Chapter 44 Drugs for Anemia
1. The nurse is caring for a patient in end-stage renal failure and anemia. What is the cause
of this patients anemia?
A) Low serum iron levels
B) Low erythropoietin levels
C) Inadequate oxygenation of tissue
D) Lack of B12 and folic acid intake
Ans B
Feedback
Anemia can occur if erythropoietin levels are low. This is seen in association with renal
failure, when the kidneys are no longer able to produce erythropoietin. Low iron levels,
hypoxia, and vitamin deficiency are not likely to be the primary cause of anemia in a
patient with kidney failure.
2. A 2-year-old child weighing 32 pounds is to take ferrous sulfate (Feosol) 6 mg/kg/d PO.
How many milligram will the child receive per dose?
A) 47 mg
B) 67 mg
C) 87 mg
D) 107 mg
Ans C
Feedback
The nurse will administer 87 mg per dose. The childs weight is first converted to
kilograms by dividing 32 by 2.2, or 32/2.2 = 14.5 kg. Next, calculate the dose by
multiplying weight times mg/kg/d or 14.5 6 = 87 mg.
3. A nurse caring for a 28-year-old woman with renal failure is to start the patient on epoetin
alfa therapy for iron replacement. What will the nurse assess before initiating therapy?
A) Weight
B) Last menstrual period
C) Intake and output (I & O) for a 24-hour period
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, D) Blood type
Ans B
Feedback
The use of epoetin alfa is not recommended during pregnancy or lactation because of
potential adverse effects to the fetus or baby. It is important to determine that the patient
is not pregnant before drug therapy has started so the nurse would assess when the
patient last menstruated. The patients weight, I & O, and blood type are not important
factors in determining whether the drug can be used.
4. The nurse improves patient compliance with the drug regimen of epoetin alfa by
providing what?
A) An appointment card for each drug administration day
B) A calendar to mark the days of the week the drug is to be administered
C) A referral for community transportation
D) The telephone number of the pharmacy where the medication can be purchased
Ans B
Feedback
The nurse should provide the patient with a calendar with the days the drug is to be
administered marked clearly to remind her when the dose is due. The patient can be
taught to self-administer the drug so there is no need for an appointment or arranging
transportation. The patient can use her choice of pharmacy and would not need the
telephone number.
5. A patient who has anemia and a severe GI absorption disorder has been ordered iron
dextran (INFeD). What is the most appropriate nursing diagnosis for the patient related
to the administration of this drug?
A) Acute pain related to drug administration
B) Deficient knowledge regarding drug therapy
C) Risk for injury related to CNS effects
D) Disturbed body image related to drug staining of teeth
A
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, Iron dextran is a parenteral form of iron. It is given intramuscularly and must be given
by the Z-track method. It can be very painful. Certainly, deficient knowledge and risk
for injury are appropriate diagnoses for this patient but would not be related to the
administration of the drug. Because this medication is not given orally, tooth staining
would not be a concern.
6. A 22-year-old woman who has severe dysmenorrhea has been prescribed ferrous
gluconate (Fergon) to treat iron deficiency anemia. What is it important for the nurse
to instruct the patient to avoid when taking the drug?
A) Eggs
B) Chocolate
C) Pork
D) Whole wheat
Ans A
Feedback
Iron is not absorbed if taken with antacids, eggs, milk, coffee, or tea. These
substances should not be administered concurrently. Chocolate, pork, and whole
wheat do not produce drugfood interactions when consumed with an iron
supplement.
7. The nurse develops a care plan for a patient who has been prescribed a folic acid
derivative that includes what priority nursing diagnosis?
A) Deficient knowledge regarding drug therapy
B) Monitor possibility of hypersensitivity reactions
C) Acute pain related to injection or nasal irritation
D) Risk for fluid volume imbalance related to cardiovascular effects
Ans D
Feedback
Nursing diagnoses related to drug therapy might include Risk for fluid volume imbalance
related to cardiovascular effects. Deficient knowledge and acute pain might apply to this
patient, but the priority nursing diagnosis this patient, but the priority nursing diagnosis
for this patient is the risk for fluid imbalance related to cardiovascular effects.
Monitoring for hypersensitivity is not a nursing diagnosis.
