A nurse is obtaining a health history from a client.
Which of the following findings should the nurse identify as possible risk factors for iron deficiency anemia?
The client eats red meat daily.
The client has had gastric bypass surgery.
The client has had treatment for gastrointestinal cancer.
The client eats mostly prepackaged, processed foods.
Correct Answer : B,C,E
Choice A rationale
Consuming red meat daily is a good source of heme iron, which is highly bioavailable. This dietary habit would typically reduce the risk of iron deficiency anemia, as iron from red meat is readily absorbed by the body. Therefore, this finding would not be identified as a risk factor.
Choice B rationale
Gastric bypass surgery significantly alters the gastrointestinal tract, particularly by bypassing parts of the stomach and duodenum. These are primary sites for iron absorption, especially non-heme iron. This anatomical alteration can lead to malabsorption of iron, increasing the risk of iron deficiency anemia.
Choice C rationale
Treatment for gastrointestinal cancer often involves surgical resections, chemotherapy, or radiation, which can impair nutrient absorption, including iron. Additionally, chronic blood loss from the tumor or treatment-related side effects like mucositis or ulcerations can contribute to iron deficiency anemia.
Choice D rationale
Prepackaged, processed foods are typically low in essential nutrients, including iron, and may contain additives that inhibit iron absorption. A diet heavily reliant on these foods often lacks the iron-rich sources necessary to meet daily physiological demands, thereby increasing the risk of developing iron deficiency anemia over time.
Choice E rationale
Ulcerative colitis is a chronic inflammatory bowel disease that causes inflammation and ulceration of the colon. This condition can lead to chronic blood loss from the inflamed mucosa, which is a significant cause of iron depletion and subsequent iron deficiency anemia due to ongoing blood loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
An absolute neutrophil count (ANC) less than 1,000/mm³ indicates neutropenia, which significantly increases the risk of infection. Limiting visitors to healthy adults minimizes exposure to pathogens that could be carried by individuals who are ill or immunocompromised, thereby reducing the risk of opportunistic infections.
Choice B rationale
Taking a rectal temperature is contraindicated in neutropenic clients due to the risk of introducing bacteria from the rectum into the bloodstream, which could lead to bacteremia or sepsis. Oral or axillary temperatures are preferred methods for temperature assessment in immunocompromised individuals to prevent mucosal trauma.
Choice C rationale
Increasing raw produce in the client's diet is contraindicated in neutropenic clients. Uncooked fruits and vegetables can harbor bacteria and fungi that, while usually harmless to individuals with intact immune systems, can cause severe infections in immunocompromised patients due to compromised gut mucosal barriers.
Choice D rationale
Instructing the client to floss his teeth daily is contraindicated in severe neutropenia. Flossing can cause micro-abrasions and bleeding of the gingiva, creating entry points for oral bacteria into the bloodstream, which can lead to systemic infections in a client with a severely compromised immune system.
Correct Answer is B
Explanation
Choice A rationale
Alteplase (tPA) is a thrombolytic agent, meaning it dissolves existing blood clots by activating plasminogen to form plasmin, which then breaks down fibrin. It is used to treat acute thrombotic events like pulmonary embolism or ischemic stroke, but it is not typically used for prophylactic prevention of DVT due to its significant bleeding risk.
Choice B rationale
Enoxaparin is a low molecular weight heparin (LMWH). It exerts its anticoagulant effect primarily by potentiating the action of antithrombin on Factor Xa, thereby inhibiting the coagulation cascade. LMWHs are highly effective and commonly used for the prophylactic prevention of deep vein thrombosis following orthopedic surgeries, including total knee replacement, due to their predictable pharmacokinetics.
Choice C rationale
Warfarin is an oral anticoagulant that works by inhibiting vitamin K epoxide reductase, an enzyme necessary for the synthesis of vitamin K-dependent clotting factors (II, VII, IX, X). While effective for long-term anticoagulation, its delayed onset of action and need for frequent INR monitoring make it less suitable for immediate postoperative DVT prophylaxis compared to LMWHs.
Choice D rationale
Clopidogrel is an antiplatelet agent that works by selectively inhibiting the binding of adenosine diphosphate (ADP) to its receptor on platelet surfaces, thereby preventing platelet activation and aggregation. It is used to prevent arterial thrombotic events like myocardial infarction and stroke, but it is not the primary medication for preventing venous thromboembolism such as DVT.
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