An 80-year-old woman has chronically low hemoglobin despite a ...

[jman1234]

An 80-year-old woman has chronically low hemoglobin despite a diet high in iron. The primary care nurse practitioner (NP) will perform laboratory tests to confirm a diagnosis and should suspect the patient will need:
 
  a. omega-3 supplements.
  b. a folic acid supplement.
  c. a daily multivitamin with iron.
  d. a diet high in green, leafy vegetables.

Question 2

A patient has been using a nicotine nasal spray for 4 months, one to two doses every hour while awake and as needed for cravings. The patient reports that the cravings have stopped and that one dose per hour is generally sufficient.
 
  The primary care NP should recommend: a. changing to Nicorette gum as needed.
  b. using a low-dose 16-hour patch for 2 weeks.
  c. continuing one dose per hour for 2 more months and then discontinuing.
  d. beginning one dose every 2 hours for 1 week and then one dose every 4 hours.

[ynlevi]

Answer to Question 1

B
Women and elderly adults are often at risk for folic acid deficiency leading to anemia because folic acid is necessary for synthesis of hemoglobin. Folic acid supplements are indicated. Omega-3 supplements are not indicated for anemia. If anemia is caused by iron deficiency alone, iron supplements must be used, which have more iron than a multivitamin with iron. Folic acid supplements are more effective than dietary folic acid.

Answer to Question 2

D
Once the patient is showing improvement, the nasal spray should be tapered by halving the number of doses used each week. Patients should not switch products, so nicotine replacement gum or the patch is not indicated. Tapering is recommended rather than an abrupt discontinuation to prevent acute withdrawal symptoms, which may contribute to relapse.

[jman1234]

TY

[ynlevi]

You're welcome