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 contraindicated in clients with low sodium levels due to the risk of hyponatremia. By having a sodium level of 130 mEq/L, the client is at risk for further lowering of sodium levels if desmopressin is administered. Therefore, the nurse should clarify the prescription with the provider to ensure the safety of the client. B: Administer the drug with an analgesic - Irrelevant and not related to the administration of desmopressin in a client with hemophilia A and low sodium levels. C: Administer the required dose orally - The route of administration does not address the concern of potential hyponatremia with desmopressin. D: Assess factor IX levels - While important in managing hemophilia A, assessing factor IX levels does not address the immediate concern of potential harm from desmopressin administration in a

Correct Answer: C

Rationale: The correct answer is C: Enlarged spleen. Filgrastim stimulates the production of neutrophils, which can lead to splenomegaly as the spleen stores a large number of these cells. This can cause symptoms such as abdominal discomfort or fullness. Dusky nail beds (A), petechiae (B), and swollen calf (D) are not typically associated with filgrastim therapy and are more likely related to other conditions or medications.

Correct Answer: D

Rationale: The correct answer is D: Inhibiting cyclooxygenase action in platelets. Aspirin works by irreversibly inhibiting cyclooxygenase, specifically COX-1, in platelets. By inhibiting COX-1, aspirin prevents the formation of thromboxane A2, which is a potent platelet aggregator. This action reduces platelet aggregation and ultimately decreases the risk of clot formation leading to a cardiovascular event. Choice A is incorrect because aspirin does not activate thromboxane A2, but rather inhibits its formation. Choice B is incorrect as aspirin does not block adenosine diphosphate receptors. Choice C is incorrect as aspirin does not suppress specific clotting factors, but rather inhibits platelet function through the mechanism described above.

Correct Answer: C

Rationale: Normocytic normochromic anemia is characterized by normal-sized red blood cells with normal hemoglobin content. Pregnancy is associated with increased blood volume and physiological hemodilution, leading to normocytic normochromic anemia. Iron deficiency (choice A) typically presents as microcytic hypochromic anemia. Primaquine (choice B) is associated with hemolytic anemia. Sickle cell disease (choice D) is characterized by sickle-shaped red blood cells and is associated with hemolytic anemia, making it different from normocytic normochromic anemia.

Correct Answer: D

Rationale: In microcytic hypochromic anemia, red cells are smaller with decreased hemoglobin content, leading to pale appearance. Choice D is correct as it describes the typical characteristics of microcytic hypochromic anemia. Choice A is incorrect as red cells are smaller, not larger. Choice B is incorrect as red blood cell count is usually decreased. Choice C is incorrect as both hematocrit and mean corpuscular hemoglobin are decreased in microcytic hypochromic anemia.