The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the health care provider. What type of anemia is the nurse concerned that the co-worker may have?

Megaloblastic anemia

Iron deficiency anemia

Sickle cell anemia

Aplastic anemia

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: Megaloblastic anemia, caused by vitamin B12 or folate deficiency, leads to macrocytic red blood cells and symptoms like fatigue and neurological issues. Ice eating (pica) is not a hallmark; it is more associated with iron deficiency, which drives unusual cravings, making this less likely.

Choice B reason: Iron deficiency anemia is associated with pica, including ice eating (pagophagia), a common symptom. Low iron impairs hemoglobin synthesis, causing microcytic anemia, fatigue, and cravings for non-nutritive substances like ice, likely due to neurological or metabolic effects of iron deficiency, matching the co-worker’s behavior.

Choice C reason: Sickle cell anemia, an inherited hemolytic anemia, causes vaso-occlusive crises and fatigue but is not linked to ice eating. Pica is specific to iron deficiency, not hemoglobinopathies like sickle cell, which involves sickled red blood cells, not iron store depletion.

Choice D reason: Aplastic anemia, due to bone marrow failure, causes pancytopenia, leading to fatigue and infections but not pica or ice eating. This behavior is characteristic of iron deficiency, not the generalized blood cell deficiency seen in aplastic anemia, making it an unlikely diagnosis.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: Effective treatment of diabetes insipidus, typically with desmopressin, restores ADH function, reducing excessive urine output and thirst. Fluid intake below 2,500 ml/day indicates improved water reabsorption in the kidneys, normalizing fluid balance and reducing polyuria, which is a key sign of successful management of this condition.

Choice B reason: A heart rate of 126 beats/minute indicates tachycardia, often a sign of dehydration or hypovolemia in untreated diabetes insipidus. Effective treatment should normalize heart rate by correcting fluid balance, so persistent tachycardia suggests ongoing fluid loss and ineffective treatment, not a successful therapeutic outcome.

Choice C reason: Blood pressure of 90/50 mm Hg indicates hypotension, which can result from severe dehydration in untreated diabetes insipidus. Effective treatment should stabilize blood pressure by restoring fluid volume through improved water reabsorption, making low blood pressure an indicator of poor treatment response rather than success.

Choice D reason: Urine output exceeding 200 ml/hour reflects polyuria, a primary symptom of untreated diabetes insipidus due to ADH deficiency. Effective treatment reduces urine output by enhancing renal water reabsorption, so high urine output indicates persistent disease activity, not a successful response to therapy.

A. I sense that you are happy it was not a stroke B. TIA symptoms are short-lived and resolve within 24 hours C. People who experience a TIA will develop a stroke D. TIA is a warning sign. Let’s talk about lowering your risks

Correct Answer is D

Explanation

Reasoning:

Choice A reason: Acknowledging the client’s relief does not educate them about the TIA’s significance. TIAs indicate transient cerebral ischemia, increasing stroke risk, but this response fails to address the need for risk modification, missing an opportunity to promote preventive measures critical for stroke prevention.

Choice B reason: Stating that TIA symptoms resolve within 24 hours is factually correct but does not emphasize the serious nature of TIAs as stroke precursors. Without addressing risk reduction, this response fails to educate the client on the need for lifestyle changes or medical intervention to prevent future events.

Choice C reason: Saying all TIA patients will develop a stroke is inaccurate, as not all progress to stroke. TIAs significantly increase stroke risk, but many can be prevented with proper management. This response is overly fatalistic and does not encourage proactive risk reduction strategies.

Choice D reason: Explaining that a TIA is a warning sign and discussing risk reduction educates the client about its significance as a transient cerebral ischemia event, increasing stroke risk. This response promotes lifestyle changes, medication adherence, and medical follow-up, empowering the client to prevent future strokes effectively.

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The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the health care provider. What type of anemia is the nurse concerned that the co-worker may have?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which outcome indicates that treatment of a client with diabetes insipidus has been effective?

Correct Answer is A

Explanation

A client who has experienced an initial transient ischemic attack (TIA) states: “I’m glad it wasn’t anything serious.” Which is the best nursing response to this statement?

Correct Answer is D

Explanation

A nurse cares for several clients with anemia and notes that all the clients have different types of anemia. What is the nurse’s best understanding of how anemias are classified, based on the deficiency of erythrocytes? (Select all that apply)

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?

A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are characteristic of iron deficiency anemia?

A client's electronic health record notes that the client has previously undergone treatment for secondary polycythemia. The nurse should assess for which factor?

A nurse is caring for an older client who has had a hemorrhagic stroke. The client has exhibited impulsive behavior and, despite reminders from the nurse, doesn’t recognize their limitations. Which priority measure should the nurse implement to prevent injury?

A nurse is caring for a critically ill client with autonomic dysreflexia. What clinical manifestations would the nurse expect in this client?

A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the health care provider immediately?