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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
According to the National Institute on Aging, health care providers play an important role in recognizing and reporting elder abuse. They have a legal and ethical obligation to report any suspected cases of abuse to the appropriate authorities. Reporting is not voluntary for health care workers.
Choice A is wrong because reporting is not voluntary for health care workers. Choice C is wrong because civil liability cannot result if the abuse can’t be proven. Health care providers are protected by immunity laws when they report suspected abuse in good faith.
Choice D is wrong because evidence of abuse does not need to be collected prior to reporting. Health care providers should report any signs or symptoms of abuse, even if they are not conclusive.
Correct Answer is C
Explanation
his intervention can help prevent pressure ulcers by reducing the amount of pressure on bony prominences and promoting blood circulation to the skin.
Choice A is wrong because placing the patient in a side-lying position only can increase the risk of skin breakdown by limiting the patient’s mobility and exposing the same areas to pressure. The patient should be repositioned frequently and encouraged to change positions if able.
Choice B is wrong because massaging bony prominences can cause tissue damage and increase the risk of skin breakdown by impairing blood flow to the area. Massaging should be avoided over bony prominences and areas of redness.
Choice D is wrong because keeping the head of the bed elevated higher than 30 degrees can cause shearing forces on the skin, which can lead to skin breakdown. The head of the bed should be kept at the lowest degree of elevation possible.
Choice E is wrong because inspecting skin every shift is not enough for a patient at risk for impaired skin integrity. The skin should be inspected at least every 2 hours or more frequently depending on the patient’s condition. Early detection of skin changes can help prevent further damage and promote healing.
Normal ranges for skin integrity are:
• Skin color: consistent with ethnicity and genetic background, no pallor, cyanosis, or jaundice.
• Skin moisture: dry to touch, no excessive perspiration or dryness. • Skin texture: smooth, soft, intact, with even surface.
• Skin temperature: warm to touch, no hyperthermia or hypothermia. • Skin turgor: elastic, returns to original shape after being pinched. • Skin integrity: no lesions, wounds, abrasions, or ulcers.
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