The nurse is caring for an older adult client who has been admitted to the unit with anemia. What would the nurse expect the client to possibly exhibit?

Elimination of iron by the body

Excessive consumption of coffee or tea

Blood loss from the gastrointestinal or genitourinary tract

Decrease in the total body iron stores with age

Answer and Explanation

The Correct Answer is C

Reasoning:

Choice A reason: Elimination of iron by the body is not a typical cause of anemia in older adults. Iron is tightly regulated, and excessive loss occurs through bleeding, not spontaneous elimination. Anemia in the elderly is more commonly due to chronic blood loss or impaired absorption, not iron excretion.

Choice B reason: Excessive coffee or tea consumption can inhibit iron absorption due to tannins binding dietary iron, but it is not a primary cause of anemia in older adults. Blood loss or chronic disease are more common culprits, making dietary inhibition a less likely contributor in this population.

Choice C reason: Blood loss from the gastrointestinal or genitourinary tract is a common cause of anemia in older adults. Chronic bleeding from ulcers, colon cancer, or urinary tract issues depletes iron stores, leading to iron deficiency anemia, a frequent finding in the elderly due to higher prevalence of these conditions.

Choice D reason: A decrease in total body iron stores with age is not a primary cause of anemia. While absorption may decline slightly, blood loss from gastrointestinal or genitourinary sources is a more significant contributor in older adults, as it directly reduces iron available for hemoglobin synthesis.

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Correct Answer is B

Explanation

Reasoning:

Choice A reason: Normal hematocrit is not typical in sickle cell anemia, a hemolytic disorder where red blood cells are destroyed prematurely due to abnormal hemoglobin (HbS). Chronic hemolysis reduces red blood cell mass, lowering hematocrit, making a normal value inconsistent with the disease’s pathophysiology.

Choice B reason: Low hematocrit is characteristic of sickle cell anemia due to chronic hemolysis. Sickled red blood cells have a shorter lifespan, reducing circulating red blood cells and hemoglobin, resulting in a decreased hematocrit. This reflects the anemia’s impact on oxygen-carrying capacity, a hallmark of the condition.

Choice C reason: High hematocrit is not associated with sickle cell anemia. Elevated hematocrit occurs in conditions like polycythemia, where red blood cell mass increases. Sickle cell anemia causes hemolysis, reducing red blood cells and hematocrit, making a high value inconsistent with the disease.

Choice D reason: A normal blood smear is not expected in sickle cell anemia. Blood smears show sickled red blood cells, anisocytosis, and poikilocytosis due to hemoglobin S polymerization. These abnormal findings contrast with a normal smear, which would not reflect the hemolytic and morphological changes of the disease.

A. Offer liquids frequently, in large quantities B. Allow optimum physical activity before meals to expedite digestion C. Help the client sit upright when eating and feed slowly D. Instruct the client to lie on the bed when eating

Correct Answer is C

Explanation

Reasoning:

Choice A reason: Offering large quantities of liquids frequently increases aspiration risk in clients with dysphagia from neurological disorders. Large volumes can overwhelm swallowing mechanisms, leading to choking or pneumonia. Controlled, small sips with proper positioning are safer to ensure nutrition without compromising airway safety.

Choice B reason: Allowing physical activity before meals may improve appetite but does not address swallowing difficulties. Activity does not facilitate safe swallowing in neurological disorders, where muscle coordination is impaired. Proper positioning and pacing during feeding are more effective to prevent aspiration and ensure nutritional intake.

Choice C reason: Helping the client sit upright and feeding slowly minimizes aspiration risk in neurological dysphagia. Upright positioning aligns the airway to prevent food or liquid entry, and slow feeding allows better coordination of swallowing muscles, reducing choking and ensuring adequate nutrition, critical for safe intake.

Choice D reason: Instructing the client to lie down while eating is dangerous in dysphagia, as it increases aspiration risk. Lying down allows food or liquids to enter the airway, potentially causing pneumonia. Upright positioning is essential to facilitate safe swallowing and prevent complications in neurological disorders.

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The nurse is caring for an older adult client who has been admitted to the unit with anemia. What would the nurse expect the client to possibly exhibit?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with sickle cell anemia has a:

Correct Answer is B

Explanation

A client with a neurological disorder has difficulty swallowing. The nurse should take special care with the client’s diet because of a potential risk of imbalanced nutrition. Which measure may be taken by the nurse to ensure that the client’s diet allows for easy swallowing?

Correct Answer is C

Explanation

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