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 D

Explanation

Choice A rationale

A low sodium, high-calorie diet may improve overall health but does not address immediate severe pain from renal colic. Dietary modifications can have long-term benefits but are not first-line interventions for acute pain caused by kidney stones. Immediate pain relief is prioritized over dietary adjustments in this scenario.

Choice B rationale

Increasing fluid intake helps flush out kidney stones and prevent their formation. However, fluid intake does not provide immediate pain relief for renal colic. It is crucial in long-term management, but acute management prioritizes analgesics to address the client’s severe pain.

Choice C rationale

Tamsulosin relaxes the smooth muscles in the urinary tract, facilitating stone passage and reducing obstruction-related discomfort. While beneficial, it takes time to work and does not immediately relieve severe pain. It is not the first prescription to implement for acute pain management in renal colic.

Choice D rationale

Morphine sulfate is an opioid analgesic that provides rapid relief for severe pain associated with renal colic. Administering morphine addresses the acute issue and allows for further interventions to manage the underlying cause. Pain control is the priority in renal colic cases with severe pain.

A. Notify a urologist to insert a metal catheter with a prostatic curve. B. Prepare the client to have a cystostomy performed. C. Insert an indwelling urethral catheter. D. Notify the health care provider to discuss surgical options with the client.

Correct Answer is C

Explanation

Choice A rationale

Metal catheters with prostatic curves are used in challenging cases of urinary retention caused by BPH. However, these catheters are not the first-line intervention due to their specialized nature and the risk of injury. Less invasive measures should be tried first.

Choice B rationale

Cystostomy, a surgical procedure that creates a suprapubic urinary drainage site, is reserved for severe cases of urinary retention where catheterization fails. It is not the initial step due to its invasive nature and requirement for surgical expertise.

Choice C rationale

Inserting an indwelling urethral catheter is the first-line action for managing acute urinary retention associated with BPH. It provides immediate bladder decompression, relieves discomfort, and reduces risks of complications like hydronephrosis or bladder rupture.

Choice D rationale

Discussing surgical options addresses the long-term management of BPH but does not resolve acute urinary retention. Interventions like catheterization should first alleviate symptoms before evaluating the need for definitive surgical treatment. .

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is reviewing the prescriptions for a client with severe pain from renal colic.Which of the following prescriptions should the nurse implement first?

Correct Answer is D

Explanation

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Correct Answer is C

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?