A client is diagnosed with megaloblastic anemia caused by vitamin B12 deficiency. The physician begins the client on cyanocobalamin (Betalin-12), 100mcg IM daily. Which substance influences Vitamin B12 absorption?

Correct Answer: A

Rationale: Intrinsic factor is a glycoprotein produced by the parietal cells of the stomach. It is essential for the absorption of vitamin B12 in the intestine. Vitamin B12 binds to intrinsic factor in the stomach, forming a complex that is absorbed in the ileum of the small intestine. Without intrinsic factor, vitamin B12 absorption is significantly impaired, leading to conditions like pernicious anemia, which is a type of megaloblastic anemia caused by vitamin B12 deficiency. By administering cyanocobalamin (Betalin-12) intramuscularly, the need for intrinsic factor in the absorption process is bypassed, which is necessary in cases where intrinsic factor production or function is disrupted.

Correct Answer: A

Rationale: Heart biopsy is performed throughout a client's lifetime after heart transplantation mainly to detect rejection. Rejection is a common complication following a heart transplant where the recipient's immune system recognizes the transplanted heart as foreign tissue and attacks it. By conducting heart biopsies, healthcare providers can monitor the health of the transplanted heart and detect signs of rejection early on. This allows for prompt intervention and adjustment of the client's immunosuppressive therapy to prevent further damage to the transplanted heart. Monitoring for rejection through heart biopsies is crucial in ensuring the long-term success of heart transplants and the overall well-being of the recipient.

Correct Answer: B

Rationale: Antacids can interfere with the absorption of iron from ferrous sulfate. Therefore, it is important to take these medications at least 2 hours apart to ensure proper absorption of the iron supplement. Taking them together can reduce the effectiveness of the ferrous sulfate therapy in treating the iron deficiency. It is not necessary to avoid taking an antacid altogether, but timing is crucial to optimize the benefits of both medications.

Correct Answer: C

Rationale: In the ABCD method used to assess skin lesions for possible skin cancer, the letter A stands for Asymmetry. Asymmetry refers to the irregular shape of the lesion when one half of the lesion does not match the other half. Lesions that are symmetrical are less likely to be concerning for skin cancer, while asymmetrical lesions should be further evaluated by a healthcare professional. This characteristic helps in identifying potentially worrisome skin lesions early on for appropriate management.

Correct Answer: C

Rationale: The ethical principle most relevant in this situation is autonomy. Autonomy refers to a person's right to make decisions about their own care and treatment. In this case, the client is expressing her wish to avoid surgery and believes her condition will improve on its own. It is important for the nurse to respect the client's autonomy and involve her in the decision-making process regarding her treatment. The nurse should provide information, support, and guidance to help the client make an informed decision that aligns with her values and preferences. While the nurse can provide education and encourage the client to consider the physician's recommendation, ultimately the decision should respect the client's autonomy.