NR 324 Final Exam – Chamberlain University
Questions with Correct Answers
When educating clients on treatments regarding Iron-deficiency anemia, what
would be priority information?
-Iron can stain the skin and if the IV is painful or swollen it can indicate infiltration
where the iron is leaking out of the vessel.
-Melena is the black tarry stools and is caused by excess iron.
-Oral iron is best taken on an empty stomach but nausea is a common side effect.
To combat this they can take it with Orange juice (which improves absorption) or
take at bedtime.
-Angular chelitis is a common symptom of iron deficiency anemia, as the anemia is
corrected the S/S of anemia should go away.
What are the priority assessments of a client diagnosed with thrombocytopenia?
Thrombocytopenia can cause serious bleeding anywhere. The most worrisome
bleeding is hidden because it is often not caught until it is severe. Altered LOC is a
priority assessment to ensure no hemorrhage has occurred in the brain.
A client in sickle cell crisis questions the need for a type and screen. What would
be the appropriate response from the nurse?
Your blood cells are being destroyed. We will check your blood type to make sure
that if you need to replace those destroyed blood cells we can give you the kind
your body will accept.
What are signs of hemorrhage?
Shortness of breath due to decreased ability to meet metabolic demand for O2
Palpitations due to tachycardia to attempt to increase cardiac output
Pallor due to decreased fluid volume, shunting to the core (decreased CO,
decreased arterial blood flow)
, What education would be priority for a client receiving a blood transfusion?
Do not ignore symptoms such as chills, back pain, shortness of breath, or
achiness.
How are clients with pernicious anemia treated?
Pernicious anemia is caused by failure to absorb B12 in the ileum, either due to
an ileostomy or the autoimmune destruction of the intrinsic factor secreting
cells. Treatment includes injections or nasal sprays for life.
Blood transfusions are reserved for clients with an Hgb of less than 7, it is not the
usual treatment of pernicious anemia.
A diet rich in meats and grains can help with B12 deficient anemia if the problem
arises from malnutrition and not an absorption problem.
A diet rich in leafy greens and fish is a treatment for folic acid deficient anemia
and would not address the decreased B12 levels.
When differentiating megaloblastic anemias, what symptomology would be most
differential?
B12 is a required element for neurologic function. Paresthesia's and confusion are
manifestations of Pernicious anemia but not folic acid deficiency anemia.
The sore beefy red tongue and Dyspepsia and Nausea are symptoms of both
megaloblastic anemias. Weakness and fatigue are common symptoms for all
anemias.
A client with a critically slow clotting time is admitted. What would be priority
concerns for this client?
Fall precautions
musculoskeletal traction
-Positioning a client in the prone position several times a day will help to reduce
the incidence of contracture
-Skin traction with a hip fracture decreases incidence of muscle spasm in the
Questions with Correct Answers
When educating clients on treatments regarding Iron-deficiency anemia, what
would be priority information?
-Iron can stain the skin and if the IV is painful or swollen it can indicate infiltration
where the iron is leaking out of the vessel.
-Melena is the black tarry stools and is caused by excess iron.
-Oral iron is best taken on an empty stomach but nausea is a common side effect.
To combat this they can take it with Orange juice (which improves absorption) or
take at bedtime.
-Angular chelitis is a common symptom of iron deficiency anemia, as the anemia is
corrected the S/S of anemia should go away.
What are the priority assessments of a client diagnosed with thrombocytopenia?
Thrombocytopenia can cause serious bleeding anywhere. The most worrisome
bleeding is hidden because it is often not caught until it is severe. Altered LOC is a
priority assessment to ensure no hemorrhage has occurred in the brain.
A client in sickle cell crisis questions the need for a type and screen. What would
be the appropriate response from the nurse?
Your blood cells are being destroyed. We will check your blood type to make sure
that if you need to replace those destroyed blood cells we can give you the kind
your body will accept.
What are signs of hemorrhage?
Shortness of breath due to decreased ability to meet metabolic demand for O2
Palpitations due to tachycardia to attempt to increase cardiac output
Pallor due to decreased fluid volume, shunting to the core (decreased CO,
decreased arterial blood flow)
, What education would be priority for a client receiving a blood transfusion?
Do not ignore symptoms such as chills, back pain, shortness of breath, or
achiness.
How are clients with pernicious anemia treated?
Pernicious anemia is caused by failure to absorb B12 in the ileum, either due to
an ileostomy or the autoimmune destruction of the intrinsic factor secreting
cells. Treatment includes injections or nasal sprays for life.
Blood transfusions are reserved for clients with an Hgb of less than 7, it is not the
usual treatment of pernicious anemia.
A diet rich in meats and grains can help with B12 deficient anemia if the problem
arises from malnutrition and not an absorption problem.
A diet rich in leafy greens and fish is a treatment for folic acid deficient anemia
and would not address the decreased B12 levels.
When differentiating megaloblastic anemias, what symptomology would be most
differential?
B12 is a required element for neurologic function. Paresthesia's and confusion are
manifestations of Pernicious anemia but not folic acid deficiency anemia.
The sore beefy red tongue and Dyspepsia and Nausea are symptoms of both
megaloblastic anemias. Weakness and fatigue are common symptoms for all
anemias.
A client with a critically slow clotting time is admitted. What would be priority
concerns for this client?
Fall precautions
musculoskeletal traction
-Positioning a client in the prone position several times a day will help to reduce
the incidence of contracture
-Skin traction with a hip fracture decreases incidence of muscle spasm in the
