Question 1

A patient with end-stage renal failure has been admitted to the hospital for severe anemia.She is refusing blood transfusions.The nurse anticipates drug therapy with which drug to stimulate the production of red blood cells?

Accepted Answer

Epoetin alfa (Epogen) is a hormone that stimulates the production of red blood cells and is used to treat anemia in patients with chronic renal failure. It is a synthetic version of erythropoietin, a hormone produced by the kidneys that stimulates red blood cell production. Since the patient is refusing blood transfusions, Epogen is the best choice to stimulate erythropoietin (EPO) production and increase red blood cell levels.

Question 2

An oral iron supplement is prescribed for a patient.The nurse would question this order if the patient's medical history includes which condition?

Accepted Answer

Hemolytic anemia is a type of anemia where red blood cells are destroyed faster than they can be produced. Iron supplementation can worsen the condition by increasing the amount of iron in the blood which can accelerate the destruction of red blood cells. Therefore, an oral iron supplement would not be appropriate for a patient with hemolytic anemia.

Question 3

A patient is to receive iron dextran injections.Which technique is appropriate when the nurse is administering this medication?

Accepted Answer

Iron dextran injections are administered via the intramuscular route using the Z-track method. This technique is used to ensure that the medication does not leak out of the muscle tissue and into the subcutaneous tissue, which can cause irritation and discoloration. Intravenous administration is not appropriate for iron dextran injections, and subcutaneous injections are not recommended for this medication. Although intramuscular injection in the upper arm is a possible option, using the Z-track method is the preferred technique.

Question 4

A woman who is planning to become pregnant should ensure that she receives adequate levels of which supplement to reduce the risk for fetal neural tube defects?

Accepted Answer

Folic acid is essential for proper fetal development and can help reduce the risk of neural tube defects such as spina bifida. It is recommended that women planning to become pregnant take 400-800 micrograms of folic acid daily. While the other nutrients listed are important for overall health during pregnancy, they do not specifically address the prevention of neural tube defects.

Question 5

The nurse is administering folic acid to a patient with a new diagnosis of anemia.Which statement about treatment with folic acid is true?

Accepted Answer

Folic acid should not be used to treat anemias until the underlying cause and type of anemia have been identified. Administering folic acid to a patient with pernicious anemia may correct the hematologic changes of anemia, but the symptoms of pernicious anemia (which is due to a vitamin B₁₂ deficiency, not a folic acid deficiency) may be deceptively masked. The other options are incorrect.

Question 6

A nurse is giving instructions to a patient who will be receiving oral iron supplements.Which instructions will be included in the teaching plan?

Accepted Answer

Although taking iron tablets with food may decrease absorption, doing so helps to reduce gastrointestinal distress. Antacids and milk may cause decreased iron absorption; iron tablets must be taken whole and not crushed. Black, tarry stools are expected adverse effects of oral iron supplements.

Question 7

The nurse is administering intravenous iron dextran for the first time to a patient with anemia.After giving a test dose,how long will the nurse wait before administering the remaining portion of the dose?

Accepted Answer

Although anaphylactic reactions usually occur within a few moments after the test dose, it is recommended that a period of at least 1 hour elapse before the remaining portion of the initial dose is given. The other options are incorrect.

Question 8

A 2-year-old child will be receiving ferrous sulfate oral drops (Fer-Iron)5 mg/kg/day in three divided doses.The child weighs 26 pounds.Identify how many milligrams will the nurse administer per dose.(record answer using one decimal place)_______

Accepted Answer

The answer of A 2-year-old child will be receiving ferrous...

Question 9

The nurse is administering liquid oral iron supplements.Which intervention is appropriate when administering this medication?

Accepted Answer

Instructing the patient to take the medication through a plastic straw can prevent staining of the teeth. Milk should not be taken with iron supplements because it can decrease absorption. Sipping the medication slowly may not prevent staining and may also increase the risk of side effects. Drinking the medication undiluted from the unit-dose cup may also increase the risk of staining and make it difficult for the patient to swallow.

Question 10

A cancer patient is receiving drug therapy with epoetin alfa (Epogen).The nurse knows that the medication must be stopped if which laboratory result is noted?

Accepted Answer

Epoetin alfa is used to stimulate the production of red blood cells in patients with anemia, often caused by cancer and/or chemotherapy. The medication should be stopped if the hemoglobin level exceeds 12 g/dL to prevent excessive red blood cell production and potential complications such as blood clots. The other laboratory values listed are within normal limits and would not necessitate stopping the medication.

Question 11

A patient has been receiving epoetin alfa (Epogen)for severe iron-deficiency anemia.Today,the provider changed the order to darbepoetin (Aranesp).The patient questions the nurse,"What is the difference in these drugs?" Which response by the nurse is correct?

Accepted Answer

Darbepoetin (Aranesp) is a longer-acting form of epoetin alfa (Epogen), so patients receiving Aranesp require less frequent injections than those receiving Epogen. Option A is incorrect because there is a difference in the drugs, and Option B and C are incorrect because they provide incorrect information about the drugs.

Question 12

A patient will be receiving epoetin alfa (Epogen)8000 units IV three times a week.The medication is available in a vial that contains 10,000 units/mL.How many milliliters will the nurse draw up for this dose? _______

Accepted Answer

The answer of A patient will be receiving epoetin alfa...

Question 13

During therapy with the hematopoietic drug epoetin alfa (Epogen),the nurse instructs the patient about adverse effects that may occur,such as:

Accepted Answer

Hypertension is a potential adverse effect of epoetin alfa therapy. Anxiety, drowsiness, and constipation are not typically associated with this medication.

Question 14

The nurse will teach a patient who is receiving oral iron supplements to watch for which expected adverse effects?

Accepted Answer

Oral iron supplements commonly cause black, tarry stools due to the dark coloration of iron. Palpitations and drowsiness or dizziness are not common adverse effects of iron supplements. Orange-red discoloration of the urine may indicate hematuria or another serious medical condition and should be reported to the healthcare provider immediately.

Question 15

A patient has been taking iron supplements for anemia for 2 months.During a follow-up assessment,the nurse will observe for which therapeutic response?

Accepted Answer

Iron supplements are used to treat anemia, which is characterized by decreased hemoglobin levels and subsequent decreased oxygen carrying capacity. As a result, patients may experience fatigue and decreased activity tolerance. Therefore, an expected therapeutic response would be an increase in activity tolerance as their hemoglobin levels increase with the use of iron supplements. Decreased palpitations may also be a therapeutic response if the palpitations were related to the anemia, but this is less specific than increased activity tolerance. Decreased weight and increased appetite are not expected therapeutic responses to iron supplementation for anemia.

Question 16

The nurse is teaching a patient with iron-deficiency anemia about foods to increase iron intake.Which food may enhance the absorption of oral iron forms?

Accepted Answer

Orange juice contains vitamin C, which enhances the absorption of oral iron forms. Milk, yogurt, and antacids can inhibit iron absorption.

Question 17

The nurse is reviewing the medical record of a patient before giving a new order for iron sucrose (Venofer).Which statement regarding the administration of iron sucrose is correct?

Accepted Answer

Iron sucrose (Venofer) is an injectable iron product indicated for the treatment of iron-deficiency anemia in patients with chronic renal disease. It is also used for patients without kidney disease. Its risk of precipitating anaphylaxis is much less than that of iron dextran, and a test dose is not required. Hypotension is the most common adverse effect and appears to be related to infusion rate. Low-weight elderly patients appear to be at greatest risk for hypotension.

Quiz 54: Anemia Drugs