The husband of an older adult woman, diagnosed with pernicious anemia, calls the clinic to report that his wife still has memory loss and some confusion since she received the first dose of nasal cyanocobalamin two days ago. He tells the nurse that he is worried that she may be getting Alzheimer's disease. Which action should the nurse take?
Ask if the client is experiencing any change in bowel habits.
Determine if the client is taking iron and folic acid supplements.
Encourage the husband to bring the client to the clinic for a complete blood count.
Explain that memory loss and confusion are common with vitamin B12 deficiency.
The Correct Answer is D
A. Ask if the client is experiencing any change in bowel habits: Changes in bowel habits are not directly related to the confusion or memory loss seen in pernicious anemia. The concern here is primarily with vitamin B12 deficiency.
B. Determine if the client is taking iron and folic acid supplements: While iron and folic acid are important, they don't directly address the memory loss and confusion related to B12 deficiency. The immediate focus should be on the effects of the B12 treatment.
C. Encourage the husband to bring the client to the clinic for a complete blood count: A CBC can help monitor anemia, but it doesn't address the memory issues. The nurse should first explain the symptoms related to B12 deficiency.
D. Explain that memory loss and confusion are common with vitamin B12 deficiency:
Memory loss and confusion are known symptoms of vitamin B12 deficiency. These symptoms may take time to improve with treatment, and educating the husband helps alleviate concerns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["1.3"]
Explanation
Rationale:
- Convert the infant's weight from pounds (lb) to kilograms (kg).
Weight in kg = 22 lb / 2.2 lb/kg
= 10 kg.
- Calculate the total daily desired dose in milligrams (mg).
Total daily desired dose (mg) = Desired dose (mg/kg/day) × Weight (kg)
= 20 mg/kg/day × 10 kg
= 200 mg/day.
- Determine the number of doses per day.
Doses are given every 8 hours, so Number of doses per day = 24 hours / 8 hours/dose
= 3 doses/day.
- Calculate the dose per administration in milligrams (mg).
Dose per administration (mg) = Total daily desired dose (mg) / Number of doses per day
= 200 mg / 3 doses
= 66.666 mg.
Available concentration of the medication = 250 mg / 5 mL.
- Calculate the volume in milliliters (mL) to administer per dose.
Volume (mL) = Desired dose per administration (mg) / (Available concentration (mg) / Available volume (mL))
= 66.666 mg / (250 mg / 5 mL)
= 66.666 mg / 50 mg/mL
= 1.333 mL.
- Round the answer to the nearest tenth.
= 1.3
Correct Answer is B
Explanation
A. Morphine: Morphine is used to relieve chest pain and anxiety in acute coronary syndromes. It acts as a vasodilator and analgesic, and there are no direct contraindications with recent sildenafil use, although blood pressure should still be monitored.
B. Nitroglycerin: Nitroglycerin is absolutely contraindicated in clients who have taken sildenafil within the past 24–48 hours. Both drugs are vasodilators, and their combination can lead to severe, life-threatening hypotension due to additive effects on vascular smooth muscle relaxation.
C. Aspirin: Aspirin is recommended in acute chest pain cases as it reduces platelet aggregation and helps prevent clot extension. It has no interaction with sildenafil and should not be withheld when myocardial ischemia is suspected.
D. Heparin: Heparin is an anticoagulant used in suspected myocardial infarction to prevent further clot formation. It does not have any adverse interactions with sildenafil and remains safe and beneficial in this context.
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