The nurse is assessing a new client with reports of acute fatigue and a sore tongue that is visibly smooth and beefy red. This client is demonstrating signs and symptoms associated with what form of hematologic disorder?

Megaloblastic anemia

Hemophilia

Thrombocytopenia

Sickle cell disease

Answer and Explanation

The Correct Answer is A

Reasoning:

Choice A reason: Megaloblastic anemia, caused by vitamin B12 or folate deficiency, impairs DNA synthesis, leading to macrocytic red blood cells. Fatigue results from reduced oxygen-carrying capacity, and a smooth, beefy red tongue (glossitis) is a classic sign due to mucosal cell turnover disruption, matching the client’s symptoms.

Choice B reason: Hemophilia, a bleeding disorder due to clotting factor deficiencies, causes bleeding tendencies like hemarthrosis, not fatigue or glossitis. It does not affect red blood cell production or mucosal tissues, making it inconsistent with the client’s symptoms of anemia and tongue changes.

Choice C reason: Thrombocytopenia, or low platelet count, causes bleeding and bruising, not fatigue or a beefy red tongue. It affects hemostasis, not red blood cell production or mucosal integrity, making it an unlikely cause of the client’s hematologic symptoms described in the scenario.

Choice D reason: Sickle cell disease causes hemolytic anemia and vaso-occlusive pain, not a smooth, beefy red tongue. Fatigue occurs from anemia, but glossitis is specific to megaloblastic anemia due to B12 or folate deficiency, not the hemoglobinopathy of sickle cell disease.

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Correct Answer is B

Explanation

Reasoning:

Choice A reason: Difficulty falling asleep is not a specific symptom of iron deficiency anemia. While fatigue is common, it affects energy levels, not sleep onset. Insomnia may result from other causes like anxiety or neurological conditions, not the reduced oxygen-carrying capacity of iron deficiency anemia.

Choice B reason: Difficulty breathing when walking 30 feet, or exertional dyspnea, is a hallmark of iron deficiency anemia. Low hemoglobin reduces oxygen delivery to tissues, causing shortness of breath during activity as the body struggles to meet oxygen demands, making this a key subjective symptom.

Choice C reason: Increased appetite is not typical in iron deficiency anemia. Some patients experience pica, craving non-food items, but not increased food appetite. Anemia causes fatigue and weakness, not hunger, which is more associated with metabolic or endocrine disorders, not iron deficiency.

Choice D reason: Feeling hot all the time is not a symptom of iron deficiency anemia. Patients often feel cold due to reduced oxygen delivery impairing thermoregulation. Feeling hot suggests hyperthyroidism or infection, not the hypoxic or circulatory issues characteristic of iron deficiency anemia.

A. Iron deficiency anemia B. Hemolytic anemia C. Sickle cell anemia D. Aplastic anemia

Correct Answer is D

Explanation

Reasoning:

Choice A reason: Iron deficiency anemia causes fatigue and anemia due to low iron, reducing hemoglobin synthesis. However, it does not typically cause neutropenia, thrombocytopenia, or left upper quadrant pain. Bruising may occur, but the triad of pancytopenia and recent infections points more strongly to bone marrow failure.

Choice B reason: Hemolytic anemia involves red blood cell destruction, causing anemia and fatigue, but neutropenia and thrombocytopenia are not typical. Left upper quadrant pain may suggest splenomegaly, but the full pancytopenia and infection history align better with bone marrow suppression than hemolytic processes alone.

Choice C reason: Sickle cell anemia causes hemolytic anemia and pain from vaso-occlusion, potentially in the spleen (left upper quadrant). However, it does not typically cause neutropenia or thrombocytopenia. The client’s pancytopenia and recurrent infections suggest a broader bone marrow issue, not specific to sickle cell disease.

Choice D reason: Aplastic anemia is characterized by bone marrow failure, leading to pancytopenia (anemia, neutropenia, thrombocytopenia), causing fatigue, bruising, and infection susceptibility. Left upper quadrant pain may indicate splenomegaly or bleeding. The history of recurrent infections supports neutropenia from bone marrow suppression, making this the most likely diagnosis.

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The nurse is assessing a new client with reports of acute fatigue and a sore tongue that is visibly smooth and beefy red. This client is demonstrating signs and symptoms associated with what form of hematologic disorder?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is collecting data for a client who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia?

Correct Answer is B

Explanation

Correct Answer is D

Explanation

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