The nurse is assessing four clients at the neighborhood clinic.
Which of these clients should the nurse identify to be at risk for the development of pernicious anemia?

35-year-old male recently diagnosed with chronic renal failure.

26-year-old woman in her second trimester of pregnancy.

50-year-old male who is following a high-fat and high-protein diet.

43-year-old male who had gastric bypass surgery one year ago.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Chronic renal failure results in decreased erythropoietin production, leading to anemia due to poor red blood cell production, not the vitamin B12 deficiency seen in pernicious anemia. Pernicious anemia specifically results from the lack of intrinsic factor causing B12 deficiency.

Choice B rationale

Pregnancy may cause iron-deficiency anemia due to increased iron demands, not pernicious anemia. Pernicious anemia stems from intrinsic factor deficiency, unrelated to pregnancy physiology. Iron supplementation is required in pregnancy-induced anemia, not B12.

Choice C rationale

A high-fat, high-protein diet does not inherently affect vitamin B12 absorption. Pernicious anemia results from the deficiency of intrinsic factor or issues with B12 absorption, not dietary composition. This individual is not at increased risk based on diet alone.

Choice D rationale

Gastric bypass surgery can disrupt intrinsic factor secretion due to altered gastric mucosa. Intrinsic factor is essential for vitamin B12 absorption in the ileum, and its deficiency directly contributes to the development of pernicious anemia in post-gastric bypass patients. .

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Correct Answer is A

Explanation

Choice A rationale

Improved tolerance for daily activities suggests increased energy levels and improved oxygen delivery to tissues, both indicative of effective iron deficiency anemia treatment. Normal hemoglobin levels are 12-16 g/dL for females and 14-18 g/dL for males, supporting enhanced activity tolerance.

Choice B rationale

Decreased paresthesia indicates improved nerve function but is not directly linked to iron deficiency anemia treatment outcomes. Iron deficiency primarily impacts oxygen transport, and improvements in energy levels and activity tolerance are better indicators of therapeutic success.

Choice C rationale

Improved white blood cell count suggests better immune function but does not directly assess anemia treatment efficacy. Iron therapy aims to normalize hemoglobin and hematocrit levels rather than leukocyte parameters, which are unrelated to anemia management.

Choice D rationale

Enhanced balance may indicate improved neuromuscular function but is not directly correlated with anemia treatment. Balance is influenced by multiple factors, including neurological or musculoskeletal health, rather than oxygenation improvements specific to anemia.

A. Assess for hypotension. B. Assess for distention above the pubis area. C. Monitor the client's laboratory values for hypernatremia. D. Maintain strict intake and output records.

Correct Answer is D

Explanation

Choice A rationale

Hypotension is not a typical sign of fluid overload. Fluid overload often presents with hypertension due to increased circulatory volume. Monitoring blood pressure is essential, but hypotension does not reliably indicate fluid overload. This option does not align with scientific understanding of fluid overload symptoms.

Choice B rationale

Distention above the pubis area suggests urinary retention or bladder distension rather than fluid overload. While important to assess, it does not directly indicate fluid overload. This symptom is more related to mechanical issues than systemic fluid imbalance and volume overload.

Choice C rationale

Hypernatremia is not a sign of fluid overload. Fluid overload typically results in dilutional hyponatremia, where excessive fluids lower sodium levels. Monitoring sodium levels is useful, but hypernatremia would suggest dehydration or other conditions, not excess fluid volume. This choice is inconsistent with scientific knowledge.

Choice D rationale

Maintaining strict intake and output records is a fundamental approach to monitoring fluid balance. Accurate measurements of fluid intake and output help detect fluid overload early. This method directly correlates with assessing excess fluid volume in clinical practice. It is a reliable, evidence-based intervention for monitoring fluid status. .

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The nurse is assessing four clients at the neighborhood clinic.Which of these clients should the nurse identify to be at risk for the development of pernicious anemia?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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The nurse is assessing four clients at the neighborhood clinic.
Which of these clients should the nurse identify to be at risk for the development of pernicious anemia?