Answer to Question 1
Correct Answer: 2
Rationale 1: Ascorbic acid affects the stability of cyanocobalamin (Nascobal), and should not be used concomitantly with cyanocobalamin.
Rationale 2: Cyanocobalamin (Nascobal), oral formulation, is a Pregnancy Category A drug, but it is a Pregnancy Category C when used parenterally.
Rationale 3: There is no evidence to support that oral cyanocobalamin (Nascobal) is teratogenic during the first or second trimesters.
Rationale 4: Cyanocobalamin (Nascobal) is a Pregnancy Category C when used parenterally.
Answer to Question 2
Correct Answer: 1
Rationale 1: The most serious adverse effect of epoetin alfa (Epogen) is hypertension, which can raise blood pressure to dangerous levels, and which occurs in as many as 30 of clients receiving the drug.
Rationale 2: Clients are at risk for a stroke, but this is a complication of uncontrolled hypertension; blood pressure assessment is a priority.
Rationale 3: Assessment of hypertension takes precedence over injection techniques.
Rationale 4: Hemoglobin and hematocrit levels should be assessed, but they are not as high a priority as blood pressure.