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:

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.

Choice A rationale:

The nurse should encourage the client with vitamin B12 deficiency anemia to consume foods rich in vitamin B12.

Meat, poultry, fish, eggs, and fortified cereals are excellent sources of vitamin B12.

Including these foods in the diet can help increase vitamin B12 intake and support the treatment of the deficiency.

Choice B rationale:

Fruits and vegetables high in vitamin C are not directly related to increasing vitamin B12 intake.

Vitamin C is essential for iron absorption, but it does not provide vitamin B12.

Encouraging the consumption of vitamin C-rich foods is important for iron-deficiency anemia, not vitamin B12 deficiency anemia.

Choice C rationale:

Dairy products and nuts are not primary sources of vitamin B12.

While they offer other essential nutrients, they do not provide significant amounts of vitamin B12.

Therefore, they should not be the primary focus when trying to increase vitamin B12 intake.

Choice D rationale:

Foods high in iron and calcium, while important for overall health, are not the primary focus when addressing vitamin B12 deficiency anemia.

Iron and calcium-rich foods are more relevant to iron-deficiency anemia and bone health, respectively.

The primary focus for vitamin B12 deficiency anemia should be on foods rich in vitamin B12, as mentioned in choice A.