A nurse is caring for a patient with vitamin B12 deficiency anemia.
The patient is prescribed vitamin B12 supplementation.
What is the appropriate route and dosage of vitamin B12 for a patient with pernicious anemia or severe malabsorption?
Administer 500 mcg of cyanocobalamin intramuscularly daily for a week, then monthly for life.
Administer 1000 mcg of cyanocobalamin orally daily for a week, then weekly for a month, then monthly for life.
Administer 1000 mcg of cyanocobalamin intramuscularly daily for a week, then monthly for life.
Administer 2000 mcg of cyanocobalamin subcutaneously daily for a week, then monthly for life.
The Correct Answer is A
Choice A rationale:
Administering 500 mcg of cyanocobalamin intramuscularly daily for a week, then monthly for life is the appropriate route and dosage for a patient with pernicious anemia or severe malabsorption.
Intramuscular injection is the preferred route for patients with impaired absorption of vitamin B12, as it ensures direct absorption into the bloodstream.
The initial daily dose helps replenish depleted stores, and the monthly maintenance dose is required to prevent recurrence.
Choice B rationale:
Administering 1000 mcg of cyanocobalamin orally daily for a week, then weekly for a month, then monthly for life is not the best choice for patients with pernicious anemia or severe malabsorption.
Oral vitamin B12 is not effective in these cases because the underlying issue is the inability to absorb vitamin B12 from the gastrointestinal tract.
Intramuscular administration bypasses this problem.
Choice C rationale:
Administering 1000 mcg of cyanocobalamin intramuscularly daily for a week, then monthly for life is a reasonable option, but it is not as effective as the regimen described in choice A.
The initial daily dose is lower, and there is no weekly dosing phase to replenish stores quickly.
Choice D rationale:
Administering 2000 mcg of cyanocobalamin subcutaneously daily for a week, then monthly for life is not the preferred route for vitamin B12 supplementation in patients with pernicious anemia or severe malabsorption.
Intramuscular injection is the preferred route as it ensures better absorption, and subcutaneous injection may not be as effective.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
They are neuropsychiatric symptoms associated with vitamin B12 deficiency anemia.
Choice A rationale:
These neuropsychiatric symptoms are actually related to vitamin B12 deficiency anemia.
Vitamin B12 deficiency can lead to neurological symptoms, including confusion, irritability, and depression.
It is not unrelated to the condition.
Choice B rationale:
Gastrointestinal symptoms are not the primary manifestation of vitamin B12 deficiency anemia.
Choice C rationale:
Glossitis is a common sign of vitamin B12 deficiency anemia, but it primarily involves inflammation and changes in the tongue.
While glossitis is associated with vitamin B12 deficiency, it does not fully explain the neuropsychiatric symptoms mentioned in the question.
Choice D rationale:
The correct answer is choice D.
Neuropsychiatric symptoms such as confusion, irritability, and depression are indeed associated with vitamin B12 deficiency anemia.
Correct Answer is C
Explanation
Choice A rationale:
Dyspnea.
Rationale: Dyspnea refers to difficulty breathing and is not a characteristic symptom of vitamin B12 deficiency anemia.
Symptoms of vitamin B12 deficiency anemia are primarily related to the blood and nervous system.
Choice B rationale:
Numbness and tingling of extremities.
Rationale: Numbness and tingling of extremities (peripheral neuropathy) can be a symptom of vitamin B12 deficiency anemia, but it is not related to the specific complaint of soreness, redness, and smoothness of the tongue mentioned in the question.
Choice C rationale:
Glossitis.
Rationale: This is the correct answer.
Glossitis refers to inflammation of the tongue, which can result in soreness, redness, and a smooth appearance of the tongue.
It is a distinctive feature of vitamin B12 deficiency anemia, as vitamin B12 plays a role in maintaining the health of the oral mucosa and nerves.
Choice D rationale:
Memory loss.
Rationale: Memory loss is not a typical symptom of vitamin B12 deficiency anemia.
Symptoms related to the nervous system, such as numbness and tingling, are more common neurological manifestations of the condition.
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