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 B

Explanation

Neglect refers to the refusal or failure to provide an elderly person with necessary care, such as food, water, shelter, personal hygiene, medicine, and other essentials of daily living. Signs and symptoms of neglect in elders can include: dehydration, malnutrition, bed sores, fractures, urinary tract infections, contractures, over-medication, elopements, and poor personal hygiene. An elderly client who is admitted to the hospital looking unkempt, with dirty clothing, and smelling of urine may be suffering from neglect by a caregiver or by themselves (self-neglect).

Choice A is wrong because institutionalism is not a type of elder abuse but a term that describes the loss of individuality and autonomy that can occur in institutional settings such as nursing homes.

Choice C is wrong because emotional abuse is the infliction of mental or emotional anguish by threat, humiliation, intimidation, or other abusive conduct. Signs and symptoms of emotional abuse in elders can include: depression, confusion, withdrawal, isolation from friends and family. An elderly client who smells of urine may not necessarily be emotionally abused.

Choice D is wrong because stubborn behavior is not a type of elder abuse but a personality trait that may or may not be present in an elderly person.

Stubborn behavior does not indicate any harm or neglect inflicted upon an older adult by others or themselves.

A. Stimulates bone marrow production of red blood cells. B. Is given to all people with anemia. C. Is given for iron deficiency anemia. D. Stimulates bone marrow production of white blood cells.

Correct Answer is A

Explanation

This helps increase the oxygen-carrying capacity of the blood and corrects anemia.

Choice B is wrong because erythropoietin is not given to all people with anemia. It is only used for certain types of anemia, such as those caused by chronic kidney disease or chemotherapy.

Choice C is wrong because erythropoietin is not given for iron deficiency anemia. Iron deficiency anemia is treated with iron supplements and dietary changes.

Choice D is wrong because erythropoietin does not stimulate bone marrow production of white blood cells. White blood cells are involved in immune responses and are produced by different growth factors.

Question 22.

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Naxlex Comprehensive Predictor Exams

An elderly client is admitted to the hospital looking unkempt, with dirty clothing, and she smells of urine. The nurse is aware this may be:

Correct Answer is B

Explanation

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

Correct Answer is A

Explanation

The RN identifies that a client is at risk for impaired skin integrity. Which interventions should the nurse add to this client’s plan of care?

A nurse is contributing to the plan of care for a client who has COPD. Which of the following interventions should the nurse include in the plan of care?

A client is hospitalized and is in police custody after being arrested for driving while intoxicated for the third time. The nurse assigned to the client lost her brother to a drunk driver two years prior. Which action on the part of the nurse aligns with the professional code of ethics for nurses?

The nurse does not turn a client every two hours as ordered, and the client develops a pressure injury. What legal concept applies?

Which thermoregulatory condition is an elderly person most at risk for?

A nurse is caring for a patient who has complaints of fatigue. If the fatigue is caused by lifestyle choices, what should the nurse recommend for fatigue prevention? (Select all that apply)

The nurse educator is presenting information to a group of nursing students regarding uninsured and underinsured clients. The nurse educator emphasizes that a lack of insurance or lack of sufficient insurance is:

An elderly client is hospitalized for the first time. Which of the following actions ensures the safety of the client? (Select all that apply).