A home health nurse is assessing a client who has pernicious anemia. Which of the following is an expected manifestation that poses a risk to the client's safety?
Loss of hearing
Muscle wasting
Paresthesia
Changes in vision
The Correct Answer is C
C. Paresthesia, or abnormal sensations like tingling, numbness, or burning, is a common neurological manifestation of pernicious anemia due to damage to the peripheral nerves caused by vitamin B12 deficiency. Paresthesia can affect balance and coordination, increasing the risk of falls and injuries, and thus posing a risk to the client's safety.
A. Loss of hearing is not typically associated with pernicious anemia.
B. Muscle wasting is not a typical manifestation of pernicious anemia. However, weakness and fatigue are common symptoms due to anemia resulting from decreased oxygen-carrying capacity of the blood.
D. While changes in vision can impact the client's safety, they are not as directly associated with pernicious anemia as paresthesia, which affects mobility and balance.
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Related Questions
Correct Answer is A
Explanation
A. Joint inflammation(arthritis) is a common manifestation of systemic lupus erythematosus. SLE can cause inflammation in the joints, leading to symptoms such as pain, swelling, stiffness, and decreased range of motion. It often affects the small joints of the hands, wrists, and knees.

B. Tophi are deposits of uric acid crystals that form under the skin in people with chronic gout.
C. Esophagitis, or inflammation of the esophagus, can occur in systemic lupus erythematosus as part of gastrointestinal involvement. However, it is not one of the most common manifestations of SLE.
D. "Bull's eye" lesion, also known as erythema multiforme, is a skin manifestation seen in conditions such as Lyme disease and certain drug reactions. It is not typically associated with systemic lupus erythematosus.
Correct Answer is D
Explanation
D. Respite care services provide temporary relief and support for caregivers by offering short-term care for their loved ones. This allows caregivers to take a break, attend to their own needs, and prevent burnout. Recommending respite care services is a proactive approach to addressing the caregiver's exhaustion and ensuring the well-being of both the caregiver and the client with Alzheimer's disease.
A. The caregiver's exhaustion and irritability may be due to the stress of caregiving rather than intentional neglect or abuse.
B. Relying on medication to manage stress and sleep may not be the best long-term solution and can potentially lead to dependence or other adverse effects.
C. Contacting hospice services for end-of-life care is not appropriate for a client with moderate Alzheimer's disease unless the client's condition has progressed to a terminal stage. Hospice care focuses on providing comfort and support for individuals with a terminal illness who have a life expectancy of six months or less.
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