Question

57. The nurse is caring for a client who states that he recently been taking dextromethorphan for cough suppression. The nurse should contact the provider promptly if the client also takes which other medication? A) Verapamil B) Phenelzine C) Metoprolol D) Hydrochlorothiazide 8What drugs might the nurse administer that have been developed to stimulate the formation of red blood cells? Select all that apply. A) Levoleucovorin B) Hydroxocobalamin C) Darbepoetin alfa D) Methoxy polyethylene glycol-epoetin beta E) Epoetin alfa 59. A 22-year-old client with no significant health history reports severe fatigue. The client is found to be anemic as a result of vitamin B12 deficiency. What assessment question by the nurse best addresses a potential etiology? A) "How would you describe your menstrual periods?" B) "Do you eat meat or animal products?" C) "Does anyone in your family have problems like this?" D) "Does your job involve exposure to any toxins?" 60. The nurse is providing care for a client who has sickle cell anemia and who is being treated with hydroxyurea. When providing health education, what topic should the nurse prioritize? A) Management of gastrointestinal irritation B) The importance of keeping immunizations up to date C) Dietary D) Foods that are high in vitamin B12 sources of iron

Answer 1

ANSWER 57.

OPTION (C ) PHENELZINE IS THE RIGHT ANSWER

DEXTROMETHORPHAN

The action of Dextromethorphan Is to suppress the cough reflex by a direct effect on the cough center in the medulla. its structure is like opioids but has no analgesic properties and causes relief from the non-productive cough.

(c) option

PHENELZINE is the monoamine oxidase inhibitor when taken with DEXTROMETHORPHAN may result in serotonin syndromes such as nausea, confusion, and increases blood pressure.

VERAPAMIL -- it is the calcium channel blocker its action is to inhibit the calcium into the myocardium and to the smooth muscles which inhibit the subsequent contractions of the myometrium.and it has no adverse interaction with DEXTROMETHORPHAN.

METOPROLOL --- It is a beta blocker which blocks the beta receptor stimulation in the myocardium, it decreases blood pressure and the heart rate and also reduces the risk of frequent angina pectoris.

HYDROCHLOROTHIAZIDE ---- It is a thiazide diuretic and antidiuretic, which helps in removal of fluid that is extra fill in the body which causes swelling due to various factors, and has no adverse interaction with the DEXTROMETHORPHAN.

ANSWER 58.

LEVOLEUCOVERIN--- it is folic acid analogs and its action is to act as the reduced form of folic acid that forms as a cofactor in the synthesis of DNA and RNA, it also works as the reversal of folic acid deficiency and reversal of toxic effects of folic acid antagonists, that helps in the stimulation of red blood cell formation.

HYDROXOCOBALAMIN--- It is vitamin B12 and also called folate which is used to treat anemia and stimulates the production of red blood cells, it provides needed and the important methyl groups which help in the proper functioning of the DNA and protein synthesis within the body, lack of vitamin B12 can lead to damage to the nerves and may affect memory.

DARBEPOETIN ALFA--- It is a hormone and therapeutically it is used as an anti anemics, it is used to treat anemia associated with the renal failure and also used to treat chemotherapy induces anemias in non-myeloid malignancies.

its action is to stimulate erythropoiesis and elevates red blood cell count and it also decreases the need for transfusions.

METHOXY POLYETHYLENE GLYCOL EPOETIN BETA

it is an erythropoietin stimulating agent which helps in stimulation of the production of red blood cell especially anemia caused by chronic kidney disease, it has a longer half-life than erythropoietin and reverses anemia.

EPOETIN ALFA

It is the method of production of erythropoietin in the human cells using a recombinant DNA technology, it is used to treat anemia associated with chronic renal disease or the anemia that occur during chemotherapy while treating cancer, it stimulates the production of red blood cells by signaling bone marrow.

hence all the given options are correct.

ANSWER 59

OPTION C IS THE CORRECT ANSWER

VIT B12 is one of the important vitamins that are important for brain functioning and the DNA SYNTHESIS lack of Vit B12 can affect the nervous system that can cause fatigue and confusion,

assessment question by the nurse best addresses the potential etiology is (option C )and that is whether she adds  

meat or animal products in her diet, vitamin B 12 provides energy to the red blood cell and makes it capable of carrying oxygen to all part of the body, lack of vitamin B12 makes body's cell incapable of providing energy that leads to fatigue, weakness, and confusion.

menstrual problem is mainly seen in iron deficiency anemia, family problems and exposure to toxins will not be the potential etiology.

ANSWER 60.

HYDROXYUREA IS THE Drug which is used to treat sickle cell anemia and cancer,

in sickle cell anemia the shape of RBCs are developed like a sickle which makes it difficult to move or pass through the blood vessels, hydroxyurea maintains the shape of the RBCs round which makes them move easily through the blood vessels, it also helps in the reduction of pain caused by anemia, fewer chest symptoms and reduces length of stay in the hospital,

While providing health education the nurse will prioritize the importance of keeping immunization up to date because hydroxyurea works effectively when taken regularly without any missing dose, missing doses although doesn't reduce the benefit of the drug, it is taught to the patient to set alarms and reminders to take medication doses without getting missed,

hence option (b) is the right answer.

remaining options are not the priority health education but those points are also the important points that patient has to follow while he is on medication hydroxyurea, such as taking vitamin B12 rich diet, iron-rich diet, etc.