8. Before administering an iron preparation, what should the nurse assess?
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1. The nurse is caring for a patient in end-stage renal failure and anemia. What is the cause
of this patients anemia?
A) Low serum iron levels
B) Low erythropoietin levels
C) Inadequate oxygenation of tissue
D) Lack of B12 and folic acid intake
Ans B
Feedback
Anemia can occur if erythropoietin levels are low. This is seen in association with renal
failure, when the kidneys are no longer able to produce erythropoietin. Low iron levels,
hypoxia, and vitamin deficiency are not likely to be the primary cause of anemia in a
patient with kidney failure.
2. A 2-year-old child weighing 32 pounds is to take ferrous sulfate (Feosol) 6 mg/kg/d PO.
How many milligram will the child receive per dose?
A) 47 mg
B) 67 mg
C) 87 mg
D) 107 mg
Ans C
Feedback
The nurse will administer 87 mg per dose. The childs weight is first converted to
kilograms by dividing 32 by 2.2, or 32/2.2 = 14.5 kg. Next, calculate the dose by
multiplying weight times mg/kg/d or 14.5 6 = 87 mg.
3. A nurse caring for a 28-year-old woman with renal failure is to start the patient on epoetin
alfa therapy for iron replacement. What will the nurse assess before initiating therapy?
A) Weight
B) Last menstrual period
C) Intake and output (I & O) for a 24-hour period
Page 1 of 16
, D) Blood type
Ans B
Feedback
The use of epoetin alfa is not recommended during pregnancy or lactation because of
potential adverse effects to the fetus or baby. It is important to determine that the patient
is not pregnant before drug therapy has started so the nurse would assess when the
patient last menstruated. The patients weight, I & O, and blood type are not important
factors in determining whether the drug can be used.
4. The nurse improves patient compliance with the drug regimen of epoetin alfa by
providing what?
A) An appointment card for each drug administration day
B) A calendar to mark the days of the week the drug is to be administered
C) A referral for community transportation
D) The telephone number of the pharmacy where the medication can be purchased
Ans B
Feedback
The nurse should provide the patient with a calendar with the days the drug is to be
administered marked clearly to remind her when the dose is due. The patient can be
taught to self-administer the drug so there is no need for an appointment or arranging
transportation. The patient can use her choice of pharmacy and would not need the
telephone number.
5. A patient who has anemia and a severe GI absorption disorder has been ordered iron
dextran (INFeD). What is the most appropriate nursing diagnosis for the patient related
to the administration of this drug?
A) Acute pain related to drug administration
B) Deficient knowledge regarding drug therapy
C) Risk for injury related to CNS effects
D) Disturbed body image related to drug staining of teeth
A
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, Iron dextran is a parenteral form of iron. It is given intramuscularly and must be given
by the Z-track method. It can be very painful. Certainly, deficient knowledge and risk
for injury are appropriate diagnoses for this patient but would not be related to the
administration of the drug. Because this medication is not given orally, tooth staining
would not be a concern.
6. A 22-year-old woman who has severe dysmenorrhea has been prescribed ferrous
gluconate (Fergon) to treat iron deficiency anemia. What is it important for the nurse
to instruct the patient to avoid when taking the drug?
A) Eggs
B) Chocolate
C) Pork
D) Whole wheat
Ans A
Feedback
Iron is not absorbed if taken with antacids, eggs, milk, coffee, or tea. These
substances should not be administered concurrently. Chocolate, pork, and whole
wheat do not produce drugfood interactions when consumed with an iron
supplement.
7. The nurse develops a care plan for a patient who has been prescribed a folic acid
derivative that includes what priority nursing diagnosis?
A) Deficient knowledge regarding drug therapy
B) Monitor possibility of hypersensitivity reactions
C) Acute pain related to injection or nasal irritation
D) Risk for fluid volume imbalance related to cardiovascular effects
Ans D
Feedback
Nursing diagnoses related to drug therapy might include Risk for fluid volume imbalance
related to cardiovascular effects. Deficient knowledge and acute pain might apply to this
patient, but the priority nursing diagnosis this patient, but the priority nursing diagnosis
for this patient is the risk for fluid imbalance related to cardiovascular effects.
Monitoring for hypersensitivity is not a nursing diagnosis.
8. Before administering an iron preparation, what should the nurse assess?
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