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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Weigh yourself once a week:
This is an important part of heart failure management as weight gain can indicate fluid retention, a common symptom of heart failure. The nurse should instruct the client to weigh themselves at the same time of day, using the same scale, and wearing similar clothing each time. Any sudden weight gain should be reported to the healthcare provider promptly.
B. Drink 3 liters of fluid per day:
This option is not appropriate for most heart failure patients, especially those with fluid retention issues. Fluid intake should be monitored and restricted based on the individual's condition and healthcare provider's recommendations. Consuming too much fluid can exacerbate fluid retention and worsen heart failure symptoms.
C. Engage in exercise daily:
Exercise is generally recommended for heart failure patients, but the type, intensity, and frequency of exercise should be tailored to the individual's condition. The nurse should encourage the client to engage in regular physical activity as tolerated, following a structured exercise plan approved by their healthcare provider. Activities like walking, cycling, or water aerobics can be beneficial for heart health.
D. Restrict dietary potassium:
This option is not typically included in lifestyle modifications for heart failure unless the client has specific potassium-related issues or is taking medications that require potassium restriction. Potassium is an important electrolyte for heart function, and most heart failure patients are advised to consume a balanced diet with moderate potassium intake, unless otherwise directed by their healthcare provider.
Correct Answer is ["1712.32"]
Explanation
To calculate the client's total intake for the 8-hour shift, we need to convert all the volumes to milliliters (mL) and then add them together. Here are the given volumes and their conversions:
1,000 mL 0.9% sodium chloride IV (no conversion needed)
One 6-oz cup of coffee:
6 oz * 29.5735 (conversion factor for oz to mL) = approximately 177.44 mL
6 oz of water:
6 oz * 29.5735 = approximately 177.44 mL
One 180-mL bowl of soup (no conversion needed)
3 oz of flavored gelatin:
3 oz * 29.5735 = approximately 88.72 mL
3 oz of ice cream:
3 oz * 29.5735 = approximately 88.72 mL
Now, let's add up all the volumes:
1,000 mL (IV fluid) + 177.44 mL (coffee) + 177.44 mL (water) + 180 mL (soup) + 88.72 mL (gelatin) + 88.72 mL (ice cream) = 1,712.32 mL
Therefore, the nurse should document the client's total intake for the shift as approximately 1,712.32 mL.
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