A client comes to the clinic reporting fatigue. Laboratory findings reveal a low serum iron level, a low transferrin saturation, and a low ferritin level. Which type of anemia does the nurse suspect that correlates with these laboratory findings?

Sickle cell disease

Pernicious anemia

Hemolytic anemia

Iron deficiency anemia

Answer and Explanation

The Correct Answer is D

Reasoning:

Choice A reason: Sickle cell disease is a hemolytic anemia caused by a hemoglobin mutation, not low iron. Laboratory findings show normal or elevated iron due to hemolysis, not low serum iron, transferrin saturation, or ferritin, which are specific to iron deficiency, ruling out sickle cell anemia.

Choice B reason: Pernicious anemia results from vitamin B12 deficiency, impairing DNA synthesis and red blood cell maturation. It is not associated with low serum iron, transferrin saturation, or ferritin, which reflect iron stores. Pernicious anemia typically shows megaloblastic changes, not microcytic anemia, unlike iron deficiency.

Choice C reason: Hemolytic anemia involves red blood cell destruction, often increasing iron levels due to hemoglobin breakdown. Low serum iron, transferrin saturation, and ferritin are not typical, as hemolysis does not deplete iron stores. These findings point to iron deficiency, not hemolytic processes.

Choice D reason: Iron deficiency anemia is characterized by low serum iron, transferrin saturation, and ferritin, reflecting depleted iron stores. Iron is essential for hemoglobin synthesis, and its deficiency causes microcytic, hypochromic anemia, leading to fatigue, matching the client’s laboratory findings and clinical presentation accurately.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: Bleeding, particularly gastrointestinal, is the most common cause of iron deficiency anemia in males and postmenopausal females. Blood loss reduces iron stores, as hemoglobin contains iron, and chronic bleeding (e.g., from ulcers or colon cancer) depletes iron faster than dietary intake can replenish, leading to anemia.

Choice B reason: Chronic alcohol use may contribute to anemia through nutritional deficiencies or liver disease, but it is not the primary cause. Alcohol can impair folate metabolism or cause gastrointestinal bleeding, but direct blood loss is a more common and significant driver of iron deficiency in these populations.

Choice C reason: Menorrhagia, or heavy menstrual bleeding, is a common cause of iron deficiency anemia in premenopausal women, not males or postmenopausal females. After menopause, menstruation ceases, eliminating this as a cause, making bleeding from other sources, like the gastrointestinal tract, more relevant.

Choice D reason: Iron malabsorption, as in celiac disease or gastric surgery, can cause iron deficiency but is less common than bleeding. Malabsorption impairs dietary iron uptake, but chronic blood loss, especially from gastrointestinal sources, is the leading cause in males and postmenopausal females due to higher prevalence.

A. Above-normal urine osmolality level, below-normal serum osmolality level B. Above-normal urine and serum osmolality levels C. Below-normal urine osmolality level, above-normal serum osmolality level D. Below-normal urine and serum osmolality levels

Correct Answer is C

Explanation

Reasoning:

Choice A reason: Above-normal urine osmolality and below-normal serum osmolality are not consistent with diabetes insipidus. High urine osmolality suggests concentrated urine, typical in syndrome of inappropriate antidiuretic hormone (SIADH), where ADH is excessive. Low serum osmolality also aligns with SIADH due to water retention, not the water loss seen in diabetes insipidus.

Choice B reason: Above-normal urine and serum osmolality levels do not reflect diabetes insipidus. High urine osmolality indicates concentrated urine, which contradicts the dilute urine output of diabetes insipidus. High serum osmolality could occur with dehydration, but the combination with high urine osmolality suggests another condition, not ADH deficiency.

Choice C reason: Below-normal urine osmolality and above-normal serum osmolality are classic findings in diabetes insipidus. Arginine vasopressin (ADH) deficiency impairs water reabsorption, leading to dilute urine (low osmolality). The resulting water loss increases serum osmolality as the body becomes dehydrated, supporting the diagnosis of diabetes insipidus.

Choice D reason: Below-normal urine and serum osmolality levels are inconsistent with diabetes insipidus. Low urine osmolality occurs due to ADH deficiency, but low serum osmolality suggests water retention, as in SIADH. Diabetes insipidus causes dehydration, elevating serum osmolality, not lowering it, making this combination unlikely in this condition.

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A client comes to the clinic reporting fatigue. Laboratory findings reveal a low serum iron level, a low transferrin saturation, and a low ferritin level. Which type of anemia does the nurse suspect that correlates with these laboratory findings?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The most common cause of iron deficiency anemia in male clients and postmenopausal female clients is:

Correct Answer is A

Explanation

Correct Answer is C

Explanation

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