A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

“Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose."

"Plan to self-administer this medication for the next 6 months."

"Lie down for 1 hour after administering the medication."

"Administer the medication into one nostril once per week."

Answer and Explanation

The Correct Answer is D

A.   “Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose": This statement is not necessary for the administration of nasal cyanocobalamin. Nasal decongestants are not routinely recommended before administering nasal medications.
B.   "Plan to self-administer this medication for the next 6 months": While the duration of treatment for pernicious anemia may vary, specifying a timeframe of 6 months for self- administration is not appropriate without considering individualized treatment plans.

C.   "Lie down for 1 hour after administering the medication": There is no need for the client to lie down after administering nasal cyanocobalamin. This instruction is not necessary and may not be practical.
D.   "Administer the medication into one nostril once per week": This is the correct instruction for administering nasal cyanocobalamin. It is typically given once weekly into one nostril. This
method provides a convenient and effective route for vitamin B12 supplementation in clients with pernicious anemia.

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Correct Answer is C

Explanation

A. The client had a decreased neutrophil count before the medication was administered: This finding may be expected in a client undergoing cytotoxic chemotherapy and receiving filgrastim to stimulate neutrophil production. It is not an indication for an incident report.
B. The client had chemotherapy 12 hr before the medication was administered: The timing of chemotherapy administration is not typically a reason to complete an incident report unless it conflicts with specific medication guidelines or protocols.
C. The vial was out of the refrigerator for 2 hr before the medication was administered:

Filgrastim should be stored in the refrigerator and protected from light. Allowing the medication vial to be out of the refrigerator for an extended period may compromise its stability and effectiveness, potentially leading to adverse effects or reduced efficacy. Therefore, this finding warrants completion of an incident report.
D. The client reported feeling nauseous after the medication was administered: Nausea is a known side effect of filgrastim and is not typically an indication for completing an incident report unless it is severe or persistent and requires intervention.

A. "Do not chew more than 40 pieces of gum per day." B. "Allow 9 months for the gum to achieve the therapeutic effect." C. "Chew the gum slowly over 30 minutes." D. "Drink a glass of water 5 minutes before chewing the gum."

Correct Answer is C

Explanation

A. This statement is incorrect. While it’s essential not to exceed the recommended dose, the

maximum daily limit for nicotine gum is 24 pieces, not 40. Using more than the recommended amount can lead to adverse effects
B. This information is not accurate. Nicotine gum is typically used for a shorter duration. The

treatment plan varies, but it’s essential to follow the recommended dosing and gradually reduce usage over time. The goal is to quit smoking successfully, not to use the gum for 9 months
C. This advice is correct. Nicotine gum is not used like ordinary chewing gum. You should chew it a few times and then “park” it between your cheek and the space below your teeth. The nicotine is absorbed mostly in your mouth. Chewing it slowly over 30 minutes allows for
effective absorption and helps control withdrawal symptoms

D. Drinking water before chewing nicotine gum is not a necessary instruction for its use.

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A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

Nursing Test Bank

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