Review Anemia

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Anemia

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Question 1:

A nurse is assessing a client diagnosed with anemia. Which of the following statements about anemia is correct?

A. Anemia is characterized by an increase in red blood cell production. B. Anemia is primarily caused by an excess of iron in the body. C. Anemia results in a decreased oxygen-carrying capacity of the blood. D. Anemia is a viral infection affecting the bone marrow.

Answer and Explanation

Choice A:

This statement is incorrect because anemia is characterized by a decrease in red blood cell production or an abnormal decrease in hemoglobin levels, not an increase in red blood cell production.

Choice B:

This statement is incorrect because anemia is caused by a deficiency in iron, not an excess of iron.

Choice C:

This statement is correct. Anemia is characterized by a reduced number of red blood cells or a decreased hemoglobin concentration, which leads to a diminished ability of the blood to carry oxygen throughout the body.

Choice D:

This statement is incorrect. Anemia is not caused by a viral infection affecting the bone marrow; rather, it is typically caused by nutritional deficiencies, chronic diseases, or blood loss.

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Question 2:

A nurse is teaching a client with iron-deficiency anemia about dietary sources of iron. Which food items should the nurse recommend? Select all that apply.

A. Oranges B. Spinach C. Red meat D. Nuts and seeds

Answer and Explanation

Choice A:

This choice is incorrect because oranges are a good source of vitamin C, which enhances iron absorption, but they do not provide significant iron content.

Choice B:

This choice is correct because spinach is a good source of iron, which is essential for clients with iron-deficiency anemia.

Choice C:

This choice is correct because red meat contains heme iron, a highly absorbable form of iron that can help improve iron levels in clients with anemia.

Choice D:

This choice is correct because nuts and seeds, such as pumpkin seeds and almonds, are good sources of iron.

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Question 3:

A client with anemia is prescribed ferrous sulfate supplements. A nurse should instruct the client to take the supplement:

A. With meals B. On an empty stomach C. At bedtime D. Simultaneously with calcium supplements

Answer and Explanation

Choice A:

This choice is correct because taking ferrous sulfate with meals can help minimize gastrointestinal side effects such as nausea and constipation.

Choice B:

This choice is incorrect because taking ferrous sulfate on an empty stomach may increase the likelihood of gastrointestinal side effects.

Choice C:

This choice is incorrect because taking ferrous sulfate at bedtime may lead to discomfort during sleep and does not necessarily enhance absorption.

Choice D:

This choice is incorrect because calcium can interfere with the absorption of iron, so it's best to take ferrous sulfate at a different time than calcium supplements.

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Question 4:

A nurse is caring for a client with megaloblastic anemia. Which vitamin deficiency is most likely responsible for this condition?

A. Vitamin A B. Vitamin B12 C. Vitamin C D. Vitamin D

Answer and Explanation

Choice A:

This choice is incorrect because vitamin A deficiency does not cause megaloblastic anemia.

Choice B:

This choice is correct because megaloblastic anemia is typically caused by a deficiency of vitamin B12 or folic acid, which are essential for normal red blood cell production.

Choice C:

This choice is incorrect because vitamin C deficiency leads to scurvy, a condition unrelated to megaloblastic anemia.

Choice D:

This choice is incorrect because vitamin D deficiency can lead to conditions like rickets, but it does not cause megaloblastic anemia.

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Question 5:

A client with anemia presents with pale skin, fatigue, and shortness of breath. The nurse should prioritize which intervention?

A. Initiating oxygen therapy B. Administering pain medication C. Assessing the client's pain level D. Encouraging rest and activity balance

Answer and Explanation

Choice A:

This choice is correct because the client is showing signs of decreased oxygen-carrying capacity due to anemia, and providing oxygen can help improve oxygen saturation levels and alleviate symptoms.

Choice B:

This choice is incorrect because pain medication does not address the underlying issue of anemia and the client's symptoms.

Choice C:

This choice is incorrect because assessing pain levels is not the priority when the client is presenting with symptoms of anemia and potential oxygen deficiency.

Choice D:

This choice is incorrect because although rest and activity balance are essential for overall well-being, they do not directly address the client's acute symptoms related to anemia.

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Question 6:

A client with sickle cell anemia is experiencing a vaso-occlusive crisis. Which intervention should the nurse implement first?

A. Administering pain medication B. Applying warm compresses C. Increasing fluid intake D. Initiating oxygen therapy

Answer and Explanation

Choice A:

This choice is incorrect because administering pain medication addresses the pain associated with the vaso-occlusive crisis, but the priority is to improve oxygenation first.

Choice B:

This choice is incorrect because warm compresses may provide comfort, but they do not directly address the underlying issue of vaso-occlusion and oxygen deficiency.

