The nurse is taking care of a patient suspected to have iron deficiency anemia. Laboratory studies are performed. The nurse reviews the results, knowing that which result indicates this type of anemia?
Red blood cells that are microcytic and hypochromic
Decreased reticulocyte count
Elevated hemoglobin level
Elevated red blood cell count
The Correct Answer is A
Choice A reason: Iron deficiency anemia causes microcytic, hypochromic red blood cells due to impaired hemoglobin synthesis. Lack of iron reduces heme production, leading to smaller (microcytic) and paler (hypochromic) RBCs. This is a hallmark finding on blood smear, confirmed by low MCV and MCHC, diagnostic of iron deficiency anemia.
Choice B reason: Decreased reticulocyte count is not typical in iron deficiency anemia. Reticulocytes may be normal or slightly elevated as the bone marrow attempts to compensate for anemia. A low count suggests bone marrow failure, not iron deficiency, which primarily affects hemoglobin production, not RBC production rate.
Choice C reason: Elevated hemoglobin level is inconsistent with iron deficiency anemia, which causes low hemoglobin due to reduced heme synthesis from iron lack. Hemoglobin typically falls below 12 g/dL in females or 13 g/dL in males, reflecting anemia severity, making this an incorrect indicator for this condition.
Choice D reason: Elevated red blood cell count is not seen in iron deficiency anemia. RBC count is typically low or normal, as iron deficiency impairs hemoglobin production, reducing RBC size and color, not number. Elevated RBC counts occur in conditions like polycythemia, not anemia, making this an incorrect choice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Delaying the transfusion and notifying the provider is critical, as a fever of 100.7°F suggests possible infection or inflammation. Transfusing blood in a febrile patient risks exacerbating underlying infection or causing transfusion reactions. The provider must evaluate the fever’s cause to ensure safe administration and prevent complications like sepsis or hemolytic reactions.
Choice B reason: Administering an antihistamine and starting the transfusion is inappropriate, as antihistamines address allergic reactions, not fever. A temperature of 100.7°F indicates potential infection, requiring investigation before transfusion. Proceeding without addressing the fever risks worsening an underlying condition or causing transfusion-related complications, making this an unsafe action.
Choice C reason: Administering acetaminophen to reduce fever and starting the transfusion is incorrect, as it masks the fever without identifying its cause. A temperature of 100.7°F may indicate infection, which must be evaluated before transfusion to avoid complications like sepsis. Treating symptoms without investigation compromises patient safety in this scenario.
Choice D reason: Beginning the transfusion as prescribed is unsafe with a fever of 100.7°F, as it may indicate infection or inflammation. Transfusing without investigating the fever risks exacerbating underlying conditions or causing transfusion reactions. Delaying and notifying the provider ensures the cause is addressed, prioritizing patient safety and appropriate management.
Correct Answer is C
Explanation
Choice A reason: Risk for injury is a concern in elderly patients due to frailty, but it is not the highest priority in gastroenteritis. Fluid volume deficit from diarrhea and dehydration poses a greater immediate risk, as it can lead to hypotension, organ failure, or shock, requiring urgent rehydration to stabilize the patient.
Choice B reason: Activity intolerance may occur in elderly patients with gastroenteritis due to weakness from dehydration, but it is secondary to fluid volume deficit. Dehydration causes tachycardia, hypotension, and fatigue, which must be addressed first to restore hemodynamic stability. Activity intolerance is a consequence, not the primary concern, in this acute condition.
Choice C reason: Fluid volume deficit is the highest priority in gastroenteritis, especially in an elderly patient. Diarrhea causes significant water and electrolyte loss, leading to dehydration, hypotension, and risk of organ failure. Rapid rehydration with IV fluids or oral rehydration solutions is critical to prevent life-threatening complications like shock or renal failure.
Choice D reason: Limited mobility is a concern in elderly patients but is not the primary issue in gastroenteritis. Dehydration from diarrhea poses a more immediate threat, causing cardiovascular and renal complications. Mobility issues may exacerbate risks like falls, but fluid volume deficit is the acute, life-threatening priority requiring immediate intervention.
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