A nurse is preparing to administer a prescribed dose of desmopressin to a client who has hemophilia A. The client's laboratory results indicate that the client has a sodium level of 130 mEq/L. Which of the following actions should the nurse take?

Correct Answer: A

Rationale: The correct answer is A: Clarify the prescription with the provider. Desmopressin is a medication that can cause hyponatremia, especially in patients with low sodium levels like this client. Before administering desmopressin, the nurse should consult with the provider to ensure it is safe to administer the medication given the client's sodium level. Administering the drug without clarifying may worsen the hyponatremia. Choice B is incorrect because administering the drug with an analgesic is not necessary or relevant in this situation. Choice C is incorrect because desmopressin is typically administered via injection, not orally. Choice D is incorrect because assessing factor IX levels is not directly related to the administration of desmopressin in this scenario.

Correct Answer: C

Rationale: Step-by-step rationale for why choice C is correct: 1. Filgrastim stimulates the production of neutrophils. 2. An enlarged spleen can indicate an increase in neutrophils. 3. Therefore, assessing the client for an enlarged spleen is crucial to monitor the drug's effectiveness and potential adverse effects. Summary of why other choices are incorrect: A: Dusky nail beds - Not directly related to filgrastim or neutropenia. B: Petechiae - Typically associated with low platelet count, not neutrophil increase. D: Swollen calf - Unlikely to be a direct adverse effect of filgrastim for neutropenia.

Correct Answer: D

Rationale: The correct answer is D: Inhibiting cyclooxygenase action in platelets. Aspirin inhibits cyclooxygenase, specifically COX-1, in platelets, leading to the inhibition of thromboxane A2 production. Thromboxane A2 is a potent platelet aggregator. By inhibiting its production, aspirin reduces platelet aggregation, thus reducing the risk of cardiovascular events. A: Activating thromboxane A2 - This is incorrect because aspirin actually inhibits the production of thromboxane A2. B: Blocking adenosine diphosphate receptor agonists - This is incorrect because aspirin primarily works through the inhibition of cyclooxygenase, not adenosine diphosphate receptors. C: Suppressing specific clotting factors - This is incorrect because aspirin's primary mechanism of action is through platelet inhibition, not through suppressing clotting factors.

Correct Answer: C

Rationale: Normocytic normochromic anemia is characterized by normal-sized red blood cells with normal hemoglobin content. Pregnancy is associated with this type of anemia due to increased blood volume and iron demands. Iron deficiency anemia (choice A) is typically microcytic hypochromic. Primaquine (choice B) is not known to cause normocytic normochromic anemia. Sickle cell disease (choice D) results in hemolytic anemia with abnormal red blood cell morphology. Thus, the correct answer is C as it aligns with the characteristics of normocytic normochromic anemia.

Correct Answer: D

Rationale: In microcytic hypochromic anemia, the correct answer is D because red cells are smaller (microcytic) and have a pale large central pallor (hypochromic). This is due to decreased hemoglobin content and iron deficiency. Choice A is incorrect as red cells are smaller, not larger. Choice B is incorrect as the red blood cell count is typically decreased in this type of anemia. Choice C is incorrect as both hematocrit and mean corpuscular hemoglobin are decreased in microcytic hypochromic anemia, not normal. Therefore, the correct answer is D based on the characteristic features of microcytic hypochromic anemia.