Exhibits

The nurse suspects that the client may have anemia.

For each statement, click to specify whether the statement is consistent with iron deficiency anemia, vitamin B12 deficient anemia, or folic acid deficient anemia. Each category may support more than one deficiency, but each deficiency must have at least one response selected.

Decreased hemoglobin and hematocrit levels

Uptake often impeded by medications

Result of dietary deficiency

Often associated with chronic alcoholism

Can be caused by malabsorption syndrome

Answer and Explanation

The Correct Answer is {"A":{"answers":"A,B,C"},"B":{"answers":"A,B,C"},"C":{"answers":"A,B,C"},"D":{"answers":"A,C"},"E":{"answers":"A,B,C"}}

Decreased hemoglobin and hematocrit levels:

Folic acid deficiency anemia: Yes, folic acid deficiency can result in low hemoglobin and hematocrit levels as folate is necessary for red blood cell (RBC) production.
Iron deficiency anemia: Yes, iron deficiency leads to decreased hemoglobin and hematocrit levels because iron is crucial for hemoglobin synthesis.
Vitamin B12 deficiency anemia: Yes, B12 deficiency can cause decreased hemoglobin and hematocrit levels due to impaired RBC production.
Rationale: All three forms of anemia can result in low hemoglobin and hematocrit levels due to impaired red blood cell production.

Uptake often impeded by medications:

Folic acid deficiency anemia: Yes, certain medications, like anticonvulsants or methotrexate, can interfere with folic acid absorption and utilization.
Iron deficiency anemia: Yes, some medications like proton pump inhibitors (PPIs) or antacids can interfere with iron absorption.
Vitamin B12 deficiency anemia: Yes, medications such as proton pump inhibitors, H2 blockers, and metformin can interfere with B12 absorption.
Rationale: Medications can affect the absorption of all three nutrients—folic acid, iron, and B12—and lead to deficiencies, especially in individuals taking these medications long-term.

Result of dietary deficiency:

Folic acid deficiency anemia: Yes, inadequate dietary intake of folate can lead to deficiency and anemia. Common in those with poor diets or increased demand (e.g., pregnancy).
Iron deficiency anemia: Yes, iron deficiency is commonly caused by inadequate dietary intake of iron-rich foods (e.g., red meat, leafy greens).
Vitamin B12 deficiency anemia: Yes, insufficient dietary intake, particularly in vegetarians or vegans who avoid animal products, can lead to B12 deficiency.
Rationale: All three anemias can be caused by inadequate dietary intake of the respective nutrients.

Often associated with chronic alcoholism:

Folic acid deficiency anemia: Yes, chronic alcohol use can impair folic acid absorption and utilization, contributing to deficiency.
Iron deficiency anemia: Less commonly associated with alcoholism, though heavy drinking can affect iron absorption and cause gastrointestinal bleeding, leading to iron loss.
Vitamin B12 deficiency anemia: Yes, alcohol use can interfere with vitamin B12 absorption and contribute to deficiency.
Rationale: Chronic alcohol use is often associated with folic acid and B12 deficiencies due to impaired absorption, while its association with iron deficiency is less direct but can occur due to GI bleeding or poor nutrition.

Can be caused by malabsorption syndrome:

Folic acid deficiency anemia: Yes, conditions like celiac disease or Crohn's disease can impair folate absorption.
Iron deficiency anemia: Yes, malabsorption syndromes (e.g., celiac disease, Crohn's) can prevent proper iron absorption.
Vitamin B12 deficiency anemia: Yes, malabsorption syndromes like pernicious anemia or celiac disease can impair B12 absorption in the intestines.
Rationale: All three types of anemia can result from malabsorption syndromes due to difficulty absorbing nutrients from the digestive tract.

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Correct Answer is D

Explanation

A. Encouraging physical activity, such as walking, is important for cardiovascular health, but it is not a measurable outcome related to the client's current condition of blurred vision and cardiovascular disease.

B. While educating the family about signs and symptoms is valuable, it does not directly address the client's health status or outcomes that can be measured.

C. A target blood pressure of less than 160/90 mm Hg does not adequately control hypertension and may still pose a risk to cardiovascular health, especially given the blurred vision, which could indicate possible complications.

D. Setting a goal for the client’s daily blood pressure to be less than 140/80 mm Hg is a clear, measurable outcome that indicates effective management of hypertension and promotes overall

A. Elevated creatinine and blood urea nitrogen (BUN). B. Hypovolemia and electrocardiographic (ECG) changes. C. Uremic irritation of mucous membranes and skin surfaces. D. Side effects of total parenteral nutrition (TPN) and intralipids.

Correct Answer is B

Explanation

A. While elevated creatinine and BUN are important indicators of kidney function, in the diuretic phase, the focus shifts to monitoring for complications, particularly fluid and electrolyte balance.

B. Hypovolemia can occur due to excessive diuresis during the diuretic phase, which can lead to significant cardiovascular effects, including ECG changes related to electrolyte imbalances, particularly potassium levels.

C. Monitoring for uremic irritation is important but less critical than monitoring for hypovolemia and ECG changes that can lead to acute complications.

D. While monitoring for side effects of TPN is relevant, it is not the priority in the context of AKI transitioning phases where fluid and electrolyte balance are paramount.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is developing a plan of care for a client who reports blurred vision and who is newly diagnosed with cardiovascular disease. Which outcome should the nurse include in the plan of care for this client?

Correct Answer is D

Explanation

A client who has developed acute kidney injury (AKI) due to an aminoglycoside antibiotic has moved from the oliguric phase to the diuretic phase of AKI. Which parameters are most important for the nurse to plan to carefully monitor?

Correct Answer is B

Explanation

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