In preparation for a patient having a Schilling test, the nurse should explain that the test:

will confirm a diagnosis of G6PD anemia.

requires the patient to be NPO for 12 hours prior to the test.

is a 24-hour urine specimen collection test.

entails administration of methylcellulose prior to the test.

Answer and Explanation

The Correct Answer is C

Choice A reason: The Schilling test is not used to diagnose G6PD anemia, which is a genetic disorder that causes red blood cells to break down when exposed to certain substances. The Schilling test is used to measure how well the body absorbs vitamin B12 from the intestine. ¹²

Choice B reason: The Schilling test does not require the patient to be NPO (nothing by mouth) for 12 hours prior to the test. The patient can drink water, but should avoid food for 8 hours before the test. ²

Choice C reason: The Schilling test is a 24-hour urine specimen collection test. The patient is given a dose of radioactive vitamin B12 by mouth and another dose of nonradioactive vitamin B12 by injection. The urine is collected for 24 hours to measure how much of the radioactive vitamin B12 is excreted. This indicates how well the body absorbs vitamin B12 from the intestine. ¹²

Choice D reason: The Schilling test does not entail administration of methylcellulose prior to the test. Methylcellulose is a type of laxative that can interfere with the absorption of vitamin B12. The patient should avoid taking any laxatives, antacids, or antibiotics before the test. ²³

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Correct Answer is D

Explanation

Choice A reason: Cucumbers are not a good source of iron for the client with iron-deficiency anemia. Iron-deficiency anemia is a condition where the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the red blood cells. Cucumbers are mostly water and have very little iron content. The client should eat foods that are rich in iron, such as meat, poultry, fish, eggs, beans, and leafy green vegetables.

Choice B reason: Bran is not a good source of iron for the client with iron-deficiency anemia. Bran is the outer layer of cereal grains that contains fiber and some minerals, but not much iron. Bran can also interfere with the absorption of iron from other foods by binding to it and preventing it from entering the bloodstream. The client should avoid eating bran or other foods that contain phytates, oxalates, or tannins, which can reduce the bioavailability of iron.

Choice C reason: Celery is not a good source of iron for the client with iron-deficiency anemia. Celery is a low-calorie vegetable that has some vitamins and minerals, but very little iron. Celery also has a high water content and can fill up the stomach without providing much nutrition. The client should eat foods that are high in iron, such as meat, poultry, fish, eggs, beans, and leafy green vegetables.

Choice D reason: This is the correct answer. Spinach is a good source of iron for the client with iron-deficiency anemia. Spinach is a leafy green vegetable that has a high iron content and can help increase the hemoglobin level and the oxygen-carrying capacity of the blood. Spinach also has other nutrients, such as vitamin C, folate, and antioxidants, that can benefit the health of the client. The client should eat spinach and other foods that are high in iron, such as meat, poultry, fish, eggs, beans, and leafy green vegetables.

A. Document the pulse rate and administer the medications as prescribed B. Assess for chest pain and administer atenolol if pain free C. Hold the atenolol and administer the diltiazem D. Withhold the medications and reassess the heart rate in 30 minutes

Correct Answer is C

Explanation

Choice A reason: This is not the best nursing action. Documenting the pulse rate and administering the medications as prescribed may be harmful to the client. Atenolol and diltiazem are both medications that lower the blood pressure and the heart rate. Atenolol is a beta blocker that blocks the effects of adrenaline on the heart and blood vessels. Diltiazem is a calcium channel blocker that relaxes the muscles of the heart and blood vessels. Giving both medications to a client who already has a low and irregular heart rate may cause further bradycardia, which is a heart rate below 60 beats/minute, or arrhythmia, which is an abnormal heart rhythm. The nurse should check the parameters and the contraindications for the medications before administering them.

Choice B reason: This is not the best nursing action. Assessing for chest pain and administering atenolol if pain free may not be appropriate for the client. Chest pain can be a sign of angina or myocardial infarction, which are conditions where the blood flow to the heart is reduced or blocked. Atenolol can help relieve chest pain by reducing the oxygen demand of the heart, but it can also lower the heart rate and the blood pressure. The client already has a low and irregular heart rate, which may indicate a problem with the electrical conduction of the heart. The nurse should not give atenolol without checking the pulse rate and the blood pressure, and consulting the health care provider.

Choice C reason: This is the best nursing action. Holding the atenolol and administering the diltiazem is the most appropriate for the client. Atenolol can lower the heart rate and the blood pressure, which may worsen the client's condition. The nurse should hold the atenolol and notify the health care provider of the client's pulse rate and rhythm. Diltiazem can also lower the heart rate and the blood pressure, but it can also help regulate the heart rhythm by slowing down the electrical impulses in the heart. The nurse should administer the diltiazem as prescribed, and monitor the client's vital signs and cardiac status.

Choice D reason: This is not the best nursing action. Withholding the medications and reassessing the heart rate in 30 minutes may delay the treatment and the care of the client. The client has a low and irregular heart rate, which may indicate a serious cardiac problem that needs immediate attention. The nurse should not wait for 30 minutes to reassess the heart rate, but rather act promptly and notify the health care provider. The nurse should also administer the diltiazem as prescribed, unless there is a specific reason to withhold it.

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In preparation for a patient having a Schilling test, the nurse should explain that the test:

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Naxlex Comprehensive Predictor Exams

When developing a plan of care for the client diagnosed with iron-deficiency anemia, the nurse would encourage intake of which foods?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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