A nurse in a provider's office is reinforcing teaching with a client who has anemia and has been taking ferrous gluconate for several weeks. Which of the following instructions should the nurse include?

Take this medication between meals.

Limit intake of Vitamin C while taking this medication.

Take this medication with milk

Limit intake of whole grains while taking this medication.

Answer and Explanation

The Correct Answer is A

A. Take this medication between meals.
Iron supplements like ferrous gluconate are absorbed better on an empty stomach. Taking them between meals or one hour before meals, with a glass of orange juice (which contains vitamin C and enhances iron absorption), helps improve absorption.

B. Limit intake of Vitamin C while taking this medication.
This is incorrect. Vitamin C enhances iron absorption and is often recommended to be taken with iron supplements.

C. Take this medication with milk.
Taking iron supplements with milk is not recommended because calcium in milk can interfere with iron absorption.

D. Limit intake of whole grains while taking this medication.
Whole grains contain phytates, which can inhibit iron absorption. Therefore, it's a good idea to avoid consuming large amounts of whole grains with iron supplements.

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Correct Answer is A

Explanation

A. Prior to percussing the abdomen:Auscultation should be performed before percussing or palpating the abdomen. Percussion and palpation can alter bowel activity, potentially leading to inaccurate assessment of bowel sounds.

B. Prior to inspecting the abdomen:Inspection should always be performed before auscultation when assessing the abdomen. This allows the nurse to observe any visible abnormalities, such as distention or skin changes, without altering bowel activity. Auscultation should follow inspection.

C. After checking for kidney tenderness:Checking for kidney tenderness (e.g., costovertebral angle tenderness) involves percussing the back and is not part of the sequence of a standard abdominal exam. It does not precede auscultation.

D. After palpating the abdomen:
Palpation can stimulate or alter bowel sounds, potentially leading to an inaccurate assessment. Therefore, auscultation should always occur before palpation.

A. Diabetes mellitus B. Hepatitis A C. Cirrhosis D. Cholecystitis

Correct Answer is C

Explanation

A. Diabetes mellitus
Diabetes mellitus can cause easy bruising and slow wound healing, but it is not typically associated with frequent nosebleeds.

B. Hepatitis A
Hepatitis A primarily affects the liver and does not cause frequent bruising and nosebleeds.

C. Cirrhosis
Cirrhosis, which is scarring of the liver tissue due to long-term liver damage, can lead to impaired liver function. One consequence of cirrhosis is decreased production of clotting factors, which can result in easy bruising. Additionally, the enlarged spleen in cirrhosis can lead to thrombocytopenia (low platelet count), contributing to bleeding tendencies, including nosebleeds. Cirrhosis is the most likely condition given the symptoms described.

D. Cholecystitis
Cholecystitis is inflammation of the gallbladder and is not directly associated with frequent bruising and nosebleeds.

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A nurse in a provider's office is reinforcing teaching with a client who has anemia and has been taking ferrous gluconate for several weeks. Which of the following instructions should the nurse include?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

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