A home health nurse is assessing a client who has pernicious anemia. Which of the following is an expected manifestation that poses a risk to the client's safety?

Loss of hearing

Muscle wasting

Paresthesia

Changes in vision

Answer and Explanation

The Correct Answer is C

C. Paresthesia, or abnormal sensations like tingling, numbness, or burning, is a common neurological manifestation of pernicious anemia due to damage to the peripheral nerves caused by vitamin B12 deficiency. Paresthesia can affect balance and coordination, increasing the risk of falls and injuries, and thus posing a risk to the client's safety.
A. Loss of hearing is not typically associated with pernicious anemia.
B. Muscle wasting is not a typical manifestation of pernicious anemia. However, weakness and fatigue are common symptoms due to anemia resulting from decreased oxygen-carrying capacity of the blood.

D. While changes in vision can impact the client's safety, they are not as directly associated with pernicious anemia as paresthesia, which affects mobility and balance.

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Correct Answer is B

Explanation

B. Sublingual nitroglycerin is intended for the immediate relief of angina symptoms. Clients should take the medication as soon as they experience chest pain or discomfort. Prompt administration can help alleviate symptoms and prevent the progression of angina episodes.
A. If the chest pain persists or worsens after taking the first dose of sublingual nitroglycerin, the client can take a second dose after 5 minutes. However, taking another dose after only 2 minutes may increase the risk of hypotension and other adverse effects.
C. Sublingual nitroglycerin tablets are not meant to be chewed or swallowed. Instead, they should be placed under the tongue and allowed to dissolve completely. Chewing or swallowing the tablet can reduce the medication's effectiveness.

D. Sublingual nitroglycerin should be placed under the tongue, not against the cheek or gum.

A. Blood glucose level B. Bowel sounds C. Blood pressure D. Pain level E. Electrocardiogram findings F. Lung sounds G. Troponin T level

Correct Answer is ["C","D","E","G"]

Explanation

The blood pressure is elevated. This may indicate a compensatory mechanism to try increases myocardial perfusion. However, this increases the oxygen demand worsening the condition.

Pain level of 7 indicates severe pain typical of acute coronary syndrome. The pain may worsen the extent of ischemia and hence morphine should be administered immediately

ECG findings are typical for myocardial infarction and intervention is key to prevent further myocardial damage.

Troponin levels are elevated due to damage of myocardium

Blood sugar level, bowel sounds and lung sounds are normal and therefore, requires no intervention.

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A home health nurse is assessing a client who has pernicious anemia. Which of the following is an expected manifestation that poses a risk to the client's safety?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client who has a new prescription for sublingual nitroglycerin. Which of the following statements made by the client indicates an understanding of the teaching?

Correct Answer is B

Explanation

A nurse is admitting a client who reports tightness in their chest that radiates to left arm. Exhibits The nurse is reviewing the client's medical record. Select the four findings that require immediate follow-up.

Correct Answer is ["C","D","E","G"]

Explanation

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