A client with rheumatoid arthritis is being discharged with a prescription for aspirin (Ecotrin), 600mg PO every 6 hours. The nurse should instruct the client to notify the physician if which adverse drug reaction occurs?

Correct Answer: B

Rationale: Tinnitus is a known adverse drug reaction to aspirin, especially at higher doses. Tinnitus is described as ringing, buzzing, or other noises in the ears. If a client experiences tinnitus while taking aspirin, it is important to notify the physician promptly as it could be a sign of aspirin toxicity. Monitoring and managing this adverse reaction are crucial to prevent further complications for the client.

Correct Answer: C

Rationale: Hemophilia is an X-linked disorder, meaning the gene responsible for hemophilia is carried on the X chromosome. Typically, hemophilia is passed down from a carrier mother to her male offspring who then express the disorder. This is because males have only one X chromosome (inherited from their mother), making them more vulnerable to X-linked disorders. Females have two X chromosomes, which means that even if one carries the hemophilia gene, the other X chromosome may carry a normal gene that can compensate, making females less likely to exhibit symptoms of hemophilia. In this case, Joel's disorder aligns with the typical pattern of inheritance for hemophilia as described in statement C.

Correct Answer: C

Rationale: Compatibility between a donor and recipient of blood is determined by testing for compatibility of blood types. The most common blood typing systems are ABO and Rh. In compatibility testing, both the donor and recipient blood samples are mixed in the laboratory. If there is no clumping (agglutination) or hemolysis (rupture of red blood cells) observed when the samples are mixed, then the donor and recipient are considered compatible. Clumping or hemolysis indicates an incompatible blood transfusion, which can lead to serious complications like agglutination, blood clotting, or immune responses. Therefore, the absence of clumping or hemolysis is a key indicator of blood compatibility in transfusion medicine.

Correct Answer: C

Rationale: Patients who have had a splenectomy are at increased risk for infections, particularly those caused by encapsulated bacteria such as Streptococcus pneumoniae. To prevent these infections, it is essential for these patients to receive vaccines against these bacteria. Vaccines recommended for patients who have had a splenectomy include the pneumococcal vaccine, meningococcal vaccine, and Hib vaccine. These vaccines help boost the body's immunity and provide protection against potentially life-threatening infections. It is important for healthcare providers to educate patients about the importance of receiving these vaccines to prevent infections post-splenectomy.

Correct Answer: A

Rationale: Citrus fruits and green leafy vegetables are good sources of vitamin C and non-heme iron, which can help improve iron absorption in individuals with iron deficiency anemia. Bananas and nuts do not have a direct impact on iron absorption. Coffee and tea contain compounds that can inhibit iron absorption. Dairy products, while an important part of a balanced diet, do not specifically aid in improving iron levels. Thus, selecting citrus fruits and green leafy vegetables indicates that the client understands the dietary instructions provided by the nurse to manage iron deficiency anemia.