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 ["B","E","F","G"]

Explanation

A. Positioning the patient supine can increase the risk of aspiration and should be avoided during feeding. The head of the bed should be elevated instead.
B. Monitoring gastric residual volumes is important to assess the tolerance of the feeding and prevent aspiration.
C. Feedings should be given slowly to avoid complications like gastric distention, not rapidly.
D. Using sterile gloves when handling a feeding tube is not necessary unless there is a risk for infection, but clean gloves are generally adequate.
E. Flushing the tube with water before and after medication administration helps to maintain patency and prevent clogging.
F. The head of the bed should be elevated at least 30 degrees during feeding to reduce the risk of aspiration.
G. Verifying tube placement before starting the feeding ensures that the feeding is going into the stomach and not the lungs.

A. Almond milk B. Low-fat milk C. Whole milk D. Soy milk

Correct Answer is B

Explanation

A. Almond milk can be a good source of calcium, but it is often lower in calcium compared to dairy products unless fortified.
B. Low-fat milk is an excellent source of calcium and is also easy for most people to digest.
C. Whole milk contains calcium, but it is higher in fat, which is not ideal for individuals at risk for osteoporosis.
D. Soy milk can be a good source of calcium if fortified, but it does not always contain as much calcium as low-fat milk.

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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

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