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NSG 530 Exam 4 – Advanced Pathophysiology Wilkes
University Graduate Nursing | Questions 1–200: 100%
Pass Guaranteed | Graded A+
1. A patient presents with fatigue, pallor, and reports craving ice chips (pica). Laboratory
results show microcytic, hypochromic red blood cells, low serum ferritin, and elevated total
iron-binding capacity (TIBC). Which type of anemia is most consistent with these findings?
A. Pernicious anemia
B. Iron deficiency anemia
C. Anemia of chronic disease
D. Sideroblastic anemia
Correct Answer: B
Explanation: Iron deficiency anemia is characterized by microcytic, hypochromic RBCs, low
serum ferritin, elevated TIBC, low serum iron, and clinical manifestations including fatigue,
pallor, and pica (craving non-food items such as ice). Pernicious anemia (A) is macrocytic with
neurological symptoms; anemia of chronic disease (C) typically presents with normal or elevated
ferritin; sideroblastic anemia (D) is characterized by ringed sideroblasts in the bone marrow.
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2. A 65-year-old patient presents with progressive fatigue, numbness and tingling in the
hands and feet, and an unsteady gait. Laboratory findings reveal macrocytic anemia with an
elevated MCV and low serum vitamin B12. Antibody testing is positive for anti-intrinsic factor
antibodies. What is the most likely diagnosis?
A. Iron deficiency anemia
B. Folate deficiency anemia
C. Pernicious anemia
D. Aplastic anemia
Correct Answer: C
Explanation: Pernicious anemia is an autoimmune condition caused by a lack of intrinsic
factor, leading to vitamin B12 deficiency. Key features include macrocytic anemia, neurologic
symptoms (paresthesias, ataxia, gait disturbance), and positive anti-intrinsic factor antibodies.
Treatment requires parenteral vitamin B12 replacement.
3. A patient with a chronic inflammatory condition such as rheumatoid arthritis presents with
anemia. Laboratory results show normocytic, normochromic red blood cells, elevated ferritin,
and decreased TIBC. Which type of anemia is most consistent with this presentation?
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A. Iron deficiency anemia
B. Anemia of chronic disease
C. Pernicious anemia
D. Hemolytic anemia
Correct Answer: B
Explanation: Anemia of chronic disease occurs in the setting of chronic inflammation,
infection, or malignancy. It is characterized by normocytic or microcytic anemia with elevated
ferritin (due to increased iron storage) and decreased TIBC (due to impaired iron utilization).
This pattern distinguishes it from iron deficiency anemia.
4. A patient with chronic kidney disease is found to have normocytic, normochromic anemia.
The most likely underlying pathophysiologic mechanism is:
A. Iron deficiency due to blood loss
B. Decreased erythropoietin production
C. Vitamin B12 deficiency
D. Hemolysis
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Correct Answer: B
Explanation: In chronic kidney disease, the kidneys produce insufficient erythropoietin
(EPO), leading to decreased red blood cell production. This results in normocytic, normochromic
anemia. Iron deficiency (A) is not the primary mechanism in CKD; vitamin B12 deficiency (C)
causes macrocytic anemia; hemolytic anemia (D) would present with signs of RBC destruction.
5. In acute leukemias such as Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid
Leukemia (AML), which of the following pathophysiologic features is characteristic?
A. Overproduction of mature, functional white blood cells
B. Accumulation of immature blast cells in the bone marrow and peripheral circulation
C. Decreased production of all hematopoietic cell lines
D. Increased production of platelets
Correct Answer: B
Explanation: Acute leukemias are characterized by a high proportion of very immature,
nonfunctional blast cells in the bone marrow and peripheral circulation. The onset is usually
NSG 530 Exam 4 – Advanced Pathophysiology Wilkes
University Graduate Nursing | Questions 1–200: 100%
Pass Guaranteed | Graded A+
1. A patient presents with fatigue, pallor, and reports craving ice chips (pica). Laboratory
results show microcytic, hypochromic red blood cells, low serum ferritin, and elevated total
iron-binding capacity (TIBC). Which type of anemia is most consistent with these findings?
A. Pernicious anemia
B. Iron deficiency anemia
C. Anemia of chronic disease
D. Sideroblastic anemia
Correct Answer: B
Explanation: Iron deficiency anemia is characterized by microcytic, hypochromic RBCs, low
serum ferritin, elevated TIBC, low serum iron, and clinical manifestations including fatigue,
pallor, and pica (craving non-food items such as ice). Pernicious anemia (A) is macrocytic with
neurological symptoms; anemia of chronic disease (C) typically presents with normal or elevated
ferritin; sideroblastic anemia (D) is characterized by ringed sideroblasts in the bone marrow.
,2
2. A 65-year-old patient presents with progressive fatigue, numbness and tingling in the
hands and feet, and an unsteady gait. Laboratory findings reveal macrocytic anemia with an
elevated MCV and low serum vitamin B12. Antibody testing is positive for anti-intrinsic factor
antibodies. What is the most likely diagnosis?
A. Iron deficiency anemia
B. Folate deficiency anemia
C. Pernicious anemia
D. Aplastic anemia
Correct Answer: C
Explanation: Pernicious anemia is an autoimmune condition caused by a lack of intrinsic
factor, leading to vitamin B12 deficiency. Key features include macrocytic anemia, neurologic
symptoms (paresthesias, ataxia, gait disturbance), and positive anti-intrinsic factor antibodies.
Treatment requires parenteral vitamin B12 replacement.
3. A patient with a chronic inflammatory condition such as rheumatoid arthritis presents with
anemia. Laboratory results show normocytic, normochromic red blood cells, elevated ferritin,
and decreased TIBC. Which type of anemia is most consistent with this presentation?
,3
A. Iron deficiency anemia
B. Anemia of chronic disease
C. Pernicious anemia
D. Hemolytic anemia
Correct Answer: B
Explanation: Anemia of chronic disease occurs in the setting of chronic inflammation,
infection, or malignancy. It is characterized by normocytic or microcytic anemia with elevated
ferritin (due to increased iron storage) and decreased TIBC (due to impaired iron utilization).
This pattern distinguishes it from iron deficiency anemia.
4. A patient with chronic kidney disease is found to have normocytic, normochromic anemia.
The most likely underlying pathophysiologic mechanism is:
A. Iron deficiency due to blood loss
B. Decreased erythropoietin production
C. Vitamin B12 deficiency
D. Hemolysis
, 4
Correct Answer: B
Explanation: In chronic kidney disease, the kidneys produce insufficient erythropoietin
(EPO), leading to decreased red blood cell production. This results in normocytic, normochromic
anemia. Iron deficiency (A) is not the primary mechanism in CKD; vitamin B12 deficiency (C)
causes macrocytic anemia; hemolytic anemia (D) would present with signs of RBC destruction.
5. In acute leukemias such as Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid
Leukemia (AML), which of the following pathophysiologic features is characteristic?
A. Overproduction of mature, functional white blood cells
B. Accumulation of immature blast cells in the bone marrow and peripheral circulation
C. Decreased production of all hematopoietic cell lines
D. Increased production of platelets
Correct Answer: B
Explanation: Acute leukemias are characterized by a high proportion of very immature,
nonfunctional blast cells in the bone marrow and peripheral circulation. The onset is usually
