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 A

Explanation

A. RR Interval:

The RR interval is the time between two consecutive R waves on an electrocardiogram (ECG) strip. It is primarily used to determine the ventricular rate and rhythm of the heart. A regular RR interval suggests a regular heart rhythm, while irregular intervals may indicate arrhythmias or other cardiac abnormalities. Calculating the RR interval can help determine the heart rate (ventricular rate) by dividing 60 seconds by the RR interval in seconds (e.g., if the RR interval is 0.8 seconds, the heart rate would be approximately 75 beats per minute).

B. QT Interval:

The QT interval represents the time from the start of the Q wave to the end of the T wave on an ECG. It reflects the time it takes for the ventricles to depolarize and repolarize. Prolongation or shortening of the QT interval can indicate certain cardiac conditions or medication effects, including an increased risk of arrhythmias such as torsades de pointes. However, it is not directly used to determine ventricular rate and rhythm as the RR interval is.

C. PP Interval:

The PP interval is the time between two consecutive P waves on an ECG strip. It is primarily used to assess the atrial rate and rhythm. Regular PP intervals indicate a regular atrial rhythm, while irregular intervals may suggest atrial arrhythmias such as atrial fibrillation or atrial flutter. The PP interval is not directly used to determine ventricular rate and rhythm.

D. PR Interval:

The PR interval is the time from the start of the P wave to the start of the QRS complex on an ECG strip. It represents the time it takes for the electrical impulse to travel from the atria to the ventricles. A normal PR interval is typically between 0.12 to 0.20 seconds. Prolongation or shortening of the PR interval can indicate certain cardiac conduction abnormalities.

A. "Only take one nitroglycerin tablet for each episode of angina." B. "Place the nitroglycerin tablet between cheek and gum." C. "Call 911 if you develop a headache following nitroglycerin use." D. "See if rest relieves the chest pain before using the nitroglycerin."

Correct Answer is A

Explanation

A. "Only take one nitroglycerin tablet for each episode of angina."

This instruction is correct. Sublingual nitroglycerin is typically administered as needed for the relief of angina symptoms, with one tablet being the initial dose. If the chest pain persists after 5 minutes, the client may take a second tablet, and if needed, a third tablet after another 5 minutes. However, if the pain is not relieved after three tablets, they should seek immediate medical attention.

B. "Place the nitroglycerin tablet between cheek and gum."

This instruction is incorrect. Sublingual nitroglycerin tablets should be placed under the tongue, allowing them to dissolve and be absorbed directly into the bloodstream. Placing the tablet between the cheek and gum is not the recommended administration route for sublingual nitroglycerin.

C. "Call 911 if you develop a headache following nitroglycerin use."

This instruction is partially correct. Headache is a common side effect of nitroglycerin due to its vasodilatory effects. Clients should be informed about this potential side effect, but not every headache following nitroglycerin use requires immediate medical attention. However, if the headache is severe, persistent, or accompanied by other concerning symptoms, the client should seek medical evaluation.

D. "See if rest relieves the chest pain before using the nitroglycerin."

This instruction is incorrect. Sublingual nitroglycerin is a rapid-acting medication used to relieve angina symptoms quickly. Clients should not delay taking nitroglycerin and wait for rest to relieve chest pain, as this can lead to worsening symptoms and complications.

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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?

Nursing Test Bank

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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