A client had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The client takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this client at risk for?

Iron deficiency anemia

Aplastic anemia

Sickle cell anemia

Pernicious anemia

Answer and Explanation

The Correct Answer is A

Reasoning:

Choice A reason: Iron deficiency anemia is a risk post-gastric bypass due to reduced stomach acid and bypassed duodenum, impairing iron absorption. Pantoprazole, a proton pump inhibitor, further reduces acid, exacerbating malabsorption. Fatigue results from low hemoglobin, as iron is essential for red blood cell production, matching the client’s profile.

Choice B reason: Aplastic anemia, caused by bone marrow failure, is not linked to gastric bypass or pantoprazole. It results from autoimmune, toxic, or idiopathic causes, leading to pancytopenia. The client’s surgical history and medication use point to malabsorption, not bone marrow suppression, ruling out this anemia.

Choice C reason: Sickle cell anemia is an inherited hemoglobinopathy, not related to gastric bypass or pantoprazole. It causes hemolytic anemia and vaso-occlusive crises, not malabsorption-related fatigue. The client’s surgical history suggests an acquired nutritional deficiency, making iron deficiency more likely than sickle cell disease.

Choice D reason: Pernicious anemia results from vitamin B12 deficiency, often due to lack of intrinsic factor, which may occur post-gastric bypass. However, pantoprazole primarily impairs iron absorption, and fatigue with this history points to iron deficiency, as B12 absorption is less affected in this scenario.

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Correct Answer is C

Explanation

Reasoning:

Choice A reason: Arranging for friends and family to sit with the client may provide comfort but does not directly prevent injury from agitation. Family presence cannot ensure physical safety during sudden movements, whereas padding side rails directly reduces harm from agitation-related impacts in head injury.

Choice B reason: Restraining the client increases agitation and injury risk in head-injured patients, as it can exacerbate distress and cause pressure injuries. Non-restrictive measures like padding are safer, reducing harm from agitation without compromising autonomy or worsening neurological status in this high-risk population.

Choice C reason: Padding side rails is the best intervention to prevent injury in an agitated client with a head injury. Agitation increases the risk of hitting bed rails, causing bruises or fractures. Padding absorbs impact, ensuring safety without restricting movement, addressing the immediate physical risk effectively.

Choice D reason: Administering opioids PRN may reduce pain but not agitation in head injury. Opioids can depress respiration and consciousness, potentially masking neurological changes or worsening ICP, making them less safe than padding side rails to prevent physical injury from agitation-related movements.

A. 12 hours B. 9 hours C. 3 hours D. 6 hours

Correct Answer is C

Explanation

Reasoning:

Choice A reason: Initiating thrombolytic therapy within 12 hours is too late for optimal ischemic stroke outcomes. Beyond 4.5 hours, the risk of hemorrhage outweighs benefits, as ischemic tissue becomes necrotic, reducing the effectiveness of thrombolytics like tPA in restoring blood flow and improving function.

Choice B reason: A 9-hour window for thrombolytic therapy exceeds the recommended time frame for ischemic stroke. After 4.5 hours, the risk of hemorrhagic transformation increases, and neuronal salvage is less likely due to prolonged ischemia, making this time frame ineffective for achieving optimal functional recovery.

Choice C reason: Thrombolytic therapy within 3 hours of ischemic stroke onset maximizes functional outcomes. Tissue plasminogen activator (tPA) dissolves clots, restoring blood flow to viable brain tissue. Early administration minimizes neuronal damage, reduces disability, and improves recovery, with guidelines supporting a 3–4.5-hour window for eligible patients.

Choice D reason: A 6-hour window for thrombolytics is beyond the optimal 3–4.5-hour period for ischemic stroke. While some patients may benefit up to 4.5 hours, delays increase hemorrhage risk and reduce the likelihood of salvaging ischemic tissue, leading to poorer functional outcomes compared to earlier intervention.

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A client had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The client takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this client at risk for?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a head injury has been increasingly agitated and the nurse has consequently identified a risk for injury. What is the nurse’s best intervention for preventing injury?

Correct Answer is C

Explanation

Thrombolytic therapy should be initiated within what time frame of an ischemic stroke to achieve the best functional outcome?

Correct Answer is C

Explanation

A client who has experienced an ischemic stroke has been admitted to the medical unit. The client’s family is adamant that the client remain on bed rest to hasten recovery and to conserve energy. What principle of care should inform the nurse’s response to the family?

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A client with sickle cell anemia has a: