An older adult client with pernicious anemia has been receiving daily injections of cyanocobalamin for two weeks and reports that the injections are painful. The nurse notes that the client's hematocrit is 43% (0.43 volume fraction). Which action should the nurse implement?

Reference Range:

Hematocrit (Hct) [37% to 47% (0.37 to 0.47 volume fraction)]

Instruct the client that since the hematocrit remains low, the daily injections are still necessary.

Notify the healthcare provider of the patient's hematocrit level so the frequency of injections can be reduced.

Advise the client that the medication is having the desired effect, but daily injections will continue to be needed for life for this chronic condition.

Offer to instruct the client in self-administration techniques to improve the client's sense of control over the painful daily injections.

Answer and Explanation

The Correct Answer is D

A. Instruct the client that since the hematocrit remains low, the daily injections are still necessary: A hematocrit of 43% is within the normal range, suggesting the client’s anemia is improving. If the hematocrit were still low, continuing daily injections would be appropriate, but this is not the case here.

B. Notify the healthcare provider of the client’s hematocrit level so the frequency of injections can be reduced: Since the hematocrit is normal, there is no need to notify the healthcare provider specifically for changing the injection frequency based solely on the hematocrit level. Reducing injection frequency should be based on the overall treatment plan and not just the current hematocrit.
C. Advise the client that the medication is having the desired effect, but daily injections will continue to be needed for life for this chronic condition: While the medication may be effective, informing the client about the potential for less frequent injections could improve adherence and reduce discomfort, if the healthcare provider approves.
D. Offer to instruct the client in self-administration techniques to improve the client's sense of control over the painful daily injections: Teaching self-administration can empower the client and potentially reduce discomfort by allowing the client to become more comfortable with the process. It also offers the opportunity for the client to manage their injections more conveniently and with greater control.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A) Coronary artery disease: It is crucial to assess for a history of coronary artery disease (CAD) before administering sumatriptan, as the medication is a serotonin receptor agonist that can cause vasoconstriction of coronary arteries. This can increase the risk of serious cardiovascular events, such as heart attack or stroke, particularly in clients with preexisting CAD.

B) Seasonal allergic rhinitis: While seasonal allergic rhinitis may be a concern for other medications due to potential allergic reactions or interactions, it is not directly related to the administration of sumatriptan. This condition does not pose a significant risk with the use of sumatriptan.

C) Type 2 diabetes mellitus: Although type 2 diabetes mellitus is an important consideration in the overall health management of a client, it is not the most critical condition to assess before administering sumatriptan. However, if the client has diabetes with associated complications like cardiovascular disease, this would increase concern for using sumatriptan.

D) Irritable bowel syndrome: Irritable bowel syndrome (IBS) is a gastrointestinal disorder that typically does not influence the decision to administer sumatriptan. While IBS may affect a client’s comfort or medication regimen, it does not present the same immediate risks as coronary artery disease when using sumatriptan.

A. Warfarin. B. Vitamin K. C. Protamine sulfate. D. Diphenhydramine HCI.

Correct Answer is C

Explanation

A. Warfarin: Warfarin is an oral anticoagulant used for long-term anticoagulation, but it is not used for reversing the effects of heparin. They are different classes of anticoagulants with distinct reversal agents.
B. Vitamin K: Vitamin K is used to reverse the effects of warfarin, not heparin.
C. Protamine sulfate: Protamine sulfate is the specific antidote for heparin overdose. It neutralizes the effects of heparin and is used to quickly reverse its anticoagulant effects in case of an overdose or excessive bleeding.
D. Diphenhydramine HCl: Diphenhydramine is an antihistamine and has no role in reversing anticoagulants.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client's history includes which problem?

Correct Answer is A

Explanation

The healthcare provider prescribes the anticoagulant heparin for a client with a pulmonary embolism. Before initiating the medication, the nurse should ensure that which drug is readily available in case of heparin overdose?

Correct Answer is C

Explanation

Which instruction should the nurse include when teaching a client about self-administration of a bulk-forming laxative?

The nurse is assessing the eyes of a client who just received mydriatic eye drops. Which physiological function of the eye will not respond during the therapuetic period after administration of the eye drops?

A client who is a vegetarian has a new prescription for warfarin. The client reports eating leafy green vegetables every day. How should the nurse respond?

A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?

A male client tells the home health nurse that he has started taking magnesium hydroxide and aluminum hydroxide to treat occasional heartburn. It is most important for the nurse to review the client's medical history regarding the presence of which disorder?

The nurse is preparing to administer warfarin sodium 10 mg PO to a client whose international normalized ratio (INR) is 5.0. Which intervention should the nurse implement? Reference Range: International 1 normalized ratio (INR) [INR: 0.8 to 1.1]

Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dl (3.5 mmol/l) Which action should the nurse implement? Reference Range: Calcium 8.5 to 10.5 mg/dL (2.25 to 2.75 mmol/L)

A patient with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the patient's plan of care?