A patient presents with fatigue, weakness, shortness of breath, and a sore, red tongue. These symptoms are indicative of:
Vitamin C deficiency
Iron deficiency anemia
Vitamin B-12 deficiency
Folate deficiency
The Correct Answer is C
A. Vitamin C deficiency: Scurvy, or vitamin C deficiency, typically manifests as capillary fragility leading to petechiae, ecchymosis, and friable, bleeding gums. While it can cause systemic weakness, it does not typically produce the classic beefy red tongue associated with megaloblastic changes. This deficiency primarily impacts collagen synthesis rather than the maturation of rapidly dividing epithelial and hematologic cells.
B. Iron deficiency anemia: This condition characterized by microcytic, hypochromic erythrocytes often presents with fatigue and pica, but the lingual signs are different. Patients with low iron usually exhibit glossitis characterized by a pale, smooth, or atrophic tongue rather than a sore, red one. The shortness of breath is common to all anemias, but the specific lingual inflammation points elsewhere.
C. Vitamin B-12 deficiency: Cobalamin deficiency impairs DNA synthesis, leading to megaloblastic anemia and the characteristic inflammation of the tongue known as Hunter's glossitis. The sore, red tongue results from the atrophy of lingual papillae and underlying mucosal inflammation. This deficiency also accounts for the decreased oxygen-carrying capacity that causes fatigue, weakness, and exertional dyspnea in affected patients.
D. Folate deficiency: Although folate deficiency also causes megaloblastic anemia and can result in glossitis, it is less commonly associated with the severe, painful red tongue seen in B-12 deficiency. Furthermore, folate deficiency lacks the neurologic complications that often accompany cobalamin issues. In clinical examinations, the combination of these specific systemic and lingual symptoms most strongly suggests a lack of vitamin B-12.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. HIV results from genetic mutations in the immune system, leading to immune deficiency: This statement describes a primary immunodeficiency, which is an intrinsic, hereditary defect present from conception. HIV is a viral infection that invades a previously functional immune system, not a product of the host's genetic code. Primary disorders are usually diagnosed in infancy, whereas HIV is an exogenous pathological acquisition.
B. HIV is acquired later in life through environmental factors and affects immune function: Secondary immunodeficiencies are characterized by an external cause, such as a pathogen, medication, or malnutrition, that impairs an otherwise normal immune system. HIV specifically targets and depletes CD4+ T-lymphocytes, leading to progressive immune failure. Because the deficit is caused by a viral agent rather than an internal genetic flaw, it fits the secondary classification.
C. HIV is present from birth and primarily affects children and adolescents: While vertical transmission from mother to child can occur, being "present from birth" is not the defining characteristic of a secondary immunodeficiency. Many primary immunodeficiencies are present from birth due to genetics. HIV is classified based on its extrinsic viral etiology regardless of the age at which the patient originally contracts the virus.
D. HIV is characterized by a complete absence of the immune system’s components: HIV causes a progressive decline in specific immune subsets, notably helper T-cells, rather than a total anatomical absence of all immune components. Severe combined immunodeficiency (SCID) more closely resembles a complete lack of functional B and T-cells. Patients with HIV retain various immune functions until the advanced stages of Acquired Immunodeficiency Syndrome (AIDS).
Correct Answer is A
Explanation
A. Altered mental status, including confusion, lethargy, and encephalopathy, is a hallmark neurological manifestation of uremic syndrome. As nitrogenous waste products like urea and creatinine accumulate in the blood, they cross the blood-brain barrier and exert toxic effects on the central nervous system. This leads to a progressive decline in cognitive function and potential coma if left untreated.
B. While tremors can sometimes be seen in metabolic disturbances, they are not the primary or most common neurological indicator of uremic syndrome. Uremia is more characteristically associated with asterixis, a flapping tremor of the hands, or peripheral neuropathy rather than simple generalized tremors. Neurological assessment in these patients focuses more on global cognitive function and specific neuromuscular irritability.
C. Hearing loss is not a standard neurological sign associated with the accumulation of uremic toxins in chronic kidney disease. While some medications used in renal patients, like loop diuretics, can be ototoxic, the uremic syndrome itself does not target the auditory pathways. The neurological impact of uremia is typically much more global, affecting the cerebral cortex and peripheral motor nerves.
D. Hypertension is a cardiovascular and renal sign rather than a neurological symptom of uremic syndrome. While it is almost always present in chronic kidney disease due to fluid overload and the renin-angiotensin-aldosterone system, it is a clinical finding rather than a subjective neurological change. Neurological symptoms are specifically those that affect the patient's sensory, motor, or cognitive processing.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.