A patient has recently started ferrous sulfate 500 mg by mouth two times per day for anemia. Which of the following data would indicate to the nurse that the therapy is successful?

International normalized ratio 1.3 seconds

Hemoglobin 14 g/dL

Serum iron 150 mcg/dL

Platelet count 250,000/mm3

Answer and Explanation

The Correct Answer is B

Choice A reason: The international normalized ratio (INR) is a measure of the blood's ability to clot. It is not affected by ferrous sulfate therapy, which is used to treat iron deficiency anemia. The normal range of INR is 0.8 to 1.2 seconds.

Choice B reason: Hemoglobin is the protein in red blood cells that carries oxygen. It is the main indicator of anemia and the response to iron therapy. The normal range of hemoglobin for adults is 12 to 18 g/dL. A hemoglobin level of 14 g/dL suggests that the patient's anemia has improved with ferrous sulfate therapy.

Choice C reason: Serum iron is the amount of iron in the blood. It is not a reliable indicator of anemia or iron therapy, as it can fluctuate with dietary intake, infection, inflammation, and other factors. The normal range of serum iron for adults is 50 to 170 mcg/dL.

Choice D reason: Platelet count is the number of platelets in the blood. Platelets are involved in blood clotting and wound healing. They are not affected by ferrous sulfate therapy, which is used to treat iron deficiency anemia. The normal range of platelet count for adults is 150,000 to 450,000/mm3.

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Correct Answer is C

Explanation

Choice A reason: This is incorrect. Assessing the apical pulse is not enough to determine if the client is safe to receive digoxin. The client's digoxin level is already above the therapeutic range of 0.5 to 2 ng/mL¹² and giving another dose could increase the risk of toxicity and arrhythmias.

Choice B reason: This is incorrect. Administering 0.25 mcg of digoxin and potassium 20 mEq IV is not appropriate for this client. The client does not need more digoxin or potassium, as both could worsen the client's condition. Potassium levels should be monitored closely in clients taking digoxin, as low or high levels can affect the drug's action and toxicity³.

Choice C reason: This is correct. Withholding the medication and notifying the healthcare provider of the digoxin level is the most appropriate action for this client. The client's digoxin level is dangerously high and could cause serious adverse effects such as nausea, vomiting, vision changes, bradycardia, and cardiac arrest³. The healthcare provider may order to stop digoxin temporarily, adjust the dose, or prescribe an antidote such as digoxin immune fab⁴.

Choice D reason: This is incorrect. Administering the digoxin with a potassium supplement is not advisable for this client. The client's digoxin level is already too high and adding potassium could increase the risk of hyperkalemia, which can impair the heart's electrical activity and lead to cardiac arrest³. Potassium supplements should only be given to clients with digoxin-induced hypokalemia, and only under the supervision of the healthcare provider³..

A. Furosemide 40 mg PO daily B. Diltiazem 30 mg PO daily C. Metoprolol 25 mg PO bid D. Nitroglycerin 0.4 mg SL PRN

Correct Answer is D

Explanation

Choice A reason: Furosemide 40 mg PO daily is not the medication that the nurse should administer for chest pain. Furosemide is a diuretic that reduces fluid volume and lowers blood pressure, but it does not relieve anginal pain.

Choice B reason: Diltiazem 30 mg PO daily is not the medication that the nurse should administer for chest pain. Diltiazem is a calcium channel blocker that relaxes the blood vessels and lowers blood pressure, but it does not act quickly enough to relieve acute anginal pain.

Choice C reason: Metoprolol 25 mg PO bid is not the medication that the nurse should administer for chest pain. Metoprolol is a beta blocker that slows down the heart rate and lowers blood pressure, but it does not act quickly enough to relieve acute anginal pain.

Choice D reason: Nitroglycerin 0.4 mg SL PRN is the medication that the nurse should administer for chest pain. Nitroglycerin is a nitrate that dilates the coronary arteries and increases blood flow to the heart, thus relieving anginal pain. It is given sublingually (under the tongue) as needed for chest pain.

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A patient has recently started ferrous sulfate 500 mg by mouth two times per day for anemia. Which of the following data would indicate to the nurse that the therapy is successful?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse prepares to administer digoxin 0.125 mg PO to a client who has chronic heart failure. The laboratory report reveals a digoxin level of 2.5 mg/mL. Which nursing action is most appropriate at this time?

Correct Answer is C

Explanation

The nurse is providing care for a client diagnosed with cardiovascular disease and hypertension who is complaining of chest pain. Which medication should the nurse administer?

Correct Answer is D

Explanation

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