Choice C:

This choice is incorrect because although increasing fluid intake can help improve blood flow, it does not take precedence over addressing the oxygen deficiency.

Choice D:

This choice is correct because initiating oxygen therapy is the first priority in managing a vaso-occlusive crisis in a client with sickle cell anemia. It helps improve oxygenation and tissue perfusion, which are crucial during this crisis.Questions

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Question 7:

A nurse is caring for a client with a low reticulocyte count. Which type of anemia is most likely to be associated with this finding?

A. Hemolytic anemia B. Iron-deficiency anemia C. Aplastic anemia D. Pernicious anemia

Answer and Explanation

Choice A:

This choice is incorrect because hemolytic anemia is characterized by an increased destruction of red blood cells, which would typically result in a high reticulocyte count.

Choice B:

This choice is incorrect because iron-deficiency anemia is characterized by a low level of iron, which leads to decreased hemoglobin production but does not necessarily affect reticulocyte count.

Choice C:

This choice is correct. Aplastic anemia is characterized by the failure of the bone marrow to produce an adequate number of red blood cells, leading to a low reticulocyte count.

Choice D:

This choice is incorrect because pernicious anemia is caused by a deficiency in vitamin B12, which affects red blood cell maturation but does not directly influence reticulocyte count.

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Question 8:

A nurse is reviewing laboratory results for a client with microcytic and hypochromic red blood cells. Which type of anemia does this finding suggest?

A. Hemolytic anemia B. Sickle cell anemia C. Thalassemia D. Pernicious anemia

Answer and Explanation

Choice A:

This choice is incorrect because hemolytic anemia typically presents with normocytic and normochromic red blood cells, as the bone marrow compensates by releasing immature red blood cells.

Choice B:

This choice is incorrect because sickle cell anemia is characterized by the presence of sickle-shaped red blood cells and is not associated with microcytic and hypochromic cells.

Choice C:

This choice is correct. Thalassemia is a type of anemia in which the synthesis of globin chains is impaired, leading to microcytic and hypochromic red blood cells.

Choice D:

This choice is incorrect because pernicious anemia is associated with macrocytic and normochromic red blood cells due to vitamin B12 deficiency.

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Question 9:

A client presents with fatigue, weakness, and a red, sore tongue. A nurse suspects the client may have a specific type of anemia. Which type is most likely based on these findings?

A. Folate-deficiency anemia B. Hemolytic anemia C. Sickle cell anemia D. Iron-deficiency anemia

Answer and Explanation

Choice A:

This choice is correct. Folate-deficiency anemia can present with fatigue, weakness, and glossitis (inflammation of the tongue), leading to a red, sore tongue.

Choice B:

This choice is incorrect because hemolytic anemia is characterized by the destruction of red blood cells, and it does not specifically cause a red, sore tongue.

Choice C:

This choice is incorrect because sickle cell anemia primarily causes vaso-occlusive crises and pain, not symptoms related to the tongue.

Choice D:

This choice is incorrect because iron-deficiency anemia does not cause glossitis; however, it may present with fatigue and weakness.

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Question 10:

A client diagnosed with chronic kidney disease is experiencing anemia. A nurse recognizes that this type of anemia is primarily due to:

A. Iron deficiency B. Impaired erythropoietin production C. Hemolysis of red blood cells D. Vitamin B12 deficiency

Answer and Explanation

Choice A:

This choice is incorrect because iron deficiency is one of the causes of anemia, but in chronic kidney disease, impaired erythropoietin production is the primary reason.

Choice B:

This choice is correct. Anemia in chronic kidney disease is primarily caused by decreased production of erythropoietin, a hormone produced by the kidneys that stimulates red blood cell production in the bone marrow.

Choice C:

This choice is incorrect because hemolysis of red blood cells is not the main cause of anemia in chronic kidney disease.

Choice D:

This choice is incorrect because vitamin B12 deficiency is not typically associated with anemia in chronic kidney disease.

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Question 11:

A nurse is caring for a client with anemia, and the laboratory results show an increased number of target cells on the peripheral blood smear. Which type of anemia is most likely to be associated with this finding?

A. Iron-deficiency anemia B. Hemolytic anemia C. Sickle cell anemia D. Aplastic anemia

Answer and Explanation

Choice A:

This choice is correct. Iron-deficiency anemia may present with an increased number of target cells on the peripheral blood smear, which are red blood cells with a central area of pallor and a surrounding ring of hemoglobin. This appearance is due to a reduced hemoglobin content in relation to cell size.

Choice B:

This choice is incorrect because hemolytic anemia is characterized by the destruction of red blood cells and typically presents with different morphological changes on the peripheral blood smear.

Choice C:

This choice is incorrect because sickle cell anemia is associated with the presence of sickle-shaped cells, not target cells.

