RNSG 2539 EXAM 2 ACTUAL
EXAMINATION 2026 QUESTIONS WITH
VERIFIED ANSWERS GRADED A+
⫸ anemia risk factors Answer: acute or chronic blood loss, increased
hemolysis, inadequate dietary intake or malabsorption, bone marrow
suppression, age
⫸ anemia expected findings Answer: ● Possibly asymptomatic in mild
cases
● Pallor
● Fatigue
● Irritability
● Numbness and tingling of extremities
● Dyspnea on exertion
● Sensitivity to cold
● Pain and hypoxia with sickle-cell crisis
⫸ Anemia physical assessment findings Answer: ● Shortness of
breath/fatigue, especially upon exertion
● Tachycardia and palpitations
● Dizziness or syncope upon standing or with exertion
● Pallor with pale nail beds and mucous membranes
● Nail bed deformities (spoon-shaped nails)
,● Smooth, sore, bright-red tongue (vitamin B12 deficiency
⫸ Anemia: Laboratory Tests Answer: CBC count
RBC indices
Iron studies
Hgb electrophoresis
Sickle-cell test
Schilling test
⫸ Anemia diagnostic tests Answer: bone marrow biopsy
⫸ Anemia nursing care Answer: Encourage increased dietary intake of
the deficient nutrient (iron, vitamin B12, folic acid).
● Monitor oxygen saturation to determine a need for oxygen therapy.
● Administer medications, as prescribed, at the proper time for optimal
absorption, and using an appropriate technique.
● Teach the client and family about energy conservation in the client
and the risk of the client experiencing dizziness upon standing.
● Teach the client about the time frame for resolution.
⫸ Anemia Medications Answer: - Iron supplements (Ferrous sulfate,
ferrous fumarate, ferrous gluconate)
- Erythropoietin: epoetin alfa
- Vitamin B12 supplementation (cyanocobalamin
,- Folic acid supplements
⫸ Iron supplements (Ferrous sulfate, ferrous fumarate, ferrous
gluconate) Answer: ● Oral iron supplements are used to replenish serum
iron and iron stores. Iron is an essential component of Hgb, and
subsequently, oxygen transport.
● Parenteral iron supplements (iron dextran) are only given for severe
anemia. NURSING CONSIDERATIONS: Administer parenteral iron
using the Z-track method
CLIENT EDUCATION
● Instruct to have hemoglobin checked in 4 to 6 weeks to determine
efficacy.
● Vitamin C can increase oral iron absorption.
● Instruct the client to take iron supplements between meals to increase
absorption, if tolerated.
● Inform the client stools can appear green to black in color while taking
iron
⫸ Erythropoietin: epoetin alfa Answer: A hematopoietic growth factor
used to increase productionof RBCs
NURSING CONSIDERATIONS
● Monitor for an increase in blood pressure.
● Monitor Hgb and Hct twice per week.
● Monitor for a cardiovascular event if Hgb increases too rapidly
(greater than 1 g/dL in 2 weeks).
CLIENT EDUCATION:
, Reinforce the importance of having Hgb and Hct evaluated on a
twice‑per‑week basis until targeted levels are reached.
⫸ Vitamin B12 supplementation (cyanocobalamin) Answer: ● Vitamin
B12 is necessary to convert folic acid from its inactive form to its active
form. All cells rely on folic acid for DNA production.
● Vitamin B12 supplementation can be given orally if the deficit is due
to inadequate dietary intake. However, if deficiency is due to lack of
intrinsic factor being produced by the parietal cells of the stomach or
malabsorption syndrome, it must be administered parenterally or
intranasally to be absorbed.
NURSING CONSIDERATIONS
● Administer vitamin B12 according to appropriate route related to
cause of vitamin B12 anemia (parenteral vs. oral).
● Administer parenteral forms of vitamin B12 IM or deep subcutaneous
to decrease irritation. Do not mix other medications in the syringe.
CLIENT EDUCATION
● Clients who lack intrinsic factor or have an irreversible-malabsorption
syndrome should be informed that this therapy must be continued for the
rest of their life.
● A client should receive vitamin B12 injections on a monthly basis
⫸ Folic Acid Supplements Answer: Folic acid is a water‑soluble,
B‑complex vitamin. It is necessary for the production of new RBCs.
NURSING CONSIDERATIONS:
Folic acid can be given orally or parenterally. CLIENT EDUCATION
● Large doses of folic acid can mask vitamin B12 deficiency.
