A client has had heavy menstrual bleeding for 6 months. Her gynecologist diagnoses microcytic hypochromic anemia and prescribes ferrous sulfate (Feosol), 300mg PO daily. Before initiating iron therapy, the nurse reviews the client's medical history. Which condition would contraindicate the use of ferrous sulfate?

Correct Answer: D

Rationale: Severely impaired liver function is a contraindication for the use of ferrous sulfate. In patients with liver disease, iron metabolism can be affected, leading to potential toxicity from iron accumulation. Ferrous sulfate is primarily metabolized by the liver, so in cases of severely impaired liver function, the metabolism of the drug may be altered, leading to potential adverse effects. It is important to consider alternative iron therapy options in patients with severe liver impairment to avoid potential complications.

Correct Answer: A

Rationale: Joel most likely requires Factor VIII concentrate. Factor VIII deficiency is characteristic of hemophilia A, which is a condition where there is a deficiency in clotting factor VIII. Treatment for hemophilia A involves replacing the missing Factor VIII through Factor VIII concentrate infusions to assist in blood clotting. Fresh frozen plasma and Factor II, VII, IX, X complex are not specific treatments for Factor VIII deficiency.

Correct Answer: C

Rationale: Thrombocytes, also known as platelets, play a crucial role in blood clotting. Medications that depress thrombocytes can lead to decreased clotting ability and an increased risk of bleeding. Therefore, monitoring for signs and symptoms of bleeding is essential. Bleeding gums and dark tarry stools are indicative of bleeding in the oral cavity and gastrointestinal tract, respectively, and are key indicators to watch for in a client taking medications that depress thrombocytes. Options A, B, and D are not directly related to the impact of thrombocyte depression on clotting function.

Correct Answer: A

Rationale: The need for iron increases during pregnancy primarily due to the increased blood volume to support the growing fetus and placenta. Iron is essential for the production of hemoglobin, which helps transport oxygen to both the mother and the developing baby. Pregnant women often require more iron to prevent iron deficiency anemia, which can have negative effects on both the mother and the baby. It is important for pregnant women to consume enough iron-rich foods or take iron supplements as recommended by their healthcare provider to support a healthy pregnancy.

Correct Answer: B

Rationale: The correct instruction the nurse will give to the client scheduled for a Schilling test is to collect his urine for 12 hours. The Schilling test is a diagnostic test used to assess the body's ability to absorb vitamin B12. The test involves collecting urine samples over a period of 24 hours after the client ingests a small amount of radioactive vitamin B12. By collecting urine for 12 hours, the healthcare provider will be able to analyze the excretion of the vitamin and determine the client's ability to absorb vitamin B12. Instructions such as fasting, enema administration, or emptying the bladder before the test are not typically associated with the Schilling test procedure.