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 B
Explanation
Choice A rationale
Gardening involves exposure to soil-borne microorganisms, fungi, and dust, which pose a significant infection risk for neutropenic clients whose compromised immune systems, characterized by a neutrophil count typically below 1.5 × 10^9/L (normal range 2.5–7.5 × 10^9/L), cannot effectively combat these environmental pathogens.
Choice B rationale
Avoiding crowds minimizes exposure to airborne pathogens, including viruses and bacteria, which are easily transmitted in close proximity. Neutropenic individuals have a severely impaired innate immune response due to a deficiency in neutrophils, making them highly susceptible to even common community-acquired infections. This reduces the pathogen load they encounter.
Choice C rationale
Fresh fruits and vegetables can harbor bacteria, molds, and pesticides on their surfaces, even after washing. For a neutropenic client, ingesting these microorganisms can lead to severe gastrointestinal infections or systemic sepsis due to the inability of their diminished neutrophil count to mount an adequate immune defense.
Choice D rationale
Taking temperature weekly is insufficient for monitoring neutropenia. A daily or even more frequent temperature assessment is crucial because fever (oral temperature >38.0°C or 100.4°F) is often the first and sometimes only sign of infection in neutropenic clients, necessitating immediate intervention given their immunocompromised state.
Correct Answer is D
Explanation
Choice A rationale
Neutropenic precautions are initiated when a client has a critically low neutrophil count, placing them at high risk for infection. While children with leukemia often experience neutropenia due to chemotherapy, the specific prompt states a critically low platelet count, which necessitates different precautions.
Choice B rationale
Contact precautions are implemented for clients with infections spread by direct or indirect contact, such as C. difficile or MRSA. Leukemia itself is not spread via contact, and a low platelet count does not increase the risk of contact-transmissible infections.
Choice C rationale
Droplet precautions are used for clients with infections spread by large respiratory droplets, such as influenza or meningococcal disease. Leukemia and a low platelet count do not directly cause or increase the risk of droplet-transmitted infections.
Choice D rationale
A critically low platelet count (thrombocytopenia) significantly impairs the body's ability to form clots, leading to an increased risk of bleeding. Therefore, bleeding precautions are essential to prevent hemorrhage. This includes avoiding venipunctures, sharp objects, and advising soft toothbrushes. Normal platelet counts range from 150,000 to 450,000 per microliter of blood.
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