EXAMINATION 2026 QUESTIONS WITH
VERIFIED ANSWERS GRADED A+
⫸ anemia risk factors Answer: acute or chronic blood loss, increased
hemolysis, inadequate dietary intake or malabsorption, bone marrow
suppression, age
⫸ anemia expected findings Answer: ● Possibly asymptomatic in mild
cases
● Pallor
● Fatigue
● Irritability
● Numbness and tingling of extremities
● Dyspnea on exertion
● Sensitivity to cold
● Pain and hypoxia with sickle-cell crisis
⫸ Anemia physical assessment findings Answer: ● Shortness of
breath/fatigue, especially upon exertion
● Tachycardia and palpitations
● Dizziness or syncope upon standing or with exertion
● Pallor with pale nail beds and mucous membranes
● Nail bed deformities (spoon-shaped nails)
,● Smooth, sore, bright-red tongue (vitamin B12 deficiency
⫸ Anemia: Laboratory Tests Answer: CBC count
RBC indices
Iron studies
Hgb electrophoresis
Sickle-cell test
Schilling test
⫸ Anemia diagnostic tests Answer: bone marrow biopsy
⫸ Anemia nursing care Answer: Encourage increased dietary intake of
the deficient nutrient (iron, vitamin B12, folic acid).
● Monitor oxygen saturation to determine a need for oxygen therapy.
● Administer medications, as prescribed, at the proper time for optimal
absorption, and using an appropriate technique.
● Teach the client and family about energy conservation in the client
and the risk of the client experiencing dizziness upon standing.
● Teach the client about the time frame for resolution.
⫸ Anemia Medications Answer: - Iron supplements (Ferrous sulfate,
ferrous fumarate, ferrous gluconate)
- Erythropoietin: epoetin alfa
- Vitamin B12 supplementation (cyanocobalamin
,- Folic acid supplements
⫸ Iron supplements (Ferrous sulfate, ferrous fumarate, ferrous
gluconate) Answer: ● Oral iron supplements are used to replenish serum
iron and iron stores. Iron is an essential component of Hgb, and
subsequently, oxygen transport.
● Parenteral iron supplements (iron dextran) are only given for severe
anemia. NURSING CONSIDERATIONS: Administer parenteral iron
using the Z-track method
CLIENT EDUCATION
● Instruct to have hemoglobin checked in 4 to 6 weeks to determine
efficacy.
● Vitamin C can increase oral iron absorption.
● Instruct the client to take iron supplements between meals to increase
absorption, if tolerated.
● Inform the client stools can appear green to black in color while taking
iron
⫸ Erythropoietin: epoetin alfa Answer: A hematopoietic growth factor
used to increase productionof RBCs
NURSING CONSIDERATIONS
● Monitor for an increase in blood pressure.
● Monitor Hgb and Hct twice per week.
● Monitor for a cardiovascular event if Hgb increases too rapidly
(greater than 1 g/dL in 2 weeks).
CLIENT EDUCATION:
, Reinforce the importance of having Hgb and Hct evaluated on a
twice‑per‑week basis until targeted levels are reached.
⫸ Vitamin B12 supplementation (cyanocobalamin) Answer: ● Vitamin
B12 is necessary to convert folic acid from its inactive form to its active
form. All cells rely on folic acid for DNA production.
● Vitamin B12 supplementation can be given orally if the deficit is due
to inadequate dietary intake. However, if deficiency is due to lack of
intrinsic factor being produced by the parietal cells of the stomach or
malabsorption syndrome, it must be administered parenterally or
intranasally to be absorbed.
NURSING CONSIDERATIONS
● Administer vitamin B12 according to appropriate route related to
cause of vitamin B12 anemia (parenteral vs. oral).
● Administer parenteral forms of vitamin B12 IM or deep subcutaneous
to decrease irritation. Do not mix other medications in the syringe.
CLIENT EDUCATION
● Clients who lack intrinsic factor or have an irreversible-malabsorption
syndrome should be informed that this therapy must be continued for the
rest of their life.
● A client should receive vitamin B12 injections on a monthly basis
⫸ Folic Acid Supplements Answer: Folic acid is a water‑soluble,
B‑complex vitamin. It is necessary for the production of new RBCs.
NURSING CONSIDERATIONS:
Folic acid can be given orally or parenterally. CLIENT EDUCATION
● Large doses of folic acid can mask vitamin B12 deficiency.