Choice D:

This choice is incorrect because aplastic anemia is characterized by a decrease in the number of all formed elements of the blood (red blood cells, white blood cells, and platelets), and it does not typically cause target cells.

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Question 12:

A client is diagnosed with anemia, and laboratory results show macrocytic and normochromic red blood cells. A nurse suspects a specific type of anemia based on these findings. Which type is most likely to be associated with this result?

A. Iron-deficiency anemia B. Aplastic anemia C. Sickle cell anemia D. Megaloblastic anemia

Answer and Explanation

Choice A:

This choice is incorrect because iron-deficiency anemia is associated with microcytic and hypochromic red blood cells, not macrocytic and normochromic cells.

Choice B:

This choice is incorrect because aplastic anemia typically presents with normocytic and normochromic red blood cells.

Choice C:

This choice is incorrect because sickle cell anemia does not cause macrocytic and normochromic red blood cells.

Choice D:

This choice is correct. Megaloblastic anemia is characterized by macrocytic (large) and normochromic (normal color) red blood cells, which are the result of impaired DNA synthesis during red blood cell production. This condition is often caused by vitamin B12 or folate deficiency.Questions

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Question 13:

A nurse is providing education to a client diagnosed with iron-deficiency anemia. Which of the following factors could contribute to the development of this condition? Select all that apply.

A. Vegetarian diet B. Chronic kidney disease C. Excessive red blood cell destruction D. Gastrointestinal bleeding

Answer and Explanation

Choice A:

This choice is correct. A vegetarian diet, especially if not well-balanced and lacking in iron-rich foods, can lead to iron-deficiency anemia.

Choice B:

This choice is incorrect. Chronic kidney disease is more likely to cause anemia due to impaired erythropoietin production rather than directly causing iron deficiency.

Choice C:

This choice is incorrect. Excessive red blood cell destruction is associated with hemolytic anemia, not iron-deficiency anemia.

Choice D:

This choice is correct. Gastrointestinal bleeding, such as from peptic ulcers or inflammatory bowel disease, can lead to chronic blood loss and iron-deficiency anemia.

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Question 14:

A nurse is caring for a client with pernicious anemia. Which of the following statements made by the client demonstrates an understanding of the condition?

A. "I should consume more iron-rich foods in my diet." B. "I need to avoid foods high in vitamin C." C. "I will need to take lifelong vitamin B12 supplements." D. "I should limit my intake of leafy green vegetables."

Answer and Explanation

Choice A:

This choice is incorrect because pernicious anemia is not related to iron deficiency, so increasing iron-rich foods will not address the underlying cause.

Choice B:

This choice is incorrect because vitamin C actually enhances the absorption of vitamin B12, which is essential in pernicious anemia.

Choice C:

This choice is correct. Pernicious anemia is caused by the lack of intrinsic factor, a protein necessary for vitamin B12 absorption. Clients with pernicious anemia will require lifelong vitamin B12 supplementation, often through intramuscular injections.

Choice D:

This choice is incorrect. Leafy green vegetables are good sources of folate, which is not directly related to pernicious anemia.

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Question 15:

A nurse is assessing a client with anemia, and the client reports a history of chronic alcoholism. Which type of anemia is most likely to be associated with alcoholism?

A. Folate-deficiency anemia B. Hemolytic anemia C. Sickle cell anemia D. Macrocytic anemia

Answer and Explanation

Choice A:

This choice is incorrect because folate-deficiency anemia is associated with a deficiency of folic acid, often caused by poor dietary intake or malabsorption, but not specifically linked to alcoholism.

Choice B:

This choice is incorrect because hemolytic anemia is characterized by the destruction of red blood cells and is not directly related to alcoholism.

Choice C:

This choice is incorrect because sickle cell anemia is a genetic disorder and is not caused by alcohol consumption.

Choice D:

This choice is correct. Macrocytic anemia is commonly associated with alcoholism due to the direct toxic effects of alcohol on bone marrow, resulting in the production of larger-than-normal red blood cells (macrocytes).

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Question 16:

A client presents with signs of hemolysis, including jaundice and an elevated bilirubin level. Which type of anemia is most likely to be associated with these findings?

A. Iron-deficiency anemia B. Hemolytic anemia C. Pernicious anemia D. Aplastic anemia

Answer and Explanation

Choice A:

This choice is incorrect because iron-deficiency anemia is not typically associated with hemolysis or elevated bilirubin levels.

Choice B:

This choice is correct. Hemolytic anemia is characterized by the destruction of red blood cells, leading to the release of bilirubin, which causes jaundice and elevated bilirubin levels.

Choice C:

This choice is incorrect because pernicious anemia is caused by a deficiency in vitamin B12 and does not directly involve hemolysis.

Choice D:

This choice is incorrect because aplastic anemia is characterized by bone marrow suppression, resulting in decreased production of all blood cells, not hemolysis.

