NURS 5432 2026 Final Exams Updated Questions and
Correct answers
What is the management for lead level 5-9 mcg/dL? - Education, repeat in 3
months.
What is the management for lead level >44 mcg/dL? - Chelation therapy.
What are early symptoms of lead poisoning? - Abdominal pain, constipation,
headache, anorexia.
What are severe symptoms of lead toxicity? - Vomiting, confusion, somnolence,
agitation.
Why does iron deficiency increase lead absorption? - Same GI transporter;
upregulated in iron deficiency.
What are key lab findings in IDA? - ↓ Hgb, ↓ MCV, ↓ MCHC, ↑ RDW, ↓ ferritin,
↑ TIBC, ↓ serum iron.
What happens to ferritin in IDA? - It decreases.
What happens to TIBC in IDA? - It increases.
How much should hemoglobin rise with proper iron treatment? - 1 g/dL every 2-
3 weeks.
, How long should iron therapy continue after levels normalize? - 2-3 months.
What is the adult elemental iron dose? - 65-130 mg/day.
What is the pediatric elemental iron dose? - 3-6 mg/kg/day.
What increases iron absorption? - Vitamin C.
What decreases iron absorption? - PPIs and antacids.
What is a common side effect of oral iron? - Constipation.
When is IV iron indicated? - Malabsorption, bariatric surgery, IBD, failure of oral
therapy.
Is anemia of chronic disease usually microcytic or normocytic? - Normocytic.
What happens to ferritin in anemia of chronic disease? - It increases.
What happens to TIBC in anemia of chronic disease? - It decreases.
What inflammatory markers may be elevated? - ESR and CRP.
What is the treatment of anemia of chronic disease? - Treat underlying cause,
epoetin alfa, transfusion if severe.
, What type of anemia is B12 deficiency? - Macrocytic.
What causes B12 deficiency? - Lack of intrinsic factor, Crohn's, celiac, vegetarian
diet, alcoholism, surgery.
What is pernicious anemia? - Lack of intrinsic factor causing B12 deficiency.
What are classic neurologic symptoms of B12 deficiency? - Paresthesias, ataxia,
decreased reflexes.
What lab confirms B12 deficiency? - B12 <200 pg/mL and elevated
methylmalonic acid (MMA).
What is the treatment for B12 deficiency? - Cyanocobalamin 1000 mcg IM daily
→ weekly → monthly.
What type of anemia is folate deficiency? - Macrocytic.
What are the causes of folate deficiency? - Poor diet, alcoholism, malabsorption,
pregnancy.
Why must B12 be checked before giving folate? - To avoid masking B12
deficiency.
What is the treatment for folate deficiency? - Folic acid 1 mg daily.
Correct answers
What is the management for lead level 5-9 mcg/dL? - Education, repeat in 3
months.
What is the management for lead level >44 mcg/dL? - Chelation therapy.
What are early symptoms of lead poisoning? - Abdominal pain, constipation,
headache, anorexia.
What are severe symptoms of lead toxicity? - Vomiting, confusion, somnolence,
agitation.
Why does iron deficiency increase lead absorption? - Same GI transporter;
upregulated in iron deficiency.
What are key lab findings in IDA? - ↓ Hgb, ↓ MCV, ↓ MCHC, ↑ RDW, ↓ ferritin,
↑ TIBC, ↓ serum iron.
What happens to ferritin in IDA? - It decreases.
What happens to TIBC in IDA? - It increases.
How much should hemoglobin rise with proper iron treatment? - 1 g/dL every 2-
3 weeks.
, How long should iron therapy continue after levels normalize? - 2-3 months.
What is the adult elemental iron dose? - 65-130 mg/day.
What is the pediatric elemental iron dose? - 3-6 mg/kg/day.
What increases iron absorption? - Vitamin C.
What decreases iron absorption? - PPIs and antacids.
What is a common side effect of oral iron? - Constipation.
When is IV iron indicated? - Malabsorption, bariatric surgery, IBD, failure of oral
therapy.
Is anemia of chronic disease usually microcytic or normocytic? - Normocytic.
What happens to ferritin in anemia of chronic disease? - It increases.
What happens to TIBC in anemia of chronic disease? - It decreases.
What inflammatory markers may be elevated? - ESR and CRP.
What is the treatment of anemia of chronic disease? - Treat underlying cause,
epoetin alfa, transfusion if severe.
, What type of anemia is B12 deficiency? - Macrocytic.
What causes B12 deficiency? - Lack of intrinsic factor, Crohn's, celiac, vegetarian
diet, alcoholism, surgery.
What is pernicious anemia? - Lack of intrinsic factor causing B12 deficiency.
What are classic neurologic symptoms of B12 deficiency? - Paresthesias, ataxia,
decreased reflexes.
What lab confirms B12 deficiency? - B12 <200 pg/mL and elevated
methylmalonic acid (MMA).
What is the treatment for B12 deficiency? - Cyanocobalamin 1000 mcg IM daily
→ weekly → monthly.
What type of anemia is folate deficiency? - Macrocytic.
What are the causes of folate deficiency? - Poor diet, alcoholism, malabsorption,
pregnancy.
Why must B12 be checked before giving folate? - To avoid masking B12
deficiency.
What is the treatment for folate deficiency? - Folic acid 1 mg daily.
