NURS 4700 EXAM 2 STUDY GUIDE | ADVANCED NURSING PRACTICE PRACTICE QUESTIONS
AND ANSWERS | FINAL REVIEW 2026/2027
What is anemia? Causes - ANS ✔✔-Definition: Low HgB (12.6-17.4), HcT (37-51), RBC (4.7-6.1)
-Cause: blood loss, impaired production of RBC, or increased destruction of erythrocytes
Anemia: Manifestations - ANS ✔✔1. Tissue hypoxia: RBC can't transport oxygen
2. Levels
-Mild: HgB 10-12
-Moderate: HbG 6-12
-Severe: <6
3. Integumentary: pallor, jaundice, pruritus
4. Cardiopulmonary: Increase HR, low blood viscosity, leads to murmurs
What are the two types of anemia that has decreased erythrocyte production? - ANS ✔✔1.
Iron-deficiency: microcytic anemia, most common
2. Megaloblastic (large RBC): cobalamin and folic acid deficiency
Iron-Deficiency anemia: Cause, labs - ANS ✔✔-Cause: inadequate diet intake, iron absorption
altered (duodenum), blood loss (GI/GU, hemodialysis)
-Labs: decrease H/H, MCV, serum iron; normal B12, folate
Iron-Deficiency anemia: tx - ANS ✔✔1. Treat underlying cause
2. Iron replacement
-Nutrition: liver, muscle meat, legumes, dried fruit, dark leafy veggies, eggs, whole grains, beans
-PRBCs
3. Iron supplements
,-Oral iron: best absorbed before meals (give with OJ), liquid iron stains teeth so use straw, SE
(*heartburn, constipation, diarrhea*)
-Parenteral iron: indications include *malabsorption or oral iron intolerance, higher dose, poor
patient compliance with oral*
Cobalamin Deficiency: Cause - ANS ✔✔-Gastric system missing intrinsic factor needed for
absorption leading to pernicious anemia
-GI alterations: surgery, chronic diseases
-Chronic alcoholics
-Long term users of: H2 histamine receptor blockers and PPI
-Vegetarians: not eating enough B12
Cobalamin Deficiency: Manifestions - ANS ✔✔-GI: sore tongue, anorexia, abdominal pain
-Neuromuscular: weakness, paresthesia, *tingling of hands and feet*, decreased vibratory and
position senses, ataxia, muscle weakness, impaired thinking, confusion
Cobalamin deficiency: treatment - ANS ✔✔-Cobalamin replacement: lifelong if no GI absorption
-Neuromuscular may not improve
Folic acid deficiency: Cause, treatment - ANS ✔✔-Cause: dietary deficiency/malabsorption
syndromes, drugs, increased requirement, alcohol abuse/anorexia, hemodialysis loss
-Treatment: folic acid supplement, diet (Liver, meat, fish legumes, whole grains, peanuts, green
leafy veggies, OJ, avocado)
Megaloblastic anemia: collaborative management - ANS ✔✔-early detection and treatment:
family hx of pernicious anemia
-Ensure safety: diminished sensations to heat/pain from neuro impairment; protect from falls,
burns, trauma
-Frequent medical screening for potential risk of developing gastric cancers
, What is SCD? Symptoms and complications - ANS ✔✔-Genetic autosomal recessive disorder
with HgB S that is very sensitive to decreased oxygen (causes RBC to go into sickled shape)
-Sx: usually asymptomatic except during sickling episodes
1. Pain from tissue hypoxia and damage
2. Pallor of mucus membranes
3. Jaundice from hemolysis
-Complications: organs affected by hypoxia; infection (major cause od eath)
SCD: Episodes vs crisis - ANS ✔✔-Episode: triggered by low oxygenation (infection, stress, high
altitude), can initially be reversed with oxygen
-Crisis: severe, painful, acute exacerbation of sickling leading to vaso-occlusive crisis; severe
capillary hypoxia leads to tissue necrosis; life threatening shock if severe
SCD: Tx (I) - ANS ✔✔1. Prevention: infection and end-organ damage
2. Education: patient and caregiver
-Avoid high altitudes
-Keep hydrated
-Treat promptly
-Importance of medical attention, pain control
-Resources
-Vaccination
3. Hospitalized: *pain treatment, oxygen, rest*, respiratory failure, DVT prophylaxis, administer
fluids and electrolytes, transfusion therapy (chelation with repeated exacerbations)
SCD: Tx (II) - ANS ✔✔4. Pain management
-Requires continuous and breakthrough analgesia with morphine and hydromorphone
AND ANSWERS | FINAL REVIEW 2026/2027
What is anemia? Causes - ANS ✔✔-Definition: Low HgB (12.6-17.4), HcT (37-51), RBC (4.7-6.1)
-Cause: blood loss, impaired production of RBC, or increased destruction of erythrocytes
Anemia: Manifestations - ANS ✔✔1. Tissue hypoxia: RBC can't transport oxygen
2. Levels
-Mild: HgB 10-12
-Moderate: HbG 6-12
-Severe: <6
3. Integumentary: pallor, jaundice, pruritus
4. Cardiopulmonary: Increase HR, low blood viscosity, leads to murmurs
What are the two types of anemia that has decreased erythrocyte production? - ANS ✔✔1.
