The nurse assesses a client's oral cavity as seen in the photo below:

What action by the nurse is most appropriate?

Encourage the client to have genetic testing.

Instruct the client on high-fiber foods.

Place the client in protective precautions.

Teach the client about cobalamin therapy.

Answer and Explanation

The Correct Answer is D

A. Genetic testing is not the first-line intervention for oral manifestations of cobalamin (vitamin B12) deficiency. The priority is correcting the deficiency.

B. While a high-fiber diet supports general digestive health, it does not address the oral or systemic effects of vitamin B12 deficiency, such as glossitis, pallor, or neuropathy.

C. Protective precautions are used for clients at risk of infection due to immunocompromised states, not for vitamin B12 deficiency.

D. The oral manifestations, such as smooth, red tongue or sores, indicate vitamin B12 deficiency, which requires cobalamin therapy. Teaching about administration routes (oral, sublingual, or IM) and adherence is the priority to correct the deficiency and prevent complications like pernicious anemia or neurological damage.

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Correct Answer is C

Explanation

A. While monitoring for fever is important because infection can precipitate a sickle cell crisis, daily temperature checks are not routinely necessary unless the child is symptomatic.

B. Limiting activity is not recommended; children should remain as active as tolerated, as regular activity helps circulation and overall health.

C. Adequate hydration is essential in preventing sickling episodes. Fluids help decrease blood viscosity, improve circulation, and reduce the risk of vaso-occlusive crises. Parents should encourage frequent oral fluid intake.

D. Cold can trigger vasoconstriction, which may worsen sickling and pain. Warm compresses are preferred to relieve pain safely.

A. Take the ferrous sulfate at bedtime. B. Take the ferrous sulfate with an antacid. C. Take the ferrous sulfate between meals. D. Take the ferrous sulfate with yogurt.

Correct Answer is C

Explanation

A. Taking iron at bedtime may reduce adherence because gastrointestinal side effects such as nausea, stomach cramps, or constipation can interfere with sleep. Therefore, it’s not the preferred timing.

B. Antacids contain magnesium or calcium, which bind to iron and significantly reduce its absorption, decreasing the effectiveness of the treatment.

C. Iron is absorbed most efficiently on an empty stomach because food, especially dairy or high-fiber products, can impair absorption. Ideally, it should be taken 1 hour before or 2 hours after meals, and vitamin C or citrus juice can be taken with it to enhance absorption.

D. Dairy products contain calcium, which competes with iron for absorption in the gut. Taking iron with yogurt can reduce its bioavailability and delay correction of anemia.

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The nurse assesses a client's oral cavity as seen in the photo below: What action by the nurse is most appropriate?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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The nurse assesses a client's oral cavity as seen in the photo below:

What action by the nurse is most appropriate?