A nurse in a provider's office is caring for a client.
For each client's finding, click to specify if the assessment finding is consistent with sickle cell disease, iron deficiency anemia, and/or pernicious anemia. Each finding may support more than 1 disease process.
Vitamin B12 level
Orthostatic hypotension
Ferritin level
Fatigue
The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A,B,C"}}
Sickle Cell Disease:
• Fatigue
Iron Deficiency Anemia:
• Ferritin level
• Fatigue
• Orthostatic hypotension
Pernicious Anemia:
• Vitamin B12 level
• Fatigue
Rationale:
• Vitamin B12 level: A decreased vitamin B12 level is characteristic of pernicious anemia, which results from impaired absorption of vitamin B12 due to intrinsic factor deficiency.
• Orthostatic hypotension: A drop in blood pressure upon standing is commonly seen in iron deficiency anemia due to reduced oxygen-carrying capacity and inadequate perfusion.
• Ferritin level: A low ferritin level indicates depleted iron stores, which is a hallmark of iron deficiency anemia.
• Fatigue: Fatigue is a common symptom in all three conditions due to reduced oxygen delivery to tissues. In sickle cell disease, fatigue results from chronic hemolysis and vaso-occlusive episodes. In iron deficiency anemia, it is caused by insufficient hemoglobin production. In pernicious anemia, fatigue results from ineffective erythropoiesis due to vitamin B12 deficiency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Increased body hair: Adrenal insufficiency leads to decreased androgen production, which may cause hair thinning rather than increased body hair. Hypertrichosis (excessive hair growth) is not a typical finding in adrenal insufficiency.
B. Decreased blood urea nitrogen level: Adrenal insufficiency is often associated with dehydration due to aldosterone deficiency, leading to reduced sodium retention and increased fluid loss. This can result in elevated blood urea nitrogen (BUN) levels rather than a decrease.
C. Hyperpigmentation of the skin: Increased melanocyte-stimulating hormone (MSH) activity, triggered by elevated adrenocorticotropic hormone (ACTH) levels, causes darkening of the skin, especially in sun-exposed areas, skin folds, and mucous membranes. This is a hallmark feature of primary adrenal insufficiency (Addison’s disease).
D. Hypocalcemia: Adrenal insufficiency is more commonly associated with hypercalcemia rather than hypocalcemia. Decreased cortisol levels can lead to reduced renal calcium excretion, contributing to elevated serum calcium levels.
Correct Answer is C
Explanation
A. Flushed cheeks: Tuberculosis typically presents with systemic symptoms such as fever, night sweats, and weight loss rather than flushed cheeks. Flushing is more commonly associated with fever spikes in other infections or conditions like menopause.
B. Severe headaches: Tuberculosis can cause headaches if it leads to tuberculous meningitis, but this is not a common initial symptom of pulmonary tuberculosis. Headaches are not a hallmark feature of active TB infection.
C. Low-grade fever: A persistent low-grade fever, particularly in the afternoon or evening, is a common symptom of tuberculosis. It is often accompanied by night sweats and weight loss due to the chronic inflammatory response.
D. Dry cough: The cough associated with tuberculosis is usually productive with purulent or blood-tinged sputum rather than dry. The infection causes lung tissue destruction, leading to a persistent cough with mucus production.
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