A 50-year-old male patient with a history of chronic alcoholism presents with fatigue, glossitis, and peripheral neuropathy. Laboratory findings show a hemoglobin level of 9.0 g/dL and mean corpuscular volume (MCV) of 110 fL. What type of anemia is most likely in this patient?

Iron deficiency anemia

Vitamin B12 deficiency anemia

Thalassemia minor

Anemia of chronic disease

Answer and Explanation

The Correct Answer is B

A.   Iron deficiency anemia typically presents with a low MCV, not an elevated MCV, and it is less likely to be associated with the symptoms of glossitis and peripheral neuropathy.
B.   Vitamin B12 deficiency anemia is a likely diagnosis in this patient. Chronic alcohol use can lead to malabsorption of vitamin B12, which contributes to macrocytic anemia (high MCV). Symptoms like glossitis and peripheral neuropathy are common in B12 deficiency.
C.   Thalassemia minor usually presents with microcytic anemia and would not typically cause the elevated MCV or neurological symptoms seen in this patient.
D.   Anemia of chronic disease typically presents with a normal or low MCV and is not associated with elevated MCV or the neurological symptoms seen in this patient.

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Correct Answer is ["C","D","F","G"]

Explanation

A. Assuming the episode was a migraine and scheduling a follow-up is not appropriate. TIAs are serious warning signs of potential future strokes and require immediate attention and evaluation.
B. Discharging the patient immediately after symptoms resolve is not appropriate. Even though symptoms resolve, TIAs are medical emergencies, and further evaluation is necessary to reduce the risk of a full-blown stroke.
C. Initiating antiplatelet therapy, such as aspirin, is an appropriate action to reduce the risk of future strokes in patients who have had a TIA.
D. Ordering a CT scan of the head is appropriate to rule out an intracranial hemorrhage and other causes of the symptoms.

E. Starting anticoagulation therapy immediately without further evaluation is not recommended. The patient must be properly assessed before starting anticoagulation to determine the cause of the TIA and if anticoagulation is appropriate.
F. Conducting a carotid ultrasound is appropriate to assess for stenosis, which could be contributing to the TIA.
G. Referring the patient for lifestyle modifications, including smoking cessation and diet changes, is crucial to reduce future stroke risk. These interventions help prevent the recurrence of TIAs and strokes.

A. Apply soft restraints to prevent injury during the seizure. B. Administer intravenous lorazepam. C. Obtain a detailed seizure history from the family. D. Ensure the patient's airway is open and position them on their side.

Correct Answer is D

Explanation

A. Applying soft restraints during a seizure could increase the risk of injury and is not recommended.
B. Administering lorazepam is often necessary in seizures, but the priority during a seizure is ensuring the airway is open and the patient is in a safe position.
C. Obtaining a seizure history is important but should be done after managing the acute situation.
D. The priority during a seizure is to ensure the patient's airway is open and to position them on their side to prevent aspiration and facilitate breathing.

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A 50-year-old male patient with a history of chronic alcoholism presents with fatigue, glossitis, and peripheral neuropathy. Laboratory findings show a hemoglobin level of 9.0 g/dL and mean corpuscular volume (MCV) of 110 fL. What type of anemia is most likely in this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["C","D","F","G"]

Explanation

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Correct Answer is D

Explanation

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