The nurse is reviewing the laboratory findings for a 34-year-old woman who is scheduled for a Schilling's test for B12 deficiency anemia. Which result should the nurse report immediately to the primary care provider?

Positive pregnancy test

Hemoglobin 9.5 g/dL and Hematocrit 32%

Glycosylated Hemoglobin (A1c) 7.5%

Serum Cholesterol 237 mg/dL

Answer and Explanation

The Correct Answer is A

Choice A Reason:
A positive pregnancy test is crucial information that must be reported immediately as it has significant implications for the patient's health and treatment options. Pregnancy can impact the results of a Schilling's test, which is used to diagnose B12 deficiency anemia, as pregnancy itself can cause changes in B12 metabolism. Therefore, the healthcare provider must be informed to adjust the diagnostic approach and ensure the safety of both the mother and the developing fetus.

Choice B Reason:
While a hemoglobin level of 9.5 g/dL is below the normal range for adult females (11.6 to 15 g/dL) and a hematocrit of 32% is at the lower end of the normal range (36% to 44%)[^10^], these results are consistent with anemia but are not as immediately critical as a positive pregnancy test in the context of a Schilling's test.

Choice C Reason:
A glycosylated hemoglobin (A1c) level of 7.5% is above the normal range (4% to 5.9%), indicating poor blood sugar control over the past two to three months, which could suggest diabetes or prediabetes. However, this is not as urgent as a positive pregnancy test when considering the administration of a Schilling's test.

Choice D Reason:
A serum cholesterol level of 237 mg/dL is considered borderline high (200 to 239 mg/dL), which may increase the risk of heart disease over time. However, this does not require immediate reporting in the context of a Schilling's test for B12 deficiency anemia as compared to a positive pregnancy test.

Nursing Test Bank

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Correct Answer is C

Explanation

Choice A Reason
While coronary artery spasm can cause chest pain, it is not the typical cause of unstable angina. Unstable angina is generally due to atherosclerotic heart disease, where plaque buildup in the coronary arteries restricts blood flow. This statement does not fully reflect an understanding of the condition.

Choice B Reason
Beta blockers are often prescribed to manage angina as they reduce the heart's workload and oxygen demand. However, they do not always prevent angina pain, especially in the case of unstable angina, which can occur unpredictably and not just during exertion. This statement shows partial understanding but lacks the urgency associated with unstable angina.

Choice C Reason
Seeking immediate medical attention when experiencing angina pain is crucial, especially in the case of unstable angina, which can signal an impending heart attack. This statement indicates that the client understands the seriousness of their condition and the need for prompt action.

Choice D Reason
While rest can help alleviate stable angina pain, unstable angina is less predictable and may not be relieved by rest. This type of angina requires medical evaluation to prevent more serious complications, such as myocardial infarction. This statement does not convey an adequate understanding of the condition.

A. An increase in urine output. B. Less dyspnea with activity. C. A blood pressure of 120/80 mmHg. D. A heart rate of 65 per minute.

Correct Answer is D

Explanation

Choice a reason:
An increase in urine output can be a sign of improved kidney function or the effect of medications, but it is not a direct indicator of reduced cardiac workload. Atenolol, a beta-blocker, primarily reduces the heart rate and myocardial oxygen demand, not urine output.

Choice b reason:
Less dyspnea with activity suggests improved cardiovascular efficiency, but it is not a specific measure of cardiac workload. Dyspnea can be influenced by respiratory conditions and is not solely determined by cardiac function.

Choice c reason:
A blood pressure of 120/80 mmHg is considered optimal for most adults and indicates good control of hypertension. However, it does not specifically reflect the cardiac workload, which is more directly affected by heart rate and myocardial oxygen demand.

Choice d reason:
A heart rate of 65 per minute is a clear indicator that atenolol is effective in reducing cardiac workload. Atenolol decreases the heart rate, which in turn reduces myocardial oxygen demand and the overall workload on the heart. This is particularly important for patients with unstable angina, where reducing the heart's workload can prevent angina attacks and potential myocardial infarction.

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The nurse is reviewing the laboratory findings for a 34-year-old woman who is scheduled for a Schilling's test for B12 deficiency anemia. Which result should the nurse report immediately to the primary care provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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