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NUR 6121 Advanced Nursing II 2024 – 2025 NUR 612
Adv Nursing 2 Exam 1 Unit 1, 2 and 3 Review
Questions and Answers with Detailed Rationales |
100% Pass Guaranteed | Graded A+ |
Which of the following conditions is associated with normocytic anemia?
A.A deficiency in vitamin B12 intake or absorption
B.Chronic blood loss
C.Concurrent chronic illness (i.e., chronic kidney disease)
D.Inadequate globin synthesis
C.Concurrent chronic illness (i.e., chronic kidney disease)
Normocytic anemia, with an MCV of 80-100fL, correlates with anemia of chronic disease. Chronic
blood loss is associated with iron deficiency anemia, a microcytic anemia. Deficiency in vitamin
B12 results in the development of macrocytic anemia. Inadequate globin synthesis occurs in beta
thalassemia, a microcytic anemia.
The FNP is following up with a patient previously diagnosed with anemia who complains of a sore
tongue and numbness and tingling of the hands and feet. The FNP recognizes that she needs to
address the patient's response to:
A.Administration of erythropoietin.
B.Ferrous sulfate supplementation.
C.Folic acid supplementation.
D.Vitamin B12 supplementation.
D. Vitamin B12 supplementation.
The case presentation is that of vitamin B12 deficiency. Although glossitis may occur with folic
acid deficiency, parasthesias of the hands and feet in a stocking/glove distribution are
characteristic of pernicious anemia; thus, it is important to evaluate the patient's response to
vitamin B12 supplementation.
The FNP is following up with a young adult woman previously diagnosed with microcytic,
hypochromic anemia. The FNP recognizes that it is important to rule out:
A.Abnormal uterine bleeding.
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B.Gastrointestinal bleeding.
C.Inadequate intake of folic acid.
Low carbohydrate diet fads
A. Abnormal uterine bleeding.
In young adult women, abnormal uterine bleeding is a common cause of iron deficiency anemia,
a microcytic, hypochromic anemia. Bleeding from the GI tract is a more common cause of IDA in
older adults. Inadequate intake of folic acid would result in macrocytic anemia. Low carbohydrate
diets still allow for adequate intake of iron from meats and green leafy vegetables.
When interpreting findings in an individual with leukocytosis, the FNP recognizes that a "left
shift" is represented by an increase in the proportion of:
A.Eosinophils.
B.Lymphocytes.
C.Monocytes.
D.Neutrophils.
D. Neutrophils.
The term "left shift" is almost always associated with neutrophils. The left shift means that the
population of cells is shifted toward most immature cells, with an increased percentage of
immature neutrophils (i.e., bands, metamyeloctyes, and myelocytes) being present to fight
infection.
What organ system is responsible for the majority of the body's production of erythropoietin?
A.Bone Marrow
B.Kidneys
C.Liver
D.Spleen
B. Kidneys
90% of the body's erythropoietin is produced by the kidneys; only about 10% is produced in the
liver.
An elevated red cell distribution width (RDW) correlates with which of the following findings on
the peripheral smear?
A.Anisocytosis
B.Microcytosis
C.Poikilocytosis
D.Reticulocytosis
A. Anisocytosis
Anisocytosis describes variance in RBC sizes that is common in anemia as new cells formed are
larger (macrocytic) or smaller (microcytic) than the healthy cells which were formed prior to the
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underlying processes that resulted in anemia. This variance in sizes of circulating red blood sizes
correlates with an increased RDW.
Women of childbearing age should have an adequate intake of what micronutrient to decrease
the risk of fetal neural tube defects?
A.Folic acid
B.Iron
C.Vitamin B6
D.Vitamin B12
A. Folic acid
Folic acid deficiency in early pregnancy has been linked to the teratogenic effect of neural tube
defects.
The most appropriate additional diagnostic test for the patient with decreased WBCs, RBCs, and
platelets is a:
A.Bone marrow biopsy.
B.Direct Coombs' test.
C.Hemoglobin electrophoresis.
Serum haptoglobin
A. Bone marrow biopsy.
Pancytopenia (a deficiency in all three cellular components of the blood) is indicative of aplastic
anemia. A bone marrow aspiration biopsy is needed to rule out myelodysplastic syndrome and
metastatic tumor deposits. The hypoplastic bone marrow of aplastic anemia will have fatty
replacement which is often accompanied by a relative increase in nonhematopoietic elements
(i.e., mast cells).
The FNP is educating an anemic patient about the procedure(s) for a Schilling test. The
practitioner recognizes that a Schilling test involves:
A.An early morning, fasting lab draw.
B.Collecting urine for 24 hours.
C.Endoscopic sampling of the gastric mucosa.
D.Serial collections of serum vitamin B12 levels.
B. Collecting urine for 24 hours.
The Schilling test is used to determine whether the body absorbs vitamin B12 normally. Patients
undergoing testing receive two doses of vitamin B12: The first is an oral radioactive form; an
intramuscular injection of non-radioactive vitamin B12 is administered one hour later. The patient
then collects urine over the next 24 hours, and the specimen is evaluated to determine how
much vitamin B12 is excreted in the urine.
What is the most likely diagnosis for a patient with the following CBC findings?: WBC: 7.1 ×
103/µl; RBC: 3.32 × 103/µl; Hgb: 11.3 g/Dl; Hct: 34.4%; MCV: 91 fL; MCHC: 32 g/dL;Plt: 364 ×
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103/µl; RDW: 13.4%; Reticulocytes: 0