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Question 17:

A nurse is caring for a client with anemia, and the client has a history of chronic inflammatory diseases such as rheumatoid arthritis. Which of the following types of anemia is most likely to be associated with chronic inflammatory conditions?

A. Iron-deficiency anemia B. Hemolytic anemia C. Aplastic anemia D. Anemia of chronic disease (ACD)

Answer and Explanation

Choice A:

This choice is incorrect because iron-deficiency anemia is not directly related to chronic inflammatory diseases; it is more commonly associated with blood loss or inadequate iron intake.

Choice B:

This choice is incorrect because hemolytic anemia is not specifically linked to chronic inflammatory diseases.

Choice C:

This choice is incorrect because aplastic anemia is characterized by bone marrow suppression and is not primarily associated with chronic inflammatory conditions.

Choice D:

This choice is correct. Anemia of chronic disease (ACD), also known as anemia of inflammation, is a type of anemia that occurs in the setting of chronic inflammatory diseases. It is typically caused by the body's response to the inflammation, leading to impaired red blood cell production and a shortened red blood cell lifespan.

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Question 18:

A client with a history of gastric bypass surgery presents with signs of anemia. The nurse should suspect which type of anemia?

A. Iron-deficiency anemia B. Pernicious anemia C. Hemolytic anemia D. Sickle cell anemia

Answer and Explanation

Choice A:

This choice is incorrect because iron-deficiency anemia is more likely in clients with gastric bypass surgery due to reduced iron absorption, but it is not specific to this surgery.

Choice B:

This choice is correct. Pernicious anemia is associated with gastric bypass surgery because the procedure can lead to the loss of intrinsic factor-producing cells in the stomach, which is essential for vitamin B12 absorption.

Choice C:

This choice is incorrect because hemolytic anemia is not directly linked to gastric bypass surgery.

Choice D:

This choice is incorrect because sickle cell anemia is a genetic disorder and is not related to gastric bypass surgery.Questions

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Question 19:

A nurse is assessing a client with anemia. Which of the following symptoms is most commonly associated with anemia?

A. Polyuria B. Increased appetite C. Shortness of breath D. Increased energy levels

Answer and Explanation

Choice A:

This choice is incorrect because polyuria, or increased urination, is not a common symptom of anemia. It may be associated with other conditions like diabetes.

Choice B:

This choice is incorrect because increased appetite is not typically associated with anemia. In fact, some clients with anemia may have a reduced appetite due to fatigue and weakness.

Choice C:

This choice is correct. Anemia leads to decreased oxygen-carrying capacity of the blood, which can result in shortness of breath, especially during physical exertion.

Choice D:

This choice is incorrect because anemia causes fatigue and decreased energy levels, not increased energy levels.

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Question 20:

A client with anemia presents with pallor of the skin and mucous membranes. The nurse should assess for which other related clinical manifestation?

A. Petechiae B. Jaundice C. Cyanosis D. Diaphoresis

Answer and Explanation

Choice A:

This choice is incorrect because petechiae, which are tiny red or purple spots on the skin, are associated with platelet disorders and not directly related to anemia.

Choice B:

This choice is correct. Pallor (pale skin) and jaundice (yellowing of the skin and mucous membranes) are related clinical manifestations of anemia. Jaundice can occur in hemolytic anemias when the breakdown of red blood cells leads to an accumulation of bilirubin.

Choice C:

This choice is incorrect because cyanosis, a bluish discoloration of the skin, is not directly related to anemia.

Choice D:

This choice is incorrect because diaphoresis, or excessive sweating, is not a typical clinical manifestation of anemia.

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Question 21:

A client reports experiencing a tingling sensation in the hands and feet, along with difficulty maintaining balance. A nurse should recognize these as possible symptoms of which type of anemia?

A. Iron-deficiency anemia B. Aplastic anemia C. Hemolytic anemia D. Vitamin B12 deficiency anemia

Answer and Explanation

Choice A:

This choice is incorrect because tingling sensation and difficulty maintaining balance are not typical symptoms of iron-deficiency anemia.

Choice B:

This choice is incorrect because aplastic anemia primarily affects the bone marrow and results in decreased production of all blood cells, not specifically causing tingling sensation or balance issues.

Choice C:

This choice is incorrect because hemolytic anemia is characterized by the destruction of red blood cells and is not directly related to neurological symptoms like tingling and balance difficulties.

Choice D:

This choice is correct. Vitamin B12 deficiency anemia can cause neurological symptoms, including tingling in the hands and feet (paresthesia) and difficulty maintaining balance due to nerve damage.

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Question 22:

A client with anemia complains of fatigue and weakness. Which additional assessment finding is commonly associated with this condition?

