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

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. Glucagon 1 mg IM: Glucagon is used to treat severe hypoglycemia when the client is unconscious, having seizures, or unable to take oral glucose. It stimulates glycogen breakdown in the liver, raising blood glucose levels. IM administration is appropriate for rapid effect in an emergency.

B. Continuous IV infusion of regular insulin: Insulin lowers blood glucose levels, which would worsen hypoglycemia. Administering insulin in this situation is inappropriate and could exacerbate the client’s condition.

C. 10 g of oral glucose gel: Oral glucose is suitable for mild to moderate hypoglycemia in a conscious client. However, since the client is experiencing a seizure, they are unable to swallow safely, making this option unsafe.

D. 1 L bolus of 0.45% sodium chloride over 1 hr: Hypoglycemia is not primarily treated with IV fluids unless the client is severely dehydrated. The priority in this case is to correct the low blood glucose level rather than administering hypotonic fluids.

A. Increased body hair B. Decreased blood urea nitrogen level C. Hyperpigmentation of the skin D. Hypocalcemia

Correct Answer is C

Explanation

A. Increased body hair: Adrenal insufficiency leads to decreased androgen production, which may cause hair thinning rather than increased body hair. Hypertrichosis (excessive hair growth) is not a typical finding in adrenal insufficiency.

B. Decreased blood urea nitrogen level: Adrenal insufficiency is often associated with dehydration due to aldosterone deficiency, leading to reduced sodium retention and increased fluid loss. This can result in elevated blood urea nitrogen (BUN) levels rather than a decrease.

C. Hyperpigmentation of the skin: Increased melanocyte-stimulating hormone (MSH) activity, triggered by elevated adrenocorticotropic hormone (ACTH) levels, causes darkening of the skin, especially in sun-exposed areas, skin folds, and mucous membranes. This is a hallmark feature of primary adrenal insufficiency (Addison’s disease).

D. Hypocalcemia: Adrenal insufficiency is more commonly associated with hypercalcemia rather than hypocalcemia. Decreased cortisol levels can lead to reduced renal calcium excretion, contributing to elevated serum calcium levels.

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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.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has diabetes mellitus and cool, clammy skin. The client begins having a seizure. Which of the following treatments should the nurse administer?

Correct Answer is A

Explanation

A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

A nurse is reviewing the laboratory results of a group of clients. Which of the following client conditions requires reporting to the local health department?

A nurse is assessing a client following extubation from a ventilator. For which of the following findings should the nurse intervene immediately

A nurse is reviewing the results of electrocardiography monitoring for a client who has atrial fibrillation. Which of the following findings should the nurse expect?

The nurse is caring for the client who has iron deficiency anemia. Which of the following instructions should the nurse include? Select all that apply.

A nurse is assessing a client who is 24 hr postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?

A nurse is planning care for a client who has a new diagnosis of sepsis. Which of the following interventions is the nurse's priority?

A home health nurse is planning to use nonpharmacological pain relief measures for a client who has severe chronic back pain. Which of the following pain management guidelines should the nurse use?

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which of the following findings indicates the client is experiencing fluid volume overload?

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.