Try Naxlex NCLEX-RN (Free-Trial)

A 14-year-old female is brought to her primary care physician after passing out at school after PE (physical Education) class. Based on her health history, symptoms and lab results, she is diagnosed with iron deficiency anemia.

Exhibits
The nurse is preparing to discharge the patient with a 6 month supply of iron supplements (ferrous sulfate). Based on your knowledge of iron supplements, what teaching should the nurse provide to the patient.

Antacids and milk increase absorption

May turn stool a bright red or dark red color

Short Term: Only 1 to 2 months to replenish iron stores

Orange Juice (Vitamin C) increases absorption

Antacids and milk decrease absorption

Can cause constipation- Add a stool softener

Best absorbed on full stomach - Take with meals

Best absorbed on empty stomach- Take 1hr before meals

Answer and Explanation

Correct Answer : D,E,F,H

Rationale:

A. Antacids and milk increase absorption: Calcium in milk and the alkaline nature of antacids actually interfere with iron absorption. Taking iron with these can significantly reduce its effectiveness in correcting anemia.

B. May turn stool a bright red or dark red color: Iron supplements do not cause bright red or dark red stools; those findings could indicate gastrointestinal bleeding. Iron may darken stools to a black or dark green hue, which is harmless and expected.

C. Short Term: Only 1 to 2 months to replenish iron stores: Iron deficiency anemia often requires several months (typically 3–6 months or longer) of supplementation to replenish both hemoglobin levels and iron stores. Stopping too soon increases the risk of relapse.

D. Orange Juice (Vitamin C) increases absorption: Vitamin C enhances the solubility and absorption of non-heme iron from supplements, making orange juice a beneficial choice to take with the iron pill. This can help improve treatment outcomes.

E. Antacids and milk decrease absorption: Both interfere with iron uptake in the gut calcium in dairy products binds with iron, and antacids raise stomach pH, reducing iron solubility. The patient should avoid taking these within a couple of hours of their iron dose.

F. Can cause constipation- Add a stool softener: Iron supplements frequently cause gastrointestinal side effects, especially constipation. Encouraging stool softeners, hydration, and dietary fiber can improve adherence and comfort.

G. Best absorbed on full stomach - Take with meals: Although taking with food may reduce gastrointestinal upset, it also decreases absorption by up to 50%, so this is not the preferred method unless stomach irritation is severe.

H. Best absorbed on empty stomach- Take 1 hr before meals: Iron is most effectively absorbed on an empty stomach when stomach acid levels are higher. Taking it about an hour before meals maximizes absorption, provided the patient tolerates it without excessive stomach discomfort.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is C

Explanation

Rationale:

A. The child withdraws and attempts to hide because they think the pain is a form of punishment: This is more typical of toddlers who have limited understanding and may associate pain with punishment, rather than preschoolers who have a better grasp of cause and effect.

B. The child denies being scared about pain in an attempt to seem brave, and withdraws to a game on mom's phone: While distraction techniques are effective, preschoolers are more likely to show visible signs of distress rather than denying fear completely, as their emotional expression is more open.

C. The child makes facial expressions such as brow contracting and chin quivering in anticipation of the pain: Preschool-aged children often express fear and anxiety about painful procedures through facial cues and body language, showing clear anticipation and emotional response.

D. The child kicks, hits and cries due to lack of control over the situation: This aggressive and oppositional behavior is more characteristic of toddlers or children with less developed coping skills, rather than preschoolers who generally have more emotional regulation.

A. A high-pitched "click" is heard with hip flexion or extension. B. A distinct "clunk is heard with Barlow and Ortolani maneuvers. C. The thigh and gluteal folds are symmetric. D. Abduction occurs to 75 degrees and adduction to within 30 degrees (with stable pelvis).

Correct Answer is B

Explanation

Rationale:

A. A high-pitched "click" is heard with hip flexion or extension: A soft or high-pitched click may occur in many healthy newborns due to ligament laxity and is not specific to developmental dysplasia of the hip (DDH). It is generally considered a benign finding.

B. A distinct "clunk" is heard with Barlow and Ortolani maneuvers: This is a hallmark finding for DDH. The “clunk” indicates the femoral head is either dislocating from or relocating into the acetabulum during these maneuvers, confirming hip instability and potential dislocation.

C. The thigh and gluteal folds are symmetric: Symmetric skin folds suggest normal hip alignment. Asymmetry of these folds is more concerning for DDH, so symmetry would not confirm the diagnosis.

D. Abduction occurs to 75 degrees and adduction to within 30 degrees (with stable pelvis): This degree of hip motion can be within normal limits, especially in the absence of instability. Restricted abduction is more consistent with DDH in older infants.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is about to administer a vaccination to a 4 year old. What developmental response to this painful procedure is MOST likely for a preschool aged child.

Correct Answer is C

Explanation

The nurse is conducting a physical examination of a child with suspected developmental dysplasia of the hip. Which finding would help confirm this diagnosis?

Correct Answer is B

Explanation

A 14-year-old male child with sickle cell anemia is being discharged after treatment for a crisis. Which instructions for avoiding future crises should the nurse provide the child and family? Select the 3 that apply.

Which of the following findings by the nurse are considered Major Characteristics of Rheumatic Fever as determined by the Jones Criteria? Select the FIVE that apply.

The nurse is preparing to discharge an 11 year old patient newly diagnosed with type 1 diabetes. Which of the following statements by the parents indicate that they are safe for discharge? Select ALL that apply

While presenting a panel discussion to a group of parents about urinary tract infections (UTIs) in children, one of the parents asks the nurse, "Why would my daughter be more at risk than my son? Which response by the nurse would be most accurate?

The nurse is presenting an information session on birth defect prevention. What supplement should be recommended to decrease the incidence of neural tube defects?

Which of the symptoms below would alert the nurse that an infant may have a cardiac issue? Select the 3 that apply

A mother brings in her 2 month old to the Pediatric Clinic for a well visit. The infant is eating well and gaining weight consistently. Mom mentions that the baby is spitting up frequently. As the nurse, which of the following is the best response to this concern from the mother?

The nurse is completing a health history with the parents of a 6-month-old infant with retinoblastoma. Which symptom should the nurse expect that the parents have observed?