Iron-deficiency: microcytic anemia, most common
2. Megaloblastic (large RBC): cobalamin and folic acid deficiency
Iron-Deficiency anemia: Cause, labs - ANS ✔✔-Cause: inadequate diet intake, iron absorption
altered (duodenum), blood loss (GI/GU, hemodialysis)
-Labs: decrease H/H, MCV, serum iron; normal B12, folate
Iron-Deficiency anemia: tx - ANS ✔✔1. Treat underlying cause
2. Iron replacement
-Nutrition: liver, muscle meat, legumes, dried fruit, dark leafy veggies, eggs, whole grains, beans
-PRBCs
3. Iron supplements
,-Oral iron: best absorbed before meals (give with OJ), liquid iron stains teeth so use straw, SE
(*heartburn, constipation, diarrhea*)
-Parenteral iron: indications include *malabsorption or oral iron intolerance, higher dose, poor
patient compliance with oral*
Cobalamin Deficiency: Cause - ANS ✔✔-Gastric system missing intrinsic factor needed for
absorption leading to pernicious anemia
-GI alterations: surgery, chronic diseases
-Chronic alcoholics
-Long term users of: H2 histamine receptor blockers and PPI
-Vegetarians: not eating enough B12
Cobalamin Deficiency: Manifestions - ANS ✔✔-GI: sore tongue, anorexia, abdominal pain
-Neuromuscular: weakness, paresthesia, *tingling of hands and feet*, decreased vibratory and
position senses, ataxia, muscle weakness, impaired thinking, confusion
Cobalamin deficiency: treatment - ANS ✔✔-Cobalamin replacement: lifelong if no GI absorption
-Neuromuscular may not improve
Folic acid deficiency: Cause, treatment - ANS ✔✔-Cause: dietary deficiency/malabsorption
syndromes, drugs, increased requirement, alcohol abuse/anorexia, hemodialysis loss
-Treatment: folic acid supplement, diet (Liver, meat, fish legumes, whole grains, peanuts, green
leafy veggies, OJ, avocado)
Megaloblastic anemia: collaborative management - ANS ✔✔-early detection and treatment:
family hx of pernicious anemia
-Ensure safety: diminished sensations to heat/pain from neuro impairment; protect from falls,
burns, trauma
-Frequent medical screening for potential risk of developing gastric cancers
, What is SCD? Symptoms and complications - ANS ✔✔-Genetic autosomal recessive disorder
with HgB S that is very sensitive to decreased oxygen (causes RBC to go into sickled shape)
-Sx: usually asymptomatic except during sickling episodes
1. Pain from tissue hypoxia and damage
2. Pallor of mucus membranes
3. Jaundice from hemolysis
-Complications: organs affected by hypoxia; infection (major cause od eath)
SCD: Episodes vs crisis - ANS ✔✔-Episode: triggered by low oxygenation (infection, stress, high
altitude), can initially be reversed with oxygen
-Crisis: severe, painful, acute exacerbation of sickling leading to vaso-occlusive crisis; severe
capillary hypoxia leads to tissue necrosis; life threatening shock if severe
SCD: Tx (I) - ANS ✔✔1. Prevention: infection and end-organ damage
2. Education: patient and caregiver
-Avoid high altitudes
-Keep hydrated
-Treat promptly
-Importance of medical attention, pain control
-Resources
-Vaccination
3. Hospitalized: *pain treatment, oxygen, rest*, respiratory failure, DVT prophylaxis, administer
fluids and electrolytes, transfusion therapy (chelation with repeated exacerbations)
SCD: Tx (II) - ANS ✔✔4. Pain management
-Requires continuous and breakthrough analgesia with morphine and hydromorphone
