Why is vitamin B12 deficiency common in patients with pernicious anemia?

A. Intrinsic factor enhances vitamin B12 storage: Intrinsic factor is for absorption, not storage.

B. Due to the lack of intrinsic factor, vitamin B12 cannot be absorbed: This is the definition of the pathology in pernicious anemia—the failure to absorb B12 due to missing intrinsic factor.

C. Intrinsic factor is destroyed by liver enzymes: Intrinsic factor functions in the intestines and is not processed by the liver in this manner.

D. Excessive excretion of vitamin B12 in urine: The issue is a failure to get the vitamin into the blood in the first place, not a loss through the kidneys.

A. Check the client for injuries: The first step of the nursing process is assessment. The nurse must check for fractures, head injuries, or bleeding before moving the client.

B. Obtain a prescription for medication to sedate: Sedation increases the risk of future falls and does not address the immediate safety of the client.

C. Assist the client back into bed and apply restraints: Restraints are a last resort and often increase the risk of injury; they should not be applied without a specific medical order and clear indication.

D. Call the family and ask them to sit with the client: While family involvement is good, it is not the immediate priority. The nurse is responsible for the client's immediate physical assessment.