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 C

Explanation

Reasoning:

Choice A reason: Elimination of iron by the body is not a typical cause of anemia in older adults. Iron is tightly regulated, and excessive loss occurs through bleeding, not spontaneous elimination. Anemia in the elderly is more commonly due to chronic blood loss or impaired absorption, not iron excretion.

Choice B reason: Excessive coffee or tea consumption can inhibit iron absorption due to tannins binding dietary iron, but it is not a primary cause of anemia in older adults. Blood loss or chronic disease are more common culprits, making dietary inhibition a less likely contributor in this population.

Choice C reason: Blood loss from the gastrointestinal or genitourinary tract is a common cause of anemia in older adults. Chronic bleeding from ulcers, colon cancer, or urinary tract issues depletes iron stores, leading to iron deficiency anemia, a frequent finding in the elderly due to higher prevalence of these conditions.

Choice D reason: A decrease in total body iron stores with age is not a primary cause of anemia. While absorption may decline slightly, blood loss from gastrointestinal or genitourinary sources is a more significant contributor in older adults, as it directly reduces iron available for hemoglobin synthesis.

A. Above-normal urine osmolality level, below-normal serum osmolality level B. Above-normal urine and serum osmolality levels C. Below-normal urine osmolality level, above-normal serum osmolality level D. Below-normal urine and serum osmolality levels

Correct Answer is C

Explanation

Reasoning:

Choice A reason: Above-normal urine osmolality and below-normal serum osmolality are not consistent with diabetes insipidus. High urine osmolality suggests concentrated urine, typical in syndrome of inappropriate antidiuretic hormone (SIADH), where ADH is excessive. Low serum osmolality also aligns with SIADH due to water retention, not the water loss seen in diabetes insipidus.

Choice B reason: Above-normal urine and serum osmolality levels do not reflect diabetes insipidus. High urine osmolality indicates concentrated urine, which contradicts the dilute urine output of diabetes insipidus. High serum osmolality could occur with dehydration, but the combination with high urine osmolality suggests another condition, not ADH deficiency.

Choice C reason: Below-normal urine osmolality and above-normal serum osmolality are classic findings in diabetes insipidus. Arginine vasopressin (ADH) deficiency impairs water reabsorption, leading to dilute urine (low osmolality). The resulting water loss increases serum osmolality as the body becomes dehydrated, supporting the diagnosis of diabetes insipidus.

Choice D reason: Below-normal urine and serum osmolality levels are inconsistent with diabetes insipidus. Low urine osmolality occurs due to ADH deficiency, but low serum osmolality suggests water retention, as in SIADH. Diabetes insipidus causes dehydration, elevating serum osmolality, not lowering it, making this combination unlikely in this condition.

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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

The nurse is caring for an older adult client who has been admitted to the unit with anemia. What would the nurse expect the client to possibly exhibit?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

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