The husband of an older adult woman, diagnosed with pernicious anemia, calls the clinic to report that his wife still has memory loss and some confusion since she received the first dose of nasal cyanocobalamin two days ago. He tells the nurse that he is worried that she may be getting Alzheimer's disease. Which action should the nurse take?

Ask if the client is experiencing any change in bowel habits.

Determine if the client is taking iron and folic acid supplements.

Encourage the husband to bring the client to the clinic for a complete blood count.

Explain that memory loss and confusion are common with vitamin B12 deficiency.

Answer and Explanation

The Correct Answer is D

A. Ask if the client is experiencing any change in bowel habits: Changes in bowel habits are not directly related to the confusion or memory loss seen in pernicious anemia. The concern here is primarily with vitamin B12 deficiency.

B. Determine if the client is taking iron and folic acid supplements: While iron and folic acid are important, they don't directly address the memory loss and confusion related to B12 deficiency. The immediate focus should be on the effects of the B12 treatment.

C. Encourage the husband to bring the client to the clinic for a complete blood count: A CBC can help monitor anemia, but it doesn't address the memory issues. The nurse should first explain the symptoms related to B12 deficiency.

D. Explain that memory loss and confusion are common with vitamin B12 deficiency:
Memory loss and confusion are known symptoms of vitamin B12 deficiency. These symptoms may take time to improve with treatment, and educating the husband helps alleviate concerns.

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Correct Answer is D

Explanation

A. Chicken, yams, pinto beans, and pecans: This meal is not ideal for a client with CKD because pinto beans and pecans are high in potassium and phosphorus, which can be problematic for clients with CKD. Yams are also high in potassium.

B. Steak and baked potato with butter and cheese topping: Steak is high in protein and phosphorus, which can overload the kidneys. Baked potato, especially with cheese, can be high in potassium, which should be monitored in CKD.

C. Canned ham and green beans: Canned ham is often high in sodium, which is not recommended for clients with CKD, as it can exacerbate fluid retention and high blood pressure. Green beans are a good choice, but the sodium content in the ham is a concern.

D. Pasta with fish and an orange: Pasta is low in potassium and phosphorus, and fish provides a good source of protein that is generally easier on the kidneys compared to red meat. This meal is lower in sodium, phosphorus, and potassium, making it a better choice for CKD.

Correct Answer is {"dropdown-group-1":"A"}

Explanation

Rationale for Correct Choice:

Depression: The client has symptoms of depression, such as general malaise, fatigue, decreased appetite, withdrawal, flat affect, and poor hygiene. Additionally, the client reports a significant change in sleep patterns, with an inability to sleep at night. His alcohol consumption could also contribute to depressive symptoms.

Rationale for Incorrect Choices:

Anxiety disorder: While anxiety can cause fatigue, disrupted sleep, and lack of energy, it typically also presents with heightened nervousness, restlessness, excessive worry, or physical symptoms like rapid heart rate, which are not reported here. The client's withdrawal and lack of energy are more consistent with depression.
Hypothyroidism: Hypothyroidism can cause fatigue, weight gain, and poor appetite, but the client's low BMI (17.7 kg/m²) suggests that weight loss, rather than gain, is occurring. Additionally, the lack of other hypothyroid symptoms, like constipation or cold intolerance, makes hypothyroidism less likely than depression in this scenario.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with chronic kidney disease (CKD). Which meal selection should the nurse recommend to the client?

Correct Answer is D

Explanation

Exhibits Chart data is reviewed. Drag from Word Choices to complete the sentence. Client symptoms are indicators of dropdown.

Correct Answer is {"dropdown-group-1":"A"}

Explanation

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