The nurse is reviewing the plan of care for a group of assigned clients on a hematological unit.
The nurse should understand that which of the following clients has an increased risk for developing iron deficiency anemia?

A 24-year-old female who is 6 months pregnant and is taking prescribed prenatal vitamins.

A 42-year-old male with a history of hypertension who exercises three times a week.

A 37-year-old male client who works 16 hours a day and consumes a high carbohydrate diet.

A 20-year-old female client with a history of menorrhagia and consumes a strict vegetarian diet.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Pregnant women may experience increased iron demands due to expanded blood volume and fetal requirements. However, prescribed prenatal vitamins typically contain sufficient iron to prevent deficiency. Compliance with supplementation reduces the risk for anemia, and pregnancy itself is not an independent factor without nutritional inadequacy. Other physiological conditions, such as menorrhagia or dietary restrictions, can significantly elevate risk factors for iron deficiency anemia.

Choice B rationale

Hypertension does not inherently increase the risk of iron deficiency anemia. Exercise three times a week is unlikely to create significant hematological challenges unless combined with conditions like poor dietary intake or chronic illness. Physical activity does not deplete iron stores unless excessive or accompanied by inappropriate nutrition. This client does not exhibit risk factors as critical as menorrhagia or dietary restrictions for anemia development.

Choice C rationale

Working long hours and consuming a high-carbohydrate diet might affect overall health, but these factors do not directly relate to iron absorption or blood loss. While poor nutritional habits can lead to deficiencies, high carbohydrate intake does not necessarily deplete iron reserves. A vegetarian or restrictive diet lacking iron-rich foods poses a greater risk for developing anemia than carbohydrate consumption alone.

Choice D rationale

Menorrhagia results in excessive blood loss during menstruation, which can deplete iron stores and lead to anemia. A strict vegetarian diet often lacks heme iron, which is more readily absorbed compared to non-heme iron from plant sources. Together, these factors create a dual risk of iron deficiency, emphasizing why this client is the most likely among the options to develop anemia. Nutritional counseling and supplementation are key preventive measures.

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Correct Answer is D

Explanation

Choice A rationale

A low-sodium, high-calorie diet is not the priority for immediate management of renal colic. Nutritional changes are addressed as part of long-term care but do not alleviate acute pain and discomfort caused by obstruction or irritation in the urinary tract.

Choice B rationale

Increasing fluid intake of 3 to 4 L/day is beneficial for preventing stone formation and enhancing urinary output, but fluid intake changes alone do not address acute renal colic. The urgency lies in alleviating the pain and promoting ureteral relaxation.

Choice C rationale

Tamsulosin (Flomax) 0.4 mg p.o. daily relaxes smooth muscles in the ureter, aiding stone passage, but does not provide immediate pain relief. It is a supportive measure rather than a first-line intervention during acute renal colic.

Choice D rationale

Morphine sulfate (Morphine) 2 mg IV every 4 hours PRN is the correct choice, as it addresses severe pain due to renal colic by acting directly on opioid receptors to block pain transmission. Pain relief improves the client’s comfort and allows further management strategies.

A. Corticosteroid. B. Diphenhydramine. C. Desmopressin (DDAVP). D. Hydrochlorothiazide (HCTZ). . .

Correct Answer is A

Explanation

Choice A rationale

Corticosteroids are the mainstay of treatment for thrombocytopenia, particularly immune-mediated types like ITP. They work by suppressing immune-mediated platelet destruction, thereby increasing platelet counts and improving symptoms effectively.

Choice B rationale

Diphenhydramine, an antihistamine, may be used for allergic reactions but has no role in treating thrombocytopenia. It does not address immune-mediated mechanisms or platelet destruction directly.

Choice C rationale

Desmopressin (DDAVP) increases von Willebrand factor and Factor VIII activity, making it appropriate for certain clotting disorders but irrelevant for thrombocytopenia, as it does not restore platelet numbers or function.

Choice D rationale

Hydrochlorothiazide, a diuretic, is used for hypertension or fluid management but has no therapeutic effect on platelet counts or immune-mediated mechanisms in thrombocytopenia. Its use is unrelated to the described condition. .

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The nurse is reviewing the plan of care for a group of assigned clients on a hematological unit.The nurse should understand that which of the following clients has an increased risk for developing iron deficiency anemia?

Nursing Test Bank

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The nurse is reviewing the plan of care for a group of assigned clients on a hematological unit.
The nurse should understand that which of the following clients has an increased risk for developing iron deficiency anemia?