The nurse is assessing a client who is a strict vegetarian. What type of anemia is the nurse aware that this client is at risk for?

Reasoning:

Choice A reason: Strict vegetarians are at risk for megaloblastic anemia due to vitamin B12 deficiency, as B12 is primarily found in animal products. B12 deficiency impairs DNA synthesis, causing macrocytic anemia and symptoms like fatigue and neurological issues, a significant concern in vegan diets without supplementation.

Choice B reason: Sickle cell anemia is an inherited disorder caused by a hemoglobin S mutation, not dietary factors like vegetarianism. It leads to hemolytic anemia and vaso-occlusive crises, unrelated to nutritional deficiencies, making it an unlikely risk for a vegetarian client without genetic predisposition.

Choice C reason: Iron deficiency anemia is possible in vegetarians due to lower bioavailability of non-heme iron from plant sources, but B12 deficiency is a more specific risk in strict vegetarians, as animal products are the primary B12 source. Iron supplements or fortified foods can mitigate this risk.

Choice D reason: Aplastic anemia results from bone marrow failure, not dietary deficiencies. It causes pancytopenia and is unrelated to vegetarianism, which primarily risks nutritional anemias like B12 or iron deficiency. The client’s diet suggests a nutrient-specific issue, not bone marrow suppression.

Reasoning:

Choice A reason: Addison disease results from adrenal insufficiency, causing deficient cortisol and aldosterone production. This leads to symptoms like hypotension, hyponatremia, and hyperkalemia, opposite to the cortisol excess seen in Cushing syndrome, which involves weight gain, hypertension, and hyperglycemia due to elevated adrenal cortex activity.

Choice B reason: Hashimoto disease is an autoimmune thyroiditis causing hypothyroidism, with low thyroid hormone levels leading to fatigue, weight gain, and cold intolerance. It does not involve adrenal cortex cortisol excess, unlike Cushing syndrome, which is characterized by hypercortisolism and distinct metabolic and physical symptoms.

Choice C reason: Cushing syndrome is defined by excess free circulating cortisol from the adrenal cortex, due to pituitary tumors, adrenal hyperplasia, or exogenous steroids. This causes weight gain, moon face, hypertension, and hyperglycemia, reflecting cortisol’s effects on metabolism, fat distribution, and fluid balance, making it the correct disorder.

Choice D reason: Graves disease is an autoimmune condition causing hyperthyroidism, with excess thyroid hormone leading to weight loss, tachycardia, and heat intolerance. It does not involve adrenal cortex cortisol production, unlike Cushing syndrome, which is specifically related to hypercortisolism and its systemic metabolic effects.