Decreased absorption of vitamin B12 due to lack of intrinsic factor in the gastric mucosa results in ______ anemia
Hemolytic
Aplastic
Iron-deficiency
Pernicious
The Correct Answer is D
A. Hemolytic is incorrect because hemolytic anemia occurs when red blood cells (RBCs) are destroyed prematurely. Causes include autoimmune reactions, certain medications, infections, or inherited RBC defects. Hemolytic anemia affects RBC lifespan rather than their production, and it is not related to vitamin B12 or intrinsic factor deficiency.
B. Aplastic is incorrect because aplastic anemia results from bone marrow failure, leading to a deficiency of red blood cells, white blood cells, and platelets. It is usually caused by toxins, radiation, medications, or autoimmune mechanisms. The issue in aplastic anemia is inadequate cell production, not impaired vitamin B12 absorption.
C. Iron-deficiency is incorrect because iron-deficiency anemia results from a lack of iron, which is required for hemoglobin synthesis. Iron deficiency produces small, pale red blood cells (microcytic, hypochromic anemia). It does not involve vitamin B12, intrinsic factor, or megaloblastic changes.
D. Pernicious is correct because pernicious anemia is caused by the body’s inability to absorb vitamin B12 due to the absence of intrinsic factor, a glycoprotein secreted by the parietal cells of the stomach. Intrinsic factor binds to vitamin B12 and allows its absorption in the terminal ileum. Vitamin B12 is essential for DNA synthesis, especially in rapidly dividing cells like red blood cells. Without it, the bone marrow produces megaloblasts—large, immature, dysfunctional red blood cells, which leads to megaloblastic anemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Bradypnea and slow heart rate is incorrect because pulmonary embolism (PE) usually triggers tachypnea and tachycardia, not slow breathing or bradycardia. These responses occur as the body attempts to compensate for hypoxemia and reduced pulmonary blood flow.
B. Bilateral peripheral edema and generalized weakness is incorrect because bilateral leg swelling is more characteristic of heart failure or systemic venous congestion. While a PE may result from deep vein thrombosis (DVT), edema is usually unilateral and not the defining manifestation of an acute PE.
C. Sudden onset of dyspnea and sharp chest pain is correct because a pulmonary embolism occurs when a blood clot obstructs a pulmonary artery, causing abrupt impairment of blood flow to the lung. This leads to sudden shortness of breath, sharp or pleuritic chest pain (worsening with inspiration), tachypnea, and sometimes hemoptysis. Other signs may include anxiety, diaphoresis, and hypoxemia. Rapid recognition is essential, as PE can be life-threatening if untreated.
D. Gradual onset of a productive cough with thick sputum is incorrect because this pattern is more typical of pneumonia or chronic bronchitis, not pulmonary embolism. PE symptoms are typically acute and sudden rather than gradual.
Correct Answer is B
Explanation
A. Macule is incorrect because a macule is a flat, non-palpable lesion that represents a change in skin color. Examples include freckles or flat rashes. Macules do not contain fluid or pus, nor are they raised.
B. Pustule is correct because a pustule is a small, elevated, erythematous lesion that contains purulent material (pus). Pustules are commonly seen in infections such as acne, impetigo, or folliculitis. The presence of pus indicates an inflammatory response to infection, trauma, or obstruction of a gland.
C. Papule is incorrect because a papule is a solid, raised lesion without fluid. Papules can be caused by a variety of dermatologic conditions such as warts or early stages of acne, but they do not contain pus.
D. Nodule is incorrect because a nodule is a larger, solid, firm lesion that extends deeper into the dermis or subcutaneous tissue. Nodules can result from cysts, tumors, or chronic inflammatory processes, but they are not typically associated with purulent exudate.
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