A. Elevated blood pressure B. Increased heart rate C. Excessive thirst D. Increased appetite

Answer and Explanation

Choice A:

This choice is incorrect because anemia is not directly associated with elevated blood pressure. In fact, low blood pressure may be observed in some individuals with anemia due to decreased blood volume.

Choice B:

This choice is correct. Anemia leads to decreased oxygen-carrying capacity in the blood, and the body compensates by increasing the heart rate to supply more oxygen to vital organs and tissues.

Choice C:

This choice is incorrect because excessive thirst is not a typical symptom of anemia.

Choice D:

This choice is incorrect because anemia is more likely to cause a decreased appetite rather than an increased appetite.

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Question 23:

A nurse is caring for a client with sickle cell anemia during a vaso-occlusive crisis. Which of the following clinical manifestations is most likely to be observed during this crisis?

A. Increased blood pressure B. Pale skin and mucous membranes C. Severe joint pain D. High energy levels

Answer and Explanation

Choice A:

This choice is incorrect because increased blood pressure is not typically observed during a vaso-occlusive crisis in sickle cell anemia.

Choice B:

This choice is incorrect because pale skin and mucous membranes are more likely to be seen in clients with anemia due to decreased red blood cell count, but it is not specific to a vaso-occlusive crisis.

Choice C:

This choice is correct. A vaso-occlusive crisis in sickle cell anemia is characterized by the blockage of small blood vessels, leading to severe pain, particularly in the joints and bones.

Choice D:

This choice is incorrect because clients experiencing a vaso-occlusive crisis are more likely to feel fatigued and weak due to the lack of oxygen delivery, rather than having high energy levels.

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Question 24:

A client with anemia is experiencing headaches and dizziness. A nurse should suspect which type of anemia?

A. Iron-deficiency anemia B. Hemolytic anemia C. Pernicious anemia D. Aplastic anemia

Answer and Explanation

Choice A:

This choice is correct. Headaches and dizziness are common symptoms of iron-deficiency anemia due to decreased oxygen delivery to the brain.

Choice B:

This choice is incorrect because headaches and dizziness are not specific to hemolytic anemia.

Choice C:

This choice is incorrect because pernicious anemia is primarily associated with neurological symptoms such as tingling and difficulty maintaining balance, but not specifically headaches and dizziness.

Choice D:

This choice is incorrect because headaches and dizziness are not directly related to aplastic anemia. Aplastic anemia primarily affects the bone marrow and leads to decreased production of all blood cells, rather than causing symptoms specific to the brain.Questions

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Question 25:

A nurse is assessing a client with suspected anemia. Which laboratory test is commonly used to confirm the diagnosis of anemia?

A. Electrocardiogram (ECG) B. Complete blood count (CBC) C. Serum creatinine D. Urinalysis

Answer and Explanation

Choice A:

This choice is incorrect because an electrocardiogram (ECG) is not a diagnostic test for anemia. It is used to assess heart function.

Choice B:

This choice is correct. A complete blood count (CBC) is the primary diagnostic test used to confirm the presence of anemia. It provides information about red blood cell count, hemoglobin levels, hematocrit, and other parameters related to blood cell characteristics.

Choice C:

This choice is incorrect because serum creatinine is used to assess kidney function, not to diagnose anemia.

Choice D:

This choice is incorrect because a urinalysis is not a diagnostic test for anemia. It is used to assess kidney function and urinary tract health.

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Question 26:

A nurse is reviewing a client's laboratory results and finds a low mean corpuscular volume (MCV). Which type of anemia does this finding suggest?

A. Iron-deficiency anemia B. Hemolytic anemia C. Megaloblastic anemia D. Pernicious anemia

Answer and Explanation

Choice A:

This choice is correct. A low mean corpuscular volume (MCV) indicates microcytic red blood cells, which are characteristic of iron-deficiency anemia.

Choice B:

This choice is incorrect because hemolytic anemia typically presents with a normal or elevated MCV, not a low MCV.

Choice C:

This choice is incorrect because megaloblastic anemia is associated with an elevated MCV due to the presence of larger-than-normal red blood cells (macrocytic).

Choice D:

This choice is incorrect because pernicious anemia is associated with a macrocytic MCV, not a microcytic MCV.

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Question 27:

A client is suspected to have anemia. The nurse advises the client to increase the intake of which dietary component to help differentiate between iron-deficiency anemia and other types of anemia?

A. Vitamin C B. Folate C. Vitamin B12 D. Protein

Answer and Explanation

Choice A:

This choice is correct. Vitamin C enhances the absorption of non-heme iron (the type of iron found in plant-based foods and supplements), so increasing vitamin C intake can help improve iron absorption. This can help differentiate between iron-deficiency anemia (improved iron absorption with increased vitamin C) and anemia of chronic disease (improved iron absorption with decreased vitamin C intake).

