A nurse is educating a group of nursing students about the diagnostic evaluation of vitamin B12 deficiency anemia.
Which laboratory test measures the absorption of radioactive vitamin B12 in the urine and helps differentiate between pernicious anemia and other causes of malabsorption?

Choice A rationale:

Dyspnea.

Rationale: Dyspnea refers to difficulty breathing and is not a characteristic symptom of vitamin B12 deficiency anemia.

Symptoms of vitamin B12 deficiency anemia are primarily related to the blood and nervous system.

Choice B rationale:

Numbness and tingling of extremities.

Rationale: Numbness and tingling of extremities (peripheral neuropathy) can be a symptom of vitamin B12 deficiency anemia, but it is not related to the specific complaint of soreness, redness, and smoothness of the tongue mentioned in the question.

Choice C rationale:

Glossitis.

Rationale: This is the correct answer.

Glossitis refers to inflammation of the tongue, which can result in soreness, redness, and a smooth appearance of the tongue.

It is a distinctive feature of vitamin B12 deficiency anemia, as vitamin B12 plays a role in maintaining the health of the oral mucosa and nerves.

Choice D rationale:

Memory loss.

Rationale: Memory loss is not a typical symptom of vitamin B12 deficiency anemia.

Symptoms related to the nervous system, such as numbness and tingling, are more common neurological manifestations of the condition.

Choice A rationale:

Oral supplements are less effective in raising vitamin B12 levels.

Rationale: Vitamin B12 deficiency anemia often results from malabsorption issues in the gastrointestinal tract, where the body cannot adequately absorb vitamin B12 from the digestive system.

In such cases, oral supplements may not be effective because they rely on the digestive system for absorption.

In contrast, vitamin B12 injections bypass the gastrointestinal tract, delivering the vitamin directly into the bloodstream, ensuring absorption, and increasing the effectiveness of treatment.

Choice B rationale:

Injections are less painful for the client.

Rationale: While the pain associated with injections can vary from person to person, it is not the primary reason for choosing injections over oral supplements in the treatment of vitamin B12 deficiency anemia.

The primary consideration is the effectiveness of absorption, as discussed in Choice A's rationale.

Choice C rationale:

Injections have fewer side effects.

Rationale: Both oral supplements and vitamin B12 injections have their own set of potential side effects, but the choice between the two primarily depends on the underlying cause of the deficiency and the ability to absorb vitamin B12.

Therefore, the assertion that injections have fewer side effects is not the primary reason for choosing them.

Choice D rationale:

Oral supplements may cause gastrointestinal distress.

Rationale: This is the correct answer.

Oral supplements of vitamin B12 may cause gastrointestinal distress, particularly in individuals with gastrointestinal issues.

These supplements can be hard for some individuals to tolerate, leading to discomfort, gas, or other gastrointestinal symptoms.

This is a significant consideration when choosing the route of administration for vitamin B12 treatment.