Which treatment is likely to be planned for a patient who develops pernicious anemia after a gastrectomy?

Triple-drug therapy.

IV therapy.

Quadruple-drug therapy.

Cobalamin replacement therapy.

Answer and Explanation

The Correct Answer is D

Choice A rationale:
Triple-drug therapy is not the standard treatment for pernicious anemia after a gastrectomy. Pernicious anemia is primarily caused by vitamin B12 deficiency due to the absence of intrinsic factor, which is essential for vitamin B12 absorption.
Choice B rationale:
IV therapy is a broad term and does not specify the treatment for pernicious anemia. In the context of pernicious anemia, cobalamin replacement therapy administered via intramuscular injections is the preferred treatment.
Choice C rationale:
Quadruple-drug therapy is not a recognized treatment for pernicious anemia. The primary treatment for pernicious anemia involves cobalamin replacement therapy to address the vitamin B12 deficiency.
Choice D rationale:
Cobalamin replacement therapy is the appropriate treatment for pernicious anemia after a gastrectomy. Since the patient lacks intrinsic factor, which is necessary for vitamin B12 absorption, cobalamin replacement therapy bypasses the need for intrinsic factor and provides the necessary vitamin B12 directly.

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Correct Answer is C

Explanation

Choice A rationale:

Enteric-coated iron is designed to be absorbed in the small intestine, not the stomach. Taking it with each meal might decrease its absorption due to interaction with food.

Choice B rationale:

Cobalamin (vitamin B12) deficiency can cause macrocytic anemia, not microcytic hypochromic anemia. Taking cobalamin with green, leafy vegetables does not address the specific iron deficiency seen in microcytic hypochromic anemia.

Choice C rationale:

Take the iron with orange juice 1 hour before meals is the correct answer. Vitamin C enhances the absorption of non-heme iron (the type of iron found in plant-based foods and iron supplements) by reducing it to a more absorbable form. Taking iron supplements with orange juice, which is high in vitamin C, can significantly improve iron absorption. Taking it before meals ensures better absorption due to reduced interaction with other dietary components.

Choice D rationale:

Decreasing the intake of antiseizure medications will not improve microcytic hypochromic anemia. Antiseizure medications do not directly influence iron absorption or the production of red blood cells.

A. Sodium level of 136 mEq/L, potassium level of 4.5 mEq/L. B. Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L. C. Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L. D. Sodium level of 144 mEq/L, potassium level of 3.7 mEq/L.

Correct Answer is C

Explanation

Choice A rationale:

The sodium level is within the normal range, but the potassium level is slightly elevated. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

Choice B rationale:

The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

Choice C rationale:

Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L is the correct answer. In this option, both sodium and potassium levels are within normal ranges. Changing the IV prescription to DSNS with 20 mEq KCl/L ensures that the patient receives adequate hydration (from the dextrose and normal saline) without causing hyperkalemia.

Choice D rationale:

The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

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Which treatment is likely to be planned for a patient who develops pernicious anemia after a gastrectomy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which instruction would the nurse include in the teaching plan for a patient newly diagnosed with microcytic hypochromic anemia?

Correct Answer is C

Explanation

The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?

Correct Answer is C

Explanation

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