A client has a history of gastric bypass surgery within the past year. She presents to her primary care office for a check-up and states she has been troubled by several seemingly unrelated ailments: a sore tongue, tingling in her fingers, and “almost” falling several times due to lack of balance. The nurse notes that she is pale and slightly tachycardic.
Which type of anemia does the nurse suspect?

Folic acid deficiency anemia.

Aplastic anemia.

Vitamin B12 deficiency anemia.

Acquired anemia.

Answer and Explanation

The Correct Answer is C

This type of anemia is caused by the reduced absorption of vitamin B12 in the small intestine after gastric bypass surgery. Vitamin B12 is needed for the production of healthy red blood cells and nerve function. The symptoms of vitamin B12 deficiency anemia include sore tongue, tingling in the fingers, and balance problems.

Choice A is wrong because folic acid deficiency anemia is caused by the lack of folic acid in the diet or increased demand for folic acid, such as during pregnancy.

Folic acid is also needed for red blood cell production, but it does not cause nerve symptoms.

Choice B is wrong because aplastic anemia is caused by the failure of the bone marrow to produce enough blood cells.

It is not related to gastric bypass surgery or nutrient deficiency. It can be caused by infections, drugs, radiation, or autoimmune diseases.

Choice D is wrong because acquired anemia is a general term for any type of anemia that is not inherited or present at birth.

It can have many causes, such as blood loss, infection, inflammation, or chronic disease.

It does not specify the type of anemia or the underlying mechanism. Normal ranges for hemoglobin are 13.5 to 17.5 g/dL for men and 12 to 15.5 g/dL for women. Normal ranges for vitamin B12 are 200 to 900 pg/mL.

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Correct Answer is C

Explanation

The role of the risk manager is to identify and analyze the factors that contributed to the adverse event and to implement strategies to prevent or reduce the likelihood of recurrence. The risk manager is not concerned with assigning blame or protecting the staff from litigation, but rather with improving the quality and safety of care.

Choice A is wrong because it implies a punitive approach that does not address the underlying system issues.

Choice B is wrong because it suggests a defensive attitude that does not foster a culture of learning and improvement.

Choice D is wrong because it assumes that the nurses were not aware of the patient’s fall risk, which may not be the case.

The risk manager should investigate all aspects of the situation, including the communication and documentation of the patient’s fall risk assessment and interventions.

A. An influenza vaccine. B. A broad-spectrum antibiotic. C. A bronchodilator. D. A corticosteroid.

Correct Answer is A

Explanation

This is because people with COPD are more likely to catch respiratory infections such as colds, flu and pneumonia, which can worsen their symptoms and cause further lung damage. An influenza vaccine can help prevent flu and reduce the risk of complications.

Choice B. A broad-spectrum antibiotic is wrong because antibiotics are only effective against bacterial infections, not viral ones. Antibiotics are usually prescribed for COPD exacerbations caused by bacterial infections, but not for prevention.

Choice C. A bronchodilator is wrong because bronchodilators are medications that relax the muscles around the airways and make breathing easier. They are used to treat the symptoms of COPD, but they do not prevent respiratory infections.

Choice D. A corticosteroid is wrong because corticosteroids are anti inflammatory drugs that reduce swelling and mucus production in the airways. They are also used to treat the symptoms of COPD, but they do not prevent respiratory infections. In fact, long-term use of corticosteroids may increase the risk of infections by suppressing the immune system.

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Naxlex Comprehensive Predictor Exams

An elderly man fell during his hospitalization and has died from a head injury sustained in the fall. What is the role of the risk manager in this situation?

Correct Answer is C

Explanation

The nurse is assigned to care for a client admitted to the hospital with chronic obstructive pulmonary disease (COPD). Which medication does the nurse anticipate to decrease this client’s risk for developing a respiratory infection?

Correct Answer is A

Explanation

A nurse is preparing to administer a medication to a client. Which of the following actions by the nurse demonstrates advocacy for client rights?

The nurse is conducting an assessment on a client who is 36 hours postoperative following an appendectomy. During the assessment, the nurse is unable to hear any bowel sounds. The client denies passing flatus (gas). Given this information, which action is most appropriate by the nurse?

A home health nurse visits a client who has COPD and receives oxygen at 2 L/min via nasal cannula. The client reports difficulty breathing. Which of the following actions is the nurse’s priority?

A new nurse is working in a hospital. Which of the following actions by the nurse is NOT related to one of the National Patient Safety Goals?

A charge nurse is providing an inservice for staff nurses on the use of new IV pumps. Which of the following actions should the charge nurse take to best evaluate staff competency with the new equipment?

A nurse is reinforcing teaching with a client who has a new diagnosis of fibromyalgia. Which of the following information should the nurse include in the teaching?

A person with anemia is prescribed erythropoietin subcutaneously. The nurse knows that erythropoietin: