The nurse notes that a patient has a smooth and shiny tongue surface.
The nurse would attribute these findings to which condition?
The patient has neutropenia.
The patient has polycythemia.
The patient has pernicious anemia.
The patient has elevated estrogen levels.
The Correct Answer is C
Choice A rationale:
Neutropenia is a condition characterized by a low number of neutrophils, a type of white blood cell. Neutropenic patients are at increased risk of infections, but neutropenia does not cause specific changes in the tongue surface. The smooth and shiny tongue surface described in the question is not indicative of neutropenia.
Choice B rationale:
Polycythemia is a condition characterized by an abnormally high concentration of hemoglobin in the blood. It can cause the skin to appear reddish or flushed, but it does not directly cause changes in the tongue surface such as smoothness and shininess.
Choice C rationale:
Pernicious anemia is a type of anemia caused by a deficiency of vitamin B12, which is essential for the formation of red blood cells and the maintenance of the nervous system. One of the characteristic signs of pernicious anemia is glossitis, which is inflammation of the tongue that can make the tongue appear smooth and shiny. This finding aligns with the description provided in the question.
Choice D rationale:
Elevated estrogen levels can cause changes in the skin, such as increased pigmentation or the development of spider veins, but they do not directly cause changes in the tongue surface as described in the question.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Fullness from ascites is a symptom associated with conditions like liver cirrhosis, not directly related to chronic heart failure. Ascites is the accumulation of fluid in the abdominal cavity, causing a feeling of fullness and abdominal discomfort.
Choice B rationale:
Hypoproteinemia, a condition characterized by low levels of proteins in the blood, can lead to fluid retention and edema. However, it is not a direct cause of frequent urination. Frequent urination in this context is more likely related to increased fluid volume in the body, which can be caused by increased renal perfusion in the supine position due to fluid redistribution from the lower extremities to the kidneys.
Choice C rationale:
Hypoperfusion to the brain can lead to neurological symptoms, but it does not directly cause frequent urination. Frequent urination is often related to the kidneys' ability to filter excess fluid and excrete it as urine.
Choice D rationale:
Increased renal perfusion in the supine position can cause frequent urination, especially at night. When a person with chronic heart failure lies down, fluid that has accumulated in the lower extremities (edema) during the day is redistributed to the kidneys due to the change in body position. This increased renal perfusion results in an increased production of urine, leading to nocturia (frequent urination at night) and disrupting the patient's ability to sleep well. This symptom is characteristic of heart failure-related fluid overload and is an important clinical sign indicating worsening heart failure.
Correct Answer is D
Explanation
Choice A rationale:
Triple-drug therapy is not the standard treatment for pernicious anemia after a gastrectomy. Pernicious anemia is primarily caused by vitamin B12 deficiency due to the absence of intrinsic factor, which is essential for vitamin B12 absorption.
Choice B rationale:
IV therapy is a broad term and does not specify the treatment for pernicious anemia. In the context of pernicious anemia, cobalamin replacement therapy administered via intramuscular injections is the preferred treatment.
Choice C rationale:
Quadruple-drug therapy is not a recognized treatment for pernicious anemia. The primary treatment for pernicious anemia involves cobalamin replacement therapy to address the vitamin B12 deficiency.
Choice D rationale:
Cobalamin replacement therapy is the appropriate treatment for pernicious anemia after a gastrectomy. Since the patient lacks intrinsic factor, which is necessary for vitamin B12 absorption, cobalamin replacement therapy bypasses the need for intrinsic factor and provides the necessary vitamin B12 directly.
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