The nurse is assessing four clients at the neighborhood clinic.
Which of these clients should the nurse identify to be at risk for the development of pernicious anemia?

35-year-old male recently diagnosed with chronic renal failure.

26-year-old woman in her second trimester of pregnancy.

50-year-old male who is following a high-fat and high-protein diet.

43-year-old male who had gastric bypass surgery one year ago.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Chronic renal failure results in decreased erythropoietin production, leading to anemia due to poor red blood cell production, not the vitamin B12 deficiency seen in pernicious anemia. Pernicious anemia specifically results from the lack of intrinsic factor causing B12 deficiency.

Choice B rationale

Pregnancy may cause iron-deficiency anemia due to increased iron demands, not pernicious anemia. Pernicious anemia stems from intrinsic factor deficiency, unrelated to pregnancy physiology. Iron supplementation is required in pregnancy-induced anemia, not B12.

Choice C rationale

A high-fat, high-protein diet does not inherently affect vitamin B12 absorption. Pernicious anemia results from the deficiency of intrinsic factor or issues with B12 absorption, not dietary composition. This individual is not at increased risk based on diet alone.

Choice D rationale

Gastric bypass surgery can disrupt intrinsic factor secretion due to altered gastric mucosa. Intrinsic factor is essential for vitamin B12 absorption in the ileum, and its deficiency directly contributes to the development of pernicious anemia in post-gastric bypass patients. .

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Correct Answer is A

Explanation

Choice A rationale

Medications, such as phosphodiesterase type-5 inhibitors (e.g., sildenafil), are typically the next line of treatment for erectile dysfunction (ED) after lifestyle modifications fail. These agents enhance blood flow to the penile tissues during sexual stimulation by inhibiting the breakdown of cyclic guanosine monophosphate, facilitating erectile function.

Choice B rationale

Negative-pressure devices, also known as vacuum erection devices, are considered third-line treatments and are typically used in clients for whom oral medications are contraindicated or have failed. These devices work by mechanically increasing blood flow to the penis but are less effective than pharmacological interventions.

Choice C rationale

Penile injections, such as alprostadil, are invasive and used as a later option when oral medications and devices are unsuccessful or contraindicated. These injections directly relax the smooth muscle to increase penile blood flow, but they are generally not first-line treatments.

Choice D rationale

Penis transplants are experimental and not recognized as a standard treatment for erectile dysfunction. This option is far from practical or feasible and is considered unsuitable for most clients, especially given the complexity of the condition.

A. How has your energy level been? B. How many pillows are you using to sleep? C. Have you been exercising regularly? D. Have you had any chest pain?.

Correct Answer is B

Explanation

Choice A rationale

Assessing energy levels provides indirect information about cardiac output but lacks specificity regarding fluid overload or pulmonary congestion, which are key indicators of heart failure exacerbation. It is a relevant question but not the best for evaluating treatment outcomes.

Choice B rationale

Asking about pillow use evaluates orthopnea, a common symptom of heart failure due to fluid buildup in the lungs when lying flat. It provides a direct assessment of fluid status and the effectiveness of heart failure management, making it the best question.

Choice C rationale

Exercising regularly is an important lifestyle aspect for heart failure patients but does not directly assess the status of symptoms such as fluid overload or cardiac function. Thus, it is not the most critical outcome measure.

Choice D rationale

Chest pain can indicate ischemia or worsening cardiac function but is not specific to fluid status or pulmonary congestion in heart failure. Therefore, it is a relevant but less optimal question for evaluating treatment goals.

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The nurse is assessing four clients at the neighborhood clinic.Which of these clients should the nurse identify to be at risk for the development of pernicious anemia?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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The nurse is assessing four clients at the neighborhood clinic.
Which of these clients should the nurse identify to be at risk for the development of pernicious anemia?