The 38-year-old patient who strictly adheres to a vegan diet complains of weakness and tingling in her lower extremities. She retains the strength in her lower extremities but proprioception is decreased.  Her complete blood count reveals a megaloblastic anemia. Which statement by the nurse is most appropriate? 

A 16-year-old boy is brought to the clinic by his mother with complaints of strange noises and movements. The boy states, “I can’t stand that I make this weird noise with my mouth. I can feel it coming, and I try to stop it for as long as I can, but eventually it just comes out. The other kids at school make fun of me. It’s so embarrassing.” The mother reports that the boy gets good grades and has no trouble concentrating at home when doing homework. Which information does the nurse give the patient and his mother about the medication he will be prescribed?  

The 18-year-old patient presents with pallor, shortness of breath, and bleeding from the gums. Extensive testing is performed and a diagnosis of very severe aplastic anemia is made. Which additional information is most important to direct treatment?