Choice B:

This choice is incorrect because increasing folate intake may help with megaloblastic anemia caused by folate deficiency, but it does not directly differentiate between iron-deficiency anemia and other types of anemia.

Choice C:

This choice is incorrect because increasing vitamin B12 intake does not help differentiate between iron-deficiency anemia and other types of anemia.

Choice D:

This choice is incorrect because increasing protein intake is important for overall health but does not directly help differentiate between iron-deficiency anemia and other types of anemia.

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Question 28:

A nurse is caring for a client with anemia. Which diagnostic test should the nurse anticipate to determine the cause of the anemia and assess the size and shape of the red blood cells?

A. Hemoglobin electrophoresis B. Reticulocyte count C. Peripheral blood smear D. Serum iron levels

Answer and Explanation

Choice A:

This choice is incorrect because hemoglobin electrophoresis is used to identify abnormal hemoglobin types, not to assess the size and shape of red blood cells.

Choice B:

This choice is incorrect because a reticulocyte count measures the number of immature red blood cells in the blood and helps determine if the bone marrow is responding appropriately to anemia, but it does not assess the size and shape of red blood cells.

Choice C:

This choice is correct. A peripheral blood smear is used to examine the morphology of red blood cells, including their size, shape, and appearance. It can help identify different types of anemia and determine the cause of anemia.

Choice D:

This choice is incorrect because serum iron levels provide information about iron status but do not directly assess the size and shape of red blood cells.

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Question 29:

A client with anemia is undergoing diagnostic evaluation. The nurse anticipates that which laboratory test will be ordered to assess the body's iron stores?

A. Serum ferritin levels B. Erythrocyte sedimentation rate (ESR) C. Total iron-binding capacity (TIBC) D. White blood cell count (WBC)

Answer and Explanation

Choice A:

This choice is correct. Serum ferritin levels are used to assess the body's iron stores. Ferritin is a protein that stores iron in the body, and low levels of serum ferritin indicate iron deficiency.

Choice B:

This choice is incorrect because the erythrocyte sedimentation rate (ESR) is a nonspecific indicator of inflammation and is not directly related to iron stores.

Choice C:

This choice is incorrect because total iron-binding capacity (TIBC) measures the amount of iron that can be bound to transferrin, a protein that transports iron in the blood, but it does not directly assess iron stores.

Choice D:

This choice is incorrect because the white blood cell count (WBC) is not directly related to iron stores or the evaluation of anemia.

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Question 30:

A client with anemia is undergoing a Schilling test to determine the cause of the condition. The nurse should recognize that this test is used to diagnose which type of anemia?

A. Iron-deficiency anemia B. Pernicious anemia C. Aplastic anemia D. Hemolytic anemia

Answer and Explanation

Choice A:

This choice is incorrect because the Schilling test is not used to diagnose iron-deficiency anemia. It is primarily used to diagnose pernicious anemia, a type of megaloblastic anemia caused by vitamin B12 deficiency.

Choice B:

This choice is correct. The Schilling test is used to diagnose pernicious anemia by assessing the body's ability to absorb vitamin B12 from the digestive system.

Choice C:

This choice is incorrect because the Schilling test is not used to diagnose aplastic anemia. Aplastic anemia is diagnosed through other means, such as bone marrow biopsy and blood tests.

Choice D:

This choice is incorrect because the Schilling test is not used to diagnose hemolytic anemia. Hemolytic anemia is diagnosed through blood tests and other assessments to determine red blood cell destruction.Questions

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Question 31:

A nurse is caring for a client diagnosed with iron-deficiency anemia. The client asks the nurse about dietary changes to improve their condition. Which food item should the nurse recommend to the client to increase their iron intake?

A. Oranges B. Milk C. Green leafy vegetables D. White bread

Answer and Explanation

Choice A:

This choice is incorrect because oranges are rich in vitamin C, which enhances iron absorption, but they do not contain significant amounts of iron.

Choice B:

This choice is incorrect because milk is not a good source of iron and may even hinder iron absorption when consumed in large quantities.

Choice C:

This choice is correct. Green leafy vegetables, such as spinach and kale, are excellent sources of iron and can help improve iron levels in clients with iron-deficiency anemia.

Choice D:

This choice is incorrect because white bread is not a significant source of iron and does not help in increasing iron levels.

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Question 32:

A client with anemia is prescribed oral iron supplements. The nurse advises the client to take the supplements with which beverage to enhance iron absorption?

A. Coffee B. Tea C. Water D. Orange juice

Answer and Explanation

Choice A:

This choice is incorrect because coffee contains substances that can inhibit iron absorption.

Choice B:

This choice is incorrect because tea, especially black tea, contains tannins that can hinder iron absorption.

Choice C:

This choice is incorrect because water does not enhance iron absorption.

