A nurse is caring for a young female adult client who reports weakness, fatigue, and heavy menstrual periods. The client has a hemoglobin level of 8 g/dL and a hematocrit level of 28 g/dL. The nurse suspects which of the following types of anemia?

Folic acid deficiency anemia

Pernicious anemia

Iron-deficiency anemia

Sickle cell anemia

Answer and Explanation

The Correct Answer is C

A. Folic acid deficiency anemia:

Folic acid deficiency anemia is characterized by a lack of folate (vitamin B9), which is essential for red blood cell production. Symptoms can include weakness and fatigue, similar to iron-deficiency anemia. However, folic acid deficiency anemia typically does not cause heavy menstrual periods. Laboratory findings may show a low level of folate in the blood, but the hemoglobin level of 8 g/dL and hematocrit level of 28 g/dL alone do not specifically indicate folic acid deficiency anemia without considering other factors like mean corpuscular volume (MCV) and red blood cell indices.

B. Pernicious anemia:

Pernicious anemia is caused by a lack of intrinsic factor, a substance needed for the absorption of vitamin B12. It can lead to symptoms such as weakness and fatigue. However, heavy menstrual periods are not a characteristic feature of pernicious anemia. Laboratory findings may show a low hemoglobin and hematocrit level, but again, other factors such as MCV and vitamin B12 levels would be needed to confirm this type of anemia.

C. Iron-deficiency anemia:

Iron-deficiency anemia occurs due to insufficient iron stores in the body, leading to decreased hemoglobin and hematocrit levels. This type of anemia is commonly associated with symptoms like weakness, fatigue, and heavy menstrual periods in women due to blood loss. The client's hemoglobin level of 8 g/dL and hematocrit level of 28 g/dL are consistent with iron-deficiency anemia, making this the most likely choice based on the information provided.

D. Sickle cell anemia:

Sickle cell anemia is a genetic disorder characterized by abnormal hemoglobin that causes red blood cells to become sickle-shaped and less flexible. It typically presents with symptoms such as anemia, pain crises, and organ damage. However, the client's symptoms of weakness, fatigue, and heavy menstrual periods are not specific to sickle cell anemia. Additionally, sickle cell anemia would have different laboratory findings, including a different pattern on peripheral blood smear and hemoglobin electrophoresis.

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Correct Answer is B

Explanation

A. "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion.": Cardiac enzymes are not used to diagnose pulmonary congestion. They are specific markers used to assess damage to the heart muscle, particularly after a myocardial infarction (MI).

B. "These tests help determine the degree of damage to the heart tissues.": This statement is correct. Cardiac enzyme studies, such as troponin levels, CK-MB (creatine kinase-MB), and LDH (lactate dehydrogenase), are used to evaluate the extent of myocardial damage during and after an MI. Elevated levels of these enzymes indicate myocardial injury.

C. "These tests will enable the provider to determine the heart structure.": While cardiac imaging studies like echocardiograms or angiograms are used to assess heart structure, cardiac enzymes are primarily used to evaluate myocardial damage and not heart structure.

D. "Cardiac enzymes will identify the location of the MI.": Cardiac enzymes can indicate the presence of an MI and the extent of myocardial damage, but they do not specifically identify the location of the MI within the heart. Additional diagnostic tests, such as electrocardiograms (ECGs) and imaging studies, are often used to determine the location of the MI.

A. When the client states he is ready to start the infusion B. As soon as the nurse can prepare the client and the administration set C. 2 hours after obtaining blood from the blood bank D. When the client has finished eating lunch

Correct Answer is B

Explanation

A. When the client states he is ready to start the infusion:

While it's important to consider the client's readiness and cooperation, the timing of the infusion should not solely depend on the client's statement. The priority is to start the infusion promptly after receiving the packed red blood cells (PRBCs) from the blood bank to ensure their safety and effectiveness.

B. As soon as the nurse can prepare the client and the administration set:

This choice is the correct answer. After receiving the unit of PRBCs from the blood bank at 1130, the nurse should begin the infusion as soon as possible after preparing the client (ensuring the correct patient, verifying the blood type compatibility, obtaining informed consent, etc.) and the administration set (priming the IV tubing, checking for any leaks, etc.). Prompt administration helps prevent delays that could compromise the quality of the blood product.

C. 2 hours after obtaining blood from the blood bank:

Waiting for 2 hours before starting the infusion is too long and could exceed the recommended timeframe for administering PRBCs after obtaining them from the blood bank. Delaying the infusion for such an extended period could impact the viability and safety of the blood product.

D. When the client has finished eating lunch:

The timing of the client's meal is not a factor in determining when to start the infusion of PRBCs. While it's generally important for the client to have adequate nutrition and hydration, the priority is to administer the blood product promptly after preparation to ensure its efficacy and safety, rather than waiting for unrelated factors such as meal times.

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A nurse is caring for a young female adult client who reports weakness, fatigue, and heavy menstrual periods. The client has a hemoglobin level of 8 g/dL and a hematocrit level of 28 g/dL. The nurse suspects which of the following types of anemia?

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Naxlex Comprehensive Predictor Exams

A nurse is teaching the partner of a client who had an acute myocardial infarction (MI) about the reason blood was drawn from the client. Which of the following statements should the nurse make regarding cardiac enzyme studies?

Correct Answer is B

Explanation

A nurse receives a unit of packed RBCs from a blood bank and notes that the time is 1130. The nurse should begin the infusion at which of the following times?

Correct Answer is B

Explanation

The nurse is collecting data for a client who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia?

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