A client had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The client takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this client at risk for?

Iron deficiency anemia

Aplastic anemia

Sickle cell anemia

Pernicious anemia

Answer and Explanation

The Correct Answer is A

Reasoning:

Choice A reason: Iron deficiency anemia is a risk post-gastric bypass due to reduced stomach acid and bypassed duodenum, impairing iron absorption. Pantoprazole, a proton pump inhibitor, further reduces acid, exacerbating malabsorption. Fatigue results from low hemoglobin, as iron is essential for red blood cell production, matching the client’s profile.

Choice B reason: Aplastic anemia, caused by bone marrow failure, is not linked to gastric bypass or pantoprazole. It results from autoimmune, toxic, or idiopathic causes, leading to pancytopenia. The client’s surgical history and medication use point to malabsorption, not bone marrow suppression, ruling out this anemia.

Choice C reason: Sickle cell anemia is an inherited hemoglobinopathy, not related to gastric bypass or pantoprazole. It causes hemolytic anemia and vaso-occlusive crises, not malabsorption-related fatigue. The client’s surgical history suggests an acquired nutritional deficiency, making iron deficiency more likely than sickle cell disease.

Choice D reason: Pernicious anemia results from vitamin B12 deficiency, often due to lack of intrinsic factor, which may occur post-gastric bypass. However, pantoprazole primarily impairs iron absorption, and fatigue with this history points to iron deficiency, as B12 absorption is less affected in this scenario.

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Correct Answer is C

Explanation

Reasoning:

Choice A reason: Bradycardia, or slow heart rate, is not typically associated with diabetes insipidus. The condition causes dehydration due to excessive water loss, leading to hypovolemia, which typically increases heart rate (tachycardia) to compensate for reduced blood volume, not slowing it, making bradycardia an unlikely sign.

Choice B reason: Oliguria, or low urine output, is not a feature of diabetes insipidus. The condition results from ADH deficiency, causing the kidneys to produce large volumes of dilute urine (polyuria). Oliguria is more common in conditions like acute kidney injury or dehydration from other causes.

Choice C reason: Hypotension is a clinical sign of diabetes insipidus due to significant water loss from polyuria, leading to hypovolemia. Reduced blood volume decreases blood pressure, as the cardiovascular system struggles to maintain adequate perfusion, making hypotension a common finding in severe or untreated cases.

Choice D reason: Hypertension is not typically associated with diabetes insipidus. The condition leads to dehydration and hypovolemia, which lower blood pressure. Hypertension might occur in conditions like SIADH, where water retention increases blood volume, but this is opposite to the pathophysiology of diabetes insipidus.

A. 12 hours B. 9 hours C. 3 hours D. 6 hours

Correct Answer is C

Explanation

Reasoning:

Choice A reason: Initiating thrombolytic therapy within 12 hours is too late for optimal ischemic stroke outcomes. Beyond 4.5 hours, the risk of hemorrhage outweighs benefits, as ischemic tissue becomes necrotic, reducing the effectiveness of thrombolytics like tPA in restoring blood flow and improving function.

Choice B reason: A 9-hour window for thrombolytic therapy exceeds the recommended time frame for ischemic stroke. After 4.5 hours, the risk of hemorrhagic transformation increases, and neuronal salvage is less likely due to prolonged ischemia, making this time frame ineffective for achieving optimal functional recovery.

Choice C reason: Thrombolytic therapy within 3 hours of ischemic stroke onset maximizes functional outcomes. Tissue plasminogen activator (tPA) dissolves clots, restoring blood flow to viable brain tissue. Early administration minimizes neuronal damage, reduces disability, and improves recovery, with guidelines supporting a 3–4.5-hour window for eligible patients.

Choice D reason: A 6-hour window for thrombolytics is beyond the optimal 3–4.5-hour period for ischemic stroke. While some patients may benefit up to 4.5 hours, delays increase hemorrhage risk and reduce the likelihood of salvaging ischemic tissue, leading to poorer functional outcomes compared to earlier intervention.

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A client had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The client takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this client at risk for?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which clinical sign is associated with diabetes insipidus?

Correct Answer is C

Explanation

Thrombolytic therapy should be initiated within what time frame of an ischemic stroke to achieve the best functional outcome?

Correct Answer is C

Explanation

A client with sickle cell anemia has a:

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