A nurse is providing care for a patient who the healthcare provider suspects may have pernicious anemia.
Which diagnostic test should the nurse anticipate the healthcare provider will order?

Choice A rationale

The task of recording strict nutritional content is within the scope of practice for an assistive personnel (AP). The AP can keep track of the client’s food and fluid intake and report this information to the nurse. This is important in this case as the client has not been eating and the provider has prescribed a regular tray with finger foods at each meal. The nurse can then use this information to assess the client’s nutritional status and make necessary adjustments to the care plan.

Choice B rationale

Administering medication, such as memantine, is not within the scope of practice for an AP. This task requires knowledge and skills related to pharmacology, assessment, and evaluation that are beyond the training of an AP. Therefore, this task should be performed by a licensed nurse.

Choice C rationale

Performing neurological checks is also not within the scope of practice for an AP. These checks involve assessing the client’s level of consciousness, orientation, and neurological function, which require advanced assessment skills. Therefore, this task should be performed by a licensed nurse.

Choice D rationale

Continuing the bowel training program could potentially be within the scope of practice for an AP, depending on the specific tasks involved. However, in this case, the family member has reported that the client is having more difficulty staying focused, which suggests that the bowel training program may need to be adjusted. This requires nursing judgment and therefore should be performed by a licensed nurse.

Choice A rationale

A sweat test is used to diagnose cystic fibrosis, a genetic disorder that affects the lungs and digestive system. It is not used to diagnose pernicious anemia.

Choice B rationale

Haptoglobin is a protein produced by the liver that binds to hemoglobin in the blood to prevent it from being excreted through the kidneys. While it can be used to diagnose conditions that cause the destruction of red blood cells, it is not used to diagnose pernicious anemia.

Choice C rationale

The Schilling test is used to determine whether the body absorbs vitamin B12 normally, which is crucial for the diagnosis of pernicious anemia. Pernicious anemia is a condition where the body is unable to absorb vitamin B12 due to a lack of intrinsic factor, a protein made in the stomach.

Choice D rationale

Antinuclear antibodies (ANAs) are a type of autoantibody that can attack the body’s own tissues. While they can be present in various autoimmune diseases, they are not used to diagnose pernicious anemia.