Choice D:

This choice is correct. Orange juice, or any other vitamin C-rich beverage, enhances the absorption of non-heme iron found in supplements and plant-based foods.

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Question 33:

A client is receiving epoetin alfa therapy as part of the management of anemia. The nurse should monitor the client for which potential side effect of this medication?

A. Hypertension B. Hyperkalemia C. Hypoglycemia D. Hypocalcemia

Answer and Explanation

Choice A:

This choice is correct. Epoetin alfa is a synthetic form of erythropoietin, a hormone that stimulates red blood cell production. One of the potential side effects of this medication is an increase in blood pressure (hypertension).

Choice B:

This choice is incorrect because hyperkalemia (high potassium levels) is not a common side effect of epoetin alfa therapy.

Choice C:

This choice is incorrect because hypoglycemia (low blood sugar) is not a common side effect of epoetin alfa therapy.

Choice D:

This choice is incorrect because hypocalcemia (low calcium levels) is not a common side effect of epoetin alfa therapy.

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Question 34:

A client with anemia is prescribed ferrous sulfate, an oral iron supplement. The nurse instructs the client to take the medication on an empty stomach. Which beverage should the nurse recommend the client to avoid while taking the supplement?

A. Water B. Orange juice C. Milk D. Tea

Answer and Explanation

Choice A:

This choice is incorrect because taking ferrous sulfate with water is generally acceptable and does not significantly affect iron absorption.

Choice B:

This choice is incorrect because taking ferrous sulfate with orange juice, which is rich in vitamin C, can enhance iron absorption and is often recommended.

Choice C:

This choice is incorrect because taking ferrous sulfate with milk can reduce iron absorption, but it is not as significant as with tea or coffee.

Choice D:

This choice is correct. Tea, especially black tea, contains tannins that can inhibit iron absorption when taken with ferrous sulfate or other iron supplements.

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Question 35:

A client diagnosed with sickle cell anemia is admitted to the hospital during a vaso-occlusive crisis. The nurse understands that which of the following interventions is a priority in managing this crisis?

A. Administering antibiotics B. Providing blood transfusions C. Initiating oxygen therapy D. Encouraging fluid intake

Answer and Explanation

Choice A:

This choice is incorrect because while antibiotics may be necessary if there is an infection, they are not the priority intervention during a vaso-occlusive crisis.

Choice B:

This choice is incorrect because blood transfusions may be needed if there is severe anemia or complications, but they are not the priority intervention during a vaso-occlusive crisis.

Choice C:

This choice is correct. Initiating oxygen therapy is a priority in managing a vaso-occlusive crisis in sickle cell anemia. Providing supplemental oxygen can help improve tissue oxygenation and reduce the severity of the crisis.

Choice D:

This choice is incorrect because although encouraging fluid intake is important in managing sickle cell anemia, it is not the priority intervention during a vaso-occlusive crisis.

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Question 36:

A client with chronic kidney disease and anemia is prescribed erythropoiesis-stimulating agents (ESAs) as part of the treatment plan. The nurse educates the client about the importance of which parameter during ESA therapy?

A. Blood pressure monitoring B. Serum potassium levels C. Dietary sodium intake D. Iron levels and supplementation

Answer and Explanation

Choice A:

This choice is incorrect because while blood pressure monitoring is essential for clients with chronic kidney disease, it is not specifically related to ESA therapy.

Choice B:

This choice is incorrect because serum potassium levels are important in chronic kidney disease, but they are not directly related to ESA therapy.

Choice C:

This choice is incorrect because dietary sodium intake is important in managing fluid balance in chronic kidney disease, but it is not directly related to ESA therapy.

Choice D:

This choice is correct. ESA therapy stimulates the production of red blood cells, and adequate iron levels are necessary for this process. Clients with chronic kidney disease often have decreased iron levels due to various factors, and iron supplementation is crucial for the success of ESA therapy.Questions

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Question 37:

A nurse is caring for a client diagnosed with anemia who is receiving iron supplementation. The nurse should instruct the client to take the iron supplement with which type of beverage to enhance absorption?

A. Orange juice B. Milk C. Tea D. Carbonated water

Answer and Explanation

Choice A:

This choice is correct. Taking iron supplements with orange juice or other vitamin C-rich beverages enhances iron absorption due to the presence of vitamin C, which facilitates the absorption of non-heme iron.

Choice B:

This choice is incorrect because milk can inhibit iron absorption when taken with iron supplements.

Choice C:

This choice is incorrect because tea, especially black tea, contains tannins that can hinder iron absorption.

Choice D:

This choice is incorrect because carbonated water does not enhance iron absorption.

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Question 38:

A client with anemia is prescribed ferrous sulfate, an oral iron supplement. The nurse advises the client to take the medication at least one hour before or two hours after meals. What should the nurse inform the client about this timing?

