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NURS 5315 Final Questions and Answers with Complete Solutions UPDATED!!!.pdf

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NURS 5315 Final Questions and Answers with Complete Solutions
UPDATED!!!

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The clinical scenario is consistent with a pernicious anemia which is secondary to a B12
deficiency. The human body stores approximately 10 years of vitamin B12 and therefore this
anemia tends to present more commonly in the elderly. Other individuals at risk for B12

,deficiency include alcoholics, vegans, those with a gastrectomy, inflammatory bowel disease,
and persons who have had a surgical resection of the ileum. The ileum is the site of
absorption of B12. Vitamin K is used to reverse the effects of warfarin and not to treat
anemia. Iron is used to treat iron deficiency anemia. Folic acid is used to treat an anemia
secondary to folic acid deficiency.


ANS: A


Patients who abuse ETOH have many nutritional deficiencies, some of which include B
vitamins, folic acid, and phosphate. Therefore they should receive thiamine supplementation.




The most appropriate diagnosis is AIDS. AIDS is defined by the presence of HIV and
either a history of an opportunistic infection or the presence of a current opportunistic
infection. PCP is an opportunistic infection and a history of it changes the diagnosis
from HIV positive to AIDS. An individual with HIV infection can also meet the criteria for
an AIDS diagnosis if their CD4 count drops below 200 even if it is a temporary drop. The
patient is not currently experiencing PCP so this is not an appropriate diagnosis. If the
patient did not have a history of PCP then HIV infection would be an appropriate
diagnosis. HIV related syndrome is a false diagnosis.




The clinical scenario is consistent with an aortic stenosis. Aortic stenosis is more common in
females and the elderly. An aortic stenosis causes a decrease in cerebral perfusion which may
result in syncope. Systolic murmurs, heard at the second intercostal space right of the sternal
border which radiate to the neck originate from the aortic valve. Systolic murmurs which
radiate to the axilla originate from the mitral valve. A valve which has regurgitation allows
some blood to flow back through the valve during the cardiac cycle. Perfusion is not typically
an issue with valvular regurgitation. There is no mention of chest pain; therefore, the syncope
is not related to angina.

,
,

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