The nurse observes the laboratory studies for a client in the hospital with fatigue, feeling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocrit of 28%. What finding would be an indicator of iron-deficiency anemia?

An increased number of erythrocytes

Erythrocytes that are microcytic and hypochromic

Clustering of platelets with sickled red blood cells

Erythrocytes that are macrocytic and hyperchromic

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: An increased number of erythrocytes is not indicative of iron-deficiency anemia, which is characterized by reduced red blood cell production due to low iron availability for hemoglobin synthesis. Increased erythrocytes suggest compensatory mechanisms or polycythemia, not the reduced erythropoiesis seen in iron deficiency.

Choice B reason: Microcytic and hypochromic erythrocytes are hallmarks of iron-deficiency anemia. Low iron impairs hemoglobin synthesis, leading to smaller (microcytic) and paler (hypochromic) red blood cells. This matches the client’s low hemoglobin and hematocrit, confirming iron deficiency as the cause of the anemia.

Choice C reason: Clustering of platelets with sickled red blood cells is specific to sickle cell anemia, not iron-deficiency anemia. Sickle cell disease involves hemoglobin S, causing cell deformation, not iron deficiency. Platelet clustering is unrelated to the microcytic, hypochromic cells of iron deficiency.

Choice D reason: Macrocytic and hyperchromic erythrocytes suggest megaloblastic anemia, typically from vitamin B12 or folate deficiency, not iron deficiency. Iron-deficiency anemia produces microcytic, hypochromic cells due to impaired hemoglobin synthesis, making macrocytic, hyperchromic cells inconsistent with the client’s laboratory findings.

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Correct Answer is B

Explanation

Reasoning:

Choice A reason: Hemoglobin A is the normal adult hemoglobin, comprising two alpha and two beta chains. In sickle cell anemia, a mutation in the beta-globin gene produces hemoglobin S, not hemoglobin A, which does not cause sickling or the vaso-occlusive crises characteristic of the disease.

Choice B reason: Hemoglobin S is the abnormal hemoglobin in sickle cell anemia, resulting from a point mutation in the beta-globin gene. This causes red blood cells to sickle under stress, leading to hemolysis and vaso-occlusion, resulting in pain, organ damage, and the clinical features of sickle cell crises.

Choice C reason: Hemoglobin M is a rare hemoglobin variant causing methemoglobinemia, not sickle cell anemia. It results from mutations affecting heme iron, leading to cyanosis, not the sickling and vaso-occlusion seen with hemoglobin S, making it irrelevant to the client’s condition.

Choice D reason: Hemoglobin F, or fetal hemoglobin, is present in newborns and persists in small amounts in adults. In sickle cell anemia, increased hemoglobin F can reduce sickling, but it is not the cause. Hemoglobin S drives the disease’s pathophysiology, not hemoglobin F.

A. A client admitted with suspected cocaine overdose B. A client admitted with sepsis C. A client with heart failure and renal failure D. A client with a stage IV pressure injury

Correct Answer is B

Explanation

Reasoning:

Choice A reason: A cocaine overdose can cause cardiovascular complications like hypertension or infarction, but it is not a primary trigger for DIC. While cocaine may induce inflammation or vascular damage, it lacks the systemic activation of coagulation pathways seen in conditions like sepsis, making it a less likely cause of DIC in this context.

Choice B reason: Sepsis is a leading cause of DIC due to systemic infection triggering widespread activation of the coagulation cascade. Endotoxins or cytokines promote microthrombi formation, consuming platelets and clotting factors, leading to bleeding tendencies. Sepsis-induced inflammation and endothelial damage make this client the most at risk for developing DIC.

Choice C reason: Heart failure and renal failure may cause fluid imbalances and inflammation but are not primary triggers for DIC. These conditions can contribute to coagulopathy indirectly, but they lack the intense systemic inflammatory response and endothelial injury seen in sepsis, making them less likely to cause DIC.

Choice D reason: A stage IV pressure injury may lead to localized infection or inflammation, but it is not a primary driver of DIC. While severe infections could contribute, the systemic activation of coagulation seen in DIC is more commonly triggered by conditions like sepsis, making this client less at risk.

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The nurse observes the laboratory studies for a client in the hospital with fatigue, feeling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocrit of 28%. What finding would be an indicator of iron-deficiency anemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client has a history of sickle cell anemia with several sickle cell crises over the past 10 years. What blood component results in sickle cell anemia?

Correct Answer is B

Explanation

The nurse is reviewing plans of care for several clients. The nurse recognizes which client is most at risk for developing disseminated intravascular coagulation (DIC)?

Correct Answer is B

Explanation

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