A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin.
Which of the following information should the nurse include in the teaching?
"Administer the medication into one nostril once per week.”
"Lie down for 1 hour after administering the medication.”
"Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose.”
"Plan to self-administer this medication for the next 6 months.”
The Correct Answer is A
Nasal cyanocobalamin is a form of vitamin B12 that is used to treat pernicious anemia.
It is typically administered once per week into one nostril.
Choice B is wrong because there is no need to lie down for 1 hour after administering the medication.
Choice C is wrong because using a nasal decongestant before administering the medication is not necessary and may interfere with the absorption of the medication.
Choice D is wrong because the duration of treatment with nasal cyanocobalamin varies and should be determined by the provider based on the client’s individual needs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale: Administering filgrastim after chemotherapy is a standard practice to boost white blood cell count. However, filgrastim should not be given within 24 hours before or after chemotherapy, as it can affect the efficacy and increase the risk of side effects. Administering the medication 12 hours after chemotherapy falls within this contraindicated window, necessitating an incident report.
Choice B rationale: Filgrastim can be stored at room temperature for short periods, and 2 hours is generally within acceptable limits for stability.
Choice C rationale: An absolute neutrophil count of 2,500/mm³ is within the normal range, and there is no contraindication for administering filgrastim.
Choice D rationale: Flushing the client's IV line with dextrose 5% in water before and after administering filgrastim is not appropriate, as this medication is typically administered with saline solution. Using an incorrect flushing solution could affect the medication's efficacy or compatibility, necessitating an incident report.
Correct Answer is C
Explanation
- A. Assist the client to a left lateral position.
- This is generally used for clients at risk of aspiration, and it's not indicated based on the lithium level.
- B. Implement fluid restrictions.
- Fluid restrictions are usually implemented when there is a risk of fluid overload or hyponatremia, and not in this case. In fact, dehydration can raise lithium levels to toxic levels, so proper hydration is important.
- C. Request a dosage increase from the provider.
- While 0.6 mEq/L is within the therapeutic range, some providers may want to see a level slightly higher for maintenance. So requesting a dosage increase from the provider is the correct action.
- D. Prepare the client for hemodialysis.
- Hemodialysis is used to remove lithium from the blood in cases of severe lithium toxicity, which is indicated by levels significantly higher than 1.5 mEq/L. This is not needed when the lithium level is 0.6 mEq/L.
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