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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
The correct answer is a. Measles, mumps, rubella (MMR) and d. Varicella (VAR).
Choice A reason:
Measles, mumps, rubella (MMR): The MMR vaccine is recommended for children at 12-15 months of age. It protects against three serious diseases: measles, mumps, and rubella. The first dose is typically given at 12-15 months, with a second dose at 4-6 years. Measles can cause severe complications such as pneumonia and encephalitis. Mumps can lead to meningitis and hearing loss, while rubella can cause congenital rubella syndrome in pregnant women. Administering the MMR vaccine at the recommended age ensures that the child is protected from these potentially severe diseases.
Choice B reason:
Rotavirus (RV): This vaccine is given to infants at 2, 4, and possibly 6 months of age. It is not typically administered to a 1-year-old child as the series should be completed by 8 months. Rotavirus is a leading cause of severe diarrhea and dehydration in infants and young children. The vaccine is given orally and is highly effective in preventing rotavirus gastroenteritis. However, since the vaccine series is completed by 8 months, it is not appropriate for a 1-year-old child.
Choice C reason:
Human papillomavirus (HPV4): The HPV vaccine is recommended starting at 11-12 years of age. It is not suitable for a 1-year-old child. HPV is a common virus that can lead to certain types of cancers, including cervical cancer. The vaccine is most effective when given before exposure to HPV, which is why it is recommended for preteens. Administering the HPV vaccine to a 1-year-old would not be appropriate as it is not within the recommended age range.
Choice D reason:
Varicella (VAR): The VAR vaccine is recommended for children at 12-15 months of age to protect against chickenpox. A second dose is given at 4-6 years. Chickenpox can cause an itchy rash, fever, and tiredness. In some cases, it can lead to severe skin infections, pneumonia, and encephalitis. Vaccinating at the recommended age ensures that the child is protected from these complications. The first dose at 12-15 months is crucial for building immunity against the varicella virus.
Choice E reason:
Diphtheria, tetanus and acellular pertussis (DTaP): The DTaP vaccine is given in a series of five doses at 2, 4, 6, 15-18 months, and 4-6 years. The 4th dose is given at 15-18 months, not at 1 year. DTaP protects against three serious diseases: diphtheria, which can cause breathing problems and heart failure; tetanus, which causes painful muscle stiffness; and pertussis (whooping cough), which can lead to severe coughing spells and pneumonia. The timing of the doses is crucial for ensuring effective immunity, and the 1-year mark is not one of the recommended times for the DTaP vaccine.
Correct Answer is A
Explanation
Choice A reason: This choice is correct because examining the child's tympanic membrane at the end of the physical examination is the best strategy to avoid upsetting or frightening the child. The tympanic membrane is the thin membrane that separates the outer ear from the middle ear, and it can be examined by using an otoscope, which is a device that has a light and a magnifying lens. Examining the tympanic membrane may be uncomfortable or painful for the child, especially if they have an ear infection or inflammation. Therefore, performing this procedure at the end of the examination can help to minimize the child's distress and resistance.
Choice B reason: This choice is incorrect because examining the child's tympanic membrane before auscultating the chest and abdomen is not a good strategy to avoid upsetting or frightening the child. Auscultating the chest and abdomen is a procedure that involves listening to the sounds of the heart, lungs, and bowel by using a stethoscope, which is a device that has a chest piece and earpieces. Auscultating the chest and abdomen may be soothing or relaxing for the child, as it does not cause any discomfort or pain. Therefore, performing this procedure before examining the tympanic membrane can help to calm and distract the child.
Choice C reason: This choice is incorrect because examining the child's tympanic membrane at the beginning of the physical examination is not a good strategy to avoid upsetting or frightening the child. Examining the tympanic membrane at the beginning of the examination may cause anxiety or fear in the child, which can affect their cooperation and trust for the rest of the examination. Therefore, performing this procedure at the beginning of the examination can increase the child's distress and resistance.
Choice D reason: This choice is incorrect because examining the child's tympanic membrane before examining the
head and neck is not a good strategy to avoid upsetting or frightening the child. Examining the head and neck is a procedure that involves inspecting and palpating the scalp, hair, face, eyes, ears, nose, mouth, throat, lymph nodes, and thyroid gland. Examining the head and neck may be easy or pleasant for the child, as it does not cause any discomfort or pain. Therefore, performing this procedure before examining the tympanic membrane can help to establish rapport and confidence with the child.
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