A patient with iron deficiency anemia who is taking oral iron supplements is evaluated by the nurse in the outpatient clinic. Which finding by the nurse is of MOST concern?

The patient takes a multivitamin tablet everyday

The patient takes an antacid with the iron to avoid nausea

The patient reports stools are black

The patient complains of occasional constipation

Answer and Explanation

The Correct Answer is B

A.   While taking a multivitamin can provide additional nutrients, it is generally not a cause for concern unless the multivitamin contains high doses of certain minerals that might interact negatively with iron absorption. However, this is less pressing compared to the interaction between antacids and iron.
B.   Antacids can significantly interfere with the absorption of oral iron supplements, leading to inadequate treatment of iron deficiency anemia. This is the most concerning finding because it may negate the effectiveness of the iron supplementation, making it harder for the patient to improve their iron levels.
C.   Black stools are a common and expected side effect of iron supplementation due to the presence of unabsorbed iron in the gastrointestinal tract. While the nurse should monitor for this, it is not inherently concerning as it indicates that the iron is being ingested.
D.   Constipation is a common side effect of iron supplements. Although it can be uncomfortable, it is not as critical as the potential interference caused by taking antacids. Management strategies can often alleviate this side effect.

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Correct Answer is ["A","C","D","E"]

Explanation

A. Paper tape is gentler on fragile skin compared to standard adhesive tape. It reduces the risk of skin tears and bleeding, making it a safer option for patients with thrombocytopenia.
B. This option is not advisable. Mouthwash containing alcohol can irritate and dry out the mucous membranes in the mouth, potentially leading to ulcers or bleeding. Instead, an alcohol-free mouthwash should be used for oral care.
C. Aspirin is an antiplatelet agent that can increase the risk of bleeding. Patients on bleeding precautions should avoid aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) to minimize the risk of excessive bleeding.
D. A soft-bristle toothbrush or oral sponge is recommended for oral care to minimize trauma to the gums and mucous membranes. This helps reduce the risk of bleeding in patients with low platelet counts.
E. Using an electric shaver is safer than a traditional razor, as it reduces the risk of cuts and nicks that can lead to bleeding. This precaution is particularly important for patients with thrombocytopenia.

A. Call the MD to report a potential Emergency B. Call the MD to request a X-ray of the shoulder C. Perform a head to toe assessment and then chart your findings D. Call the MD to request an increase to their opioid dosage

Correct Answer is A

Explanation

A. A sudden new pain in a patient with SCD can be a sign of a serious complication, such as acute chest syndrome or stroke. Prompt medical evaluation is crucial to identify and address any underlying complications.
B. While an X-ray may be helpful to rule out other causes of shoulder pain, it is not the most urgent priority in this case. The patient's sudden onset of pain could be a sign of a serious complication that requires immediate attention.
C. While a head-to-toe assessment is important for any patient, it is not the most urgent priority in this case. The patient's new pain could be a sign of a serious complication that requires immediate medical attention.
D. Increasing the opioid dosage may provide temporary relief from the pain, but it does not address the underlying cause of the new pain.

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A patient with iron deficiency anemia who is taking oral iron supplements is evaluated by the nurse in the outpatient clinic. Which finding by the nurse is of MOST concern?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patients receiving chemotherapy are at risk for thrombocytopenia related to chemotherapy or disease processes. Which actions. are needed for patients who must be placed on bleeding precautions? (Select all that apply)

Correct Answer is ["A","C","D","E"]

Explanation

You are caring for a patient who has Sickle Cell Disease (SCD) who is in the hospital for an acute worsening of their disease. Your patient is receiving ATC opioids for their severe pain, when they suddenly report a new sharp pain in their left shoulder. What is your BEST action?

Correct Answer is A

Explanation

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