A nurse cares for several clients with anemia and notes that all the clients have different types of anemia. What is the nurse’s best understanding of how anemias are classified, based on the deficiency of erythrocytes? (Select all that apply)

Defective production of erythrocytes

Destruction of erythrocytes

Loss of erythrocytes

Shape of erythrocytes

Quantity of erythrocytes

Answer and Explanation

Correct Answer : A,B,C

Reasoning:

Choice A reason: Defective production of erythrocytes is a key classification of anemia, as seen in conditions like aplastic anemia or iron deficiency anemia. Impaired bone marrow function or nutrient deficiencies reduce red blood cell synthesis, leading to decreased hemoglobin and oxygen-carrying capacity, a common mechanism in various anemias.

Choice B reason: Destruction of erythrocytes, or hemolysis, is a major anemia classification. Conditions like hemolytic anemia cause premature red blood cell breakdown due to immune-mediated destruction, membrane defects, or hemoglobinopathies, reducing circulating erythrocytes and causing anemia despite normal or increased bone marrow production.

Choice C reason: Loss of erythrocytes through bleeding is a primary anemia classification. Chronic or acute blood loss from gastrointestinal, genitourinary, or traumatic sources depletes red blood cells and iron stores, leading to iron deficiency anemia, a common cause, particularly in older adults or those with chronic bleeding.

Choice D reason: Shape of erythrocytes is not a primary classification for anemia. While abnormal shapes, like sickle cells, contribute to specific anemias (e.g., sickle cell anemia), classification focuses on mechanisms like production, destruction, or loss. Shape is a characteristic, not a primary cause of anemia.

Choice E reason: Quantity of erythrocytes is a consequence, not a classification, of anemia. All anemias involve reduced erythrocyte counts, but the classification is based on underlying causes—defective production, destruction, or loss—not the resulting low quantity, which is a defining feature rather than a mechanistic category.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: Diabetes insipidus is likely due to the client’s symptoms of polyuria, thirst, and weight loss following a head injury. Trauma can disrupt the posterior pituitary, reducing ADH secretion, leading to excessive dilute urine output, dehydration, and subsequent thirst and weight loss from fluid depletion, consistent with central DI.

Choice B reason: A pituitary tumor may cause diabetes insipidus but is not the condition itself. Tumors can disrupt ADH production, but the symptoms described—polyuria, thirst, and weight loss—point directly to diabetes insipidus as the primary condition, with a tumor being a potential underlying cause requiring further investigation.

Choice C reason: Hypothyroidism, caused by thyroid hormone deficiency, leads to symptoms like fatigue and weight gain, not polyuria or weight loss. It is unrelated to head injury or ADH dysfunction, making it an unlikely diagnosis for the client’s symptoms of excessive urine output and dehydration.

Choice D reason: SIADH causes water retention, leading to concentrated urine, hyponatremia, and potential weight gain, opposite to the client’s symptoms of dilute urine, weight loss, and thirst. Head injury may cause SIADH, but the clinical presentation aligns with diabetes insipidus, not water retention.

A. Iron deficiency anemia B. Aplastic anemia C. Sickle cell anemia D. Pernicious anemia

Correct Answer is A

Explanation

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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A nurse cares for several clients with anemia and notes that all the clients have different types of anemia. What is the nurse’s best understanding of how anemias are classified, based on the deficiency of erythrocytes? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

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?

Correct Answer is A

Explanation

A client has a history of sickle cell anemia with several sickle cell crises over the past 10 years. What blood component results in sickle cell anemia?

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Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex?

Which outcome indicates that treatment of a client with diabetes insipidus has been effective?

Which endocrine disorder causes the client to have dilutional hyponatremia?

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