The client with pernicious anemia asks why vitamin B12 injections are necessary. What is the best response by the nurse?

Vitamin B12 contributes to the increased production of RBCs after significant blood loss.

Vitamin B12 is needed to prevent excessive production of red blood cells.

Vitamin B12 is needed to prevent RBCs from sticking together.

Your stomach does not provide a substance necessary for the absorption of vitamin B12.

Answer and Explanation

The Correct Answer is D

Choice A reason: Vitamin B12 does not contribute to the increased production of RBCs after significant blood loss. Vitamin B12 is a type of vitamin that is essential for the normal formation and maturation of red blood cells (RBCs), which carry oxygen throughout the body. ¹ However, vitamin B12 does not increase the production of RBCs in response to blood loss. That is the role of erythropoietin, a hormone that stimulates the bone marrow to produce more RBCs. ²

Choice B reason: Vitamin B12 is not needed to prevent excessive production of red blood cells. Vitamin B12 is needed for the normal production of red blood cells, not for the prevention of overproduction. Excessive production of red blood cells, also known as polycythemia, can cause the blood to become thick and viscous, increasing the risk of clotting and stroke. ³ Polycythemia can be caused by various factors, such as smoking, dehydration, or genetic mutations, but not by a lack of vitamin B12.

Choice C reason: Vitamin B12 is not needed to prevent RBCs from sticking together. Vitamin B12 is needed for the normal formation and maturation of RBCs, not for the prevention of aggregation. RBCs can stick together and form clumps, also known as rouleaux, which can impair blood flow and oxygen delivery. Rouleaux can be caused by various factors, such as inflammation, infection, or cancer, but not by a lack of vitamin B12.

Choice D reason: Vitamin B12 is needed for the normal formation and maturation of RBCs, but it cannot be absorbed by the body without a substance called intrinsic factor. Intrinsic factor is a protein that is produced by the stomach and binds to vitamin B12, allowing it to be absorbed by the small intestine. ¹ Pernicious anemia is a type of anemia that occurs when the stomach does not produce enough intrinsic factor, leading to vitamin B12 deficiency. The only way to treat pernicious anemia is by giving vitamin B12 injections, which bypass the need for intrinsic factor.

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Correct Answer is D

Explanation

Choice A reason: I should continue to read the labels of foods I select at the grocery store is not a statement that indicates a need for further clarification by the nurse. This statement shows that the client understands the importance of choosing foods that are low in sodium, fat, and calories, which can help lower blood pressure and prevent complications.

Choice B reason: Keeping my blood pressure under control reduces my risk for a heart attack is not a statement that indicates a need for further clarification by the nurse. This statement shows that the client understands the benefits of pharmacologic therapy for hypertension, which can prevent or delay the development of cardiovascular disease.

Choice C reason: When I get out of bed in the morning, I should first sit for a few minutes and then stand is not a statement that indicates a need for further clarification by the nurse. This statement shows that the client understands how to prevent or minimize orthostatic hypotension, which is a possible side effect of some anti-hypertensive medications.

Choice D reason: I will be able to stop my anti-hypertensive medication when my blood pressure is normal is a statement that indicates a need for further clarification by the nurse. This statement shows that the client has a misconception about the nature and duration of pharmacologic therapy for hypertension. The nurse should explain that hypertension is a chronic condition that requires lifelong treatment and monitoring, and that stopping the medication abruptly can cause a rebound increase in blood pressure and increase the risk of complications.

A. An early morning headache. B. Occasional nausea. C. A chronic cough. D. A dry mouth after eating.

Correct Answer is C

Explanation

Choice A reason: An early morning headache is not the most common side effect of lisinopril. Lisinopril is a drug that lowers blood pressure and prevents the complications of heart failure. ¹ It belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors, which work by relaxing the blood vessels and reducing the workload of the heart. ¹ Headache is a possible side effect of lisinopril, but it is not very frequent or specific to this drug. ²

Choice B reason: Occasional nausea is not the most common side effect of lisinopril. Lisinopril is a drug that lowers the blood pressure and prevents the complications of heart failure. ¹ It belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors, which work by relaxing the blood vessels and reducing the workload of the heart. ¹ Nausea is a possible side effect of lisinopril, but it is not very frequent or specific to this drug. ²

Choice C reason: A chronic cough is the most common side effect of lisinopril. Lisinopril is a drug that lowers the blood pressure and prevents the complications of heart failure. ¹ It belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors, which work by relaxing the blood vessels and reducing the workload of the heart. ¹ However, ACE inhibitors can also cause a dry, persistent cough that does not go away with time or treatment. ² This cough is due to the accumulation of a substance called bradykinin in the lungs, which irritates the airways and triggers the cough reflex. ³ The cough can be annoying and interfere with the quality of life of the client, but it is not harmful or dangerous. ²

Choice D reason: A dry mouth after eating is not the most common side effect of lisinopril. Lisinopril is a drug that lowers the blood pressure and prevents the complications of heart failure. ¹ It belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors, which work by relaxing the blood vessels and reducing the workload of the heart. ¹ Dry mouth is a possible side effect of lisinopril, but it is not very frequent or specific to this drug. ² Dry mouth can be caused by many factors, such as dehydration, medication, or disease. It can be relieved by drinking water, chewing gum, or using saliva substitutes.

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The client with pernicious anemia asks why vitamin B12 injections are necessary. What is the best response by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement, made by a client receiving pharmacologic therapy for hypertension, indicates a need for further clarification by the nurse?

Correct Answer is D

Explanation

The nurse is providing medication teaching to a client prescribed lisinopril 10 mg PO daily. Which side effect of the medication will the nurse explain to the client is most common?

Correct Answer is C

Explanation

The nurse is evaluating the effects of the prescribed carvedilol 6.25 mg PO daily for a client with a history of unstable angina. Which of the following reflects that the medication has been effective?

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?

The nurse should teach the client who is taking digoxin 0.125 mg PO daily to call the healthcare provider if which side effect is experienced?

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?

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?

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

When caring for a client diagnosed with thrombocytopenia, the nurse should plan to:

A client with coronary artery disease complains of chest pain while brushing their teeth in the bathroom. Which action should the nurse implement first?