanation

Choice A reason: This choice is incorrect because taking glyburide with breakfast is not recommended for an adolescent who has type 1 diabetes mellitus. Glyburide is an oral hypoglycemic medication that lowers blood glucose levels by stimulating insulin secretion from the pancreas. It may be used for clients who have type 2 diabetes mellitus, but it does not work for clients who have type 1 diabetes mellitus or DKA.

Choice B reason: This choice is correct because obtaining an inﬂuenza vaccine annually is recommended for an adolescent who has type 1 diabetes mellitus. The inﬂuenza vaccine is a vaccine that protects against inﬂuenza, a viral infection that aﬀects the respiratory system. It may prevent or reduce the severity of inﬂuenza and its complications, such as pneumonia or sepsis. It is recommended for everyone who is 6 months or older, especially those who have chronic conditions such as diabetes mellitus that increase their risk of inﬂuenza-related complications.

Choice C reason: This choice is incorrect because administering glucagon for hyperglycemia is not indicated for an adolescent who has type 1 diabetes mellitus. Glucagon is a hormone that raises blood glucose levels by stimulating glycogen breakdown in the liver. It may be used for clients who have hypoglycemia, which is a condition in which blood glucose levels are lower than normal (less than 70 mg/dL). It may cause symptoms such as sweating, trembling, confusion, or loss of consciousness. However, in type 1 diabetes mellitus, hyperglycemia (high blood glucose levels) rather than hypoglycemia is more likely to occur due to insulin deficiency or resistance.

Choice D reason: This choice is incorrect because injecting insulin in the deltoid muscle is not an optimal method for an adolescent who has type 1 diabetes mellitus. Insulin is a hormone that lowers blood glucose levels by facilitating glucose uptake into the cells. It may be administered by injection or infusion, and it may vary in onset, peak, and duration of action. The preferred sites for insulin injection are the abdomen, the thighs, the buttocks, or the upper arms, as they have more subcutaneous fat and less muscle tissue. Injecting insulin into the deltoid muscle may cause faster absorption and shorter duration of action, which can affect blood glucose control and increase the risk of hypoglycemia.

A. A 10-year-old child who has sickle cell anemia who reports severe chest pain B. A 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.016 C. A 4-year-old child who has asthma and an O2 sat of 97% D. A 1-year-old toddler who has roseola and a temperature of 39°C/102.2°F

Correct Answer is A

Explanation

Choice A: A 10-year-old child who has sickle cell anemia and reports severe chest pain should be assessed first, as this is a sign of acute chest syndrome, which is a life-threatening complication of sickle cell disease. Acute chest syndrome occurs when sickle-shaped red blood cells block the blood flow to the lungs, causing hypoxia, inﬂammation, and infection. Acute chest syndrome can lead to respiratory failure, pulmonary hypertension, or stroke.

Choice B: A 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.016 should be assessed second, as this is a sign of dehydration, which is a common complication of diabetes insipidus. Diabetes insipidus is a condition in which the body does not produce enough antidiuretic hormone (ADH) or does not respond to it properly, resulting in excessive urination and thirst. Dehydration can cause electrolyte imbalance, hypotension, or shock.

Choice C: A 4-year-old child who has asthma and an O2 sat of 97% should be assessed third, as this is a sign of adequate oxygenation, which is a desired outcome of asthma management. Asthma is a condition in which the airways become inﬂamed, narrow, and produce excess mucus, causing difficulty breathing, wheezing, coughing, or chest tightness. Asthma can be triggered by allergens, irritants, exercise, or infections.

Choice D: A 1-year-old toddler who has roseola and a temperature of 39°C/102.2°F should be assessed last, as this is a sign of a mild viral infection, which is self-limiting and usually resolves within a week. Roseola is a common childhood illness that causes a high fever followed by a pink rash on the trunk, face, and limbs. Roseola can also cause irritability, swollen lymph nodes, or mild diarrhea.

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A nurse in a pediatric clinic is caring for a child who has iron deficiency anemia and a new prescription for ferrous sulfate tablets. Which of the following instructions should the nurse provide the parents regarding the administration of this medication?

Nursing Test Bank

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