A nurse in a provider's office is caring for a client.
For each client's finding, click to specify if the assessment finding is consistent with sickle cell disease, iron deficiency anemia, and/or pernicious anemia. Each finding may support more than 1 disease process.
Vitamin B12 level
Orthostatic hypotension
Ferritin level
Fatigue
The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A,B,C"}}
Sickle Cell Disease:
• Fatigue
Iron Deficiency Anemia:
• Ferritin level
• Fatigue
• Orthostatic hypotension
Pernicious Anemia:
• Vitamin B12 level
• Fatigue
Rationale:
• Vitamin B12 level: A decreased vitamin B12 level is characteristic of pernicious anemia, which results from impaired absorption of vitamin B12 due to intrinsic factor deficiency.
• Orthostatic hypotension: A drop in blood pressure upon standing is commonly seen in iron deficiency anemia due to reduced oxygen-carrying capacity and inadequate perfusion.
• Ferritin level: A low ferritin level indicates depleted iron stores, which is a hallmark of iron deficiency anemia.
• Fatigue: Fatigue is a common symptom in all three conditions due to reduced oxygen delivery to tissues. In sickle cell disease, fatigue results from chronic hemolysis and vaso-occlusive episodes. In iron deficiency anemia, it is caused by insufficient hemoglobin production. In pernicious anemia, fatigue results from ineffective erythropoiesis due to vitamin B12 deficiency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "I will hold my cellphone on the opposite side of the pacemaker.": Cellphones emit electromagnetic signals that can interfere with pacemaker function if held directly over the device. Keeping the phone on the opposite side minimizes the risk of interference and ensures proper pacemaker function.
B. "I can resume physical activity within 2 weeks.": Strenuous physical activity should be avoided for about 4-6 weeks to allow proper healing of the pacemaker site. Early resumption of activity can lead to lead dislodgement or complications.
C. "I need to cover my pacemaker with a dressing when I shower.": After the initial post-procedure period, there is no need to keep the pacemaker site covered while showering. The incision should be kept dry until it fully heals, but a permanent dressing is unnecessary.
D. "I should avoid using a microwave oven.": Modern pacemakers are shielded against microwave interference, making it safe to use a microwave. This is a common misconception, as older pacemakers were more susceptible to electrical interference.
Correct Answer is B
Explanation
A. A client who has aspiration pneumonia: Pneumonia leads to hypoventilation and carbon dioxide retention, which causes respiratory acidosis. It does not typically result in metabolic alkalosis since it affects gas exchange rather than acid-base balance at the metabolic level.
B. A client who is receiving continuous gastric suctioning: Prolonged removal of gastric secretions depletes hydrochloric acid, leading to an excess of bicarbonate in the blood and resulting in metabolic alkalosis. This is a common cause of alkalosis, along with excessive vomiting or diuretic use.
C. A client who is experiencing an opioid overdose: Opioids depress the respiratory system, reducing ventilation and causing carbon dioxide buildup, leading to respiratory acidosis. This does not cause metabolic alkalosis, as the issue originates in the lungs, not metabolism.
D. A client who has uncontrolled diabetes mellitus: Diabetic ketoacidosis results in excessive production of acidic ketone bodies, which lower blood pH and cause metabolic acidosis. The acid-base disturbance in diabetes is typically acidosis, not alkalosis.
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