A. Taking the supplement with meals may reduce gastrointestinal side effects. B. Taking the supplement with meals may enhance iron absorption. C. Taking the supplement with meals may improve its effectiveness. D. Taking the supplement with meals may prevent interactions with other medications.

Answer and Explanation

Choice A:

This choice is correct. Taking the iron supplement with meals may reduce gastrointestinal side effects, such as nausea and stomach upset, which are common with iron supplementation.

Choice B:

This choice is incorrect because taking iron supplements with meals may reduce iron absorption due to interference with other dietary components.

Choice C:

This choice is incorrect because taking the supplement with meals does not directly improve its effectiveness in treating anemia.

Choice D:

This choice is incorrect because interactions with other medications are not specifically related to the timing of iron supplementation with meals.

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Question 39:

A client with anemia is receiving erythropoiesis-stimulating agents (ESAs) to promote red blood cell production. The nurse should monitor the client for which adverse effect related to ESA therapy?

A. Hypotension B. Hypokalemia C. Hypoglycemia D. Thrombosis

Answer and Explanation

Choice A:

This choice is incorrect because ESA therapy is not typically associated with hypotension. In fact, an increase in blood pressure is a potential side effect of ESAs.

Choice B:

This choice is incorrect because hypokalemia (low potassium levels) is not a common adverse effect of ESA therapy.

Choice C:

This choice is incorrect because hypoglycemia (low blood sugar) is not a typical side effect of ESA therapy.

Choice D:

This choice is correct. ESA therapy can increase the risk of thrombosis (blood clot formation) due to the stimulation of red blood cell production. Clients receiving ESAs should be monitored for signs of thrombosis, such as swelling, pain, and redness in the extremities.

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Question 40:

A nurse is educating a client with anemia about dietary modifications to enhance iron absorption. Which of the following food combinations should the nurse recommend to the client to optimize iron uptake?

A. Whole-grain bread with eggs B. Red meat with dairy products C. Spinach with nuts D. Lentils with beans

Answer and Explanation

Choice A:

This choice is incorrect because whole-grain bread contains phytates that can inhibit iron absorption, and although eggs enhance non-heme iron absorption, the combination with whole-grain bread may not be as effective as other options.

Choice B:

This choice is correct. Red meat is a rich source of heme iron, which is well-absorbed, and dairy products are sources of calcium that do not significantly inhibit heme iron absorption. Combining heme iron with calcium-rich foods can help optimize iron uptake.

Choice C:

This choice is incorrect because although spinach is a source of non-heme iron, it also contains substances such as oxalates that can hinder iron absorption. Nuts, while being nutritious, do not specifically enhance iron absorption.

Choice D:

This choice is incorrect because both lentils and beans are sources of non-heme iron, and the combination does not provide a significant enhancer of iron absorption.

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Question 41:

A client with anemia is receiving packed red blood cell (PRBC) transfusions. The nurse should prioritize which action during the transfusion process?

A. Monitoring the client's temperature B. Administering pain medication C. Obtaining informed consent D. Checking the client's blood type

Answer and Explanation

Choice A:

This choice is incorrect because monitoring the client's temperature is important, but it is not the priority during the PRBC transfusion process.

Choice B:

This choice is incorrect because administering pain medication may be necessary if the client is experiencing discomfort during or after the transfusion, but it is not the priority action.

Choice C:

This choice is incorrect because obtaining informed consent is an essential step before any medical intervention, including transfusions, but it is not the priority during the transfusion process.

Choice D:

This choice is correct. Checking the client's blood type is a priority before administering a PRBC transfusion to ensure compatibility and prevent adverse reactions. Transfusion reactions can be life-threatening, so verifying the blood type is crucial for client safety.

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Question 42:

A nurse is caring for a client with anemia who is experiencing fatigue and weakness. The nurse should recommend which activity to conserve energy and manage the symptoms?

A. Participating in regular aerobic exercises B. Engaging in resistance training C. Taking frequent naps throughout the day D. Limiting fluid intake to avoid frequent bathroom trips

Answer and Explanation

Choice A:

This choice is incorrect because while regular aerobic exercises can be beneficial for overall health, they may be too strenuous for a client experiencing fatigue and weakness due to anemia.

Choice B:

This choice is incorrect because resistance training may require a significant amount of energy and effort, which may not be suitable for a client with anemia and symptoms of fatigue and weakness.

Choice C:

This choice is correct. Taking frequent naps throughout the day can help the client conserve energy and manage the symptoms of fatigue and weakness associated with anemia.

Choice D:

This choice is incorrect because limiting fluid intake is not a recommended strategy for managing fatigue and weakness in clients with anemia. Adequate hydration is important for overall health, and clients should be encouraged to drink enough fluids.Questions

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