A 50-year-old male patient with a history of chronic alcoholism presents with fatigue, glossitis, and peripheral neuropathy. Laboratory findings show a hemoglobin level of 9.0 g/dL and mean corpuscular volume (MCV) of 110 fL. What type of anemia is most likely in this patient?

Iron deficiency anemia

Vitamin B12 deficiency anemia

Thalassemia minor

Anemia of chronic disease

Answer and Explanation

The Correct Answer is B

A.   Iron deficiency anemia typically presents with a low MCV, not an elevated MCV, and it is less likely to be associated with the symptoms of glossitis and peripheral neuropathy.
B.   Vitamin B12 deficiency anemia is a likely diagnosis in this patient. Chronic alcohol use can lead to malabsorption of vitamin B12, which contributes to macrocytic anemia (high MCV). Symptoms like glossitis and peripheral neuropathy are common in B12 deficiency.
C.   Thalassemia minor usually presents with microcytic anemia and would not typically cause the elevated MCV or neurological symptoms seen in this patient.
D.   Anemia of chronic disease typically presents with a normal or low MCV and is not associated with elevated MCV or the neurological symptoms seen in this patient.

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Correct Answer is D

Explanation

A. Anti-cyclic citrullinated peptide (anti-CCP) antibodies are specific for rheumatoid arthritis but are not necessarily linked to disease activity.
B. Elevated rheumatoid factor (RF) levels are common in rheumatoid arthritis but not always indicative of disease activity.
C. A decreased erythrocyte sedimentation rate (ESR) is typically a sign of less inflammation, not more.
D. Elevated C-reactive protein (CRP) levels are a direct marker of inflammation and are often correlated with increased disease activity in rheumatoid arthritis.

A. Administer the feeding solution directly from the refrigerator. B. Flush the tube with 10 mL of cold water C. Position the patient supine at 30 degrees. D. Verify the pH of gastric aspirate is less than 5.0.

Correct Answer is D

Explanation

A. Administering feeding solution directly from the refrigerator can cause discomfort to the patient and increase the risk of gastric upset.
B. Flushing the tube with cold water is not appropriate, as it may irritate the stomach and cause discomfort.
C. Positioning the patient supine at 30 degrees is unsafe, as it increases the risk of aspiration. The patient should be at a higher angle, typically 30-45 degrees.
D. Verifying the pH of gastric aspirate is crucial to ensure the feeding tube is in the correct position and to prevent aspiration of feeding material into the lungs.

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A 50-year-old male patient with a history of chronic alcoholism presents with fatigue, glossitis, and peripheral neuropathy. Laboratory findings show a hemoglobin level of 9.0 g/dL and mean corpuscular volume (MCV) of 110 fL. What type of anemia is most likely in this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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