The nurse is reviewing the plan of care for a group of assigned clients on a hematological unit.
The nurse should understand that which of the following clients has an increased risk for developing iron deficiency anemia?
A 24-year-old female who is 6 months pregnant and is taking prescribed prenatal vitamins.
A 42-year-old male with a history of hypertension who exercises three times a week.
A 37-year-old male client who works 16 hours a day and consumes a high carbohydrate diet.
A 20-year-old female client with a history of menorrhagia and consumes a strict vegetarian diet.
The Correct Answer is D
Choice A rationale
Pregnant women may experience increased iron demands due to expanded blood volume and fetal requirements. However, prescribed prenatal vitamins typically contain sufficient iron to prevent deficiency. Compliance with supplementation reduces the risk for anemia, and pregnancy itself is not an independent factor without nutritional inadequacy. Other physiological conditions, such as menorrhagia or dietary restrictions, can significantly elevate risk factors for iron deficiency anemia.
Choice B rationale
Hypertension does not inherently increase the risk of iron deficiency anemia. Exercise three times a week is unlikely to create significant hematological challenges unless combined with conditions like poor dietary intake or chronic illness. Physical activity does not deplete iron stores unless excessive or accompanied by inappropriate nutrition. This client does not exhibit risk factors as critical as menorrhagia or dietary restrictions for anemia development.
Choice C rationale
Working long hours and consuming a high-carbohydrate diet might affect overall health, but these factors do not directly relate to iron absorption or blood loss. While poor nutritional habits can lead to deficiencies, high carbohydrate intake does not necessarily deplete iron reserves. A vegetarian or restrictive diet lacking iron-rich foods poses a greater risk for developing anemia than carbohydrate consumption alone.
Choice D rationale
Menorrhagia results in excessive blood loss during menstruation, which can deplete iron stores and lead to anemia. A strict vegetarian diet often lacks heme iron, which is more readily absorbed compared to non-heme iron from plant sources. Together, these factors create a dual risk of iron deficiency, emphasizing why this client is the most likely among the options to develop anemia. Nutritional counseling and supplementation are key preventive measures.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Trouble breathing is a hallmark symptom of left-sided heart failure. Suggesting that it should not occur would be inaccurate. The failure of the left ventricle leads to blood accumulation in the pulmonary vessels, creating pulmonary congestion and shortness of breath. Prompt provider notification may be necessary but does not address the underlying pathophysiology. Pulmonary symptoms are expected in this type of heart failure.
Choice B rationale
While left-sided heart failure can eventually lead to right-sided heart failure, the initial problem is with left ventricular dysfunction. This causes reduced forward blood flow and pulmonary congestion due to backflow of blood into the lungs. Right-sided heart failure is not the primary event leading to pulmonary symptoms in left-sided heart failure.
Choice C rationale
The left ventricle's inability to pump effectively results in blood backing up into the pulmonary circulation, causing pulmonary congestion and symptoms like shortness of breath. This is consistent with the hemodynamics of left-sided heart failure. Pulmonary capillary pressure increases, leading to fluid leakage and impaired gas exchange, explaining the client's breathing difficulty.
Choice D rationale
Although difficulty breathing with exertion (dyspnea on exertion) is common, resting symptoms, including orthopnea and paroxysmal nocturnal dyspnea, can also occur in left-sided heart failure due to fluid redistribution. Limiting symptoms to exertion inaccurately portrays the clinical presentation and disregards other significant pulmonary signs.
Correct Answer is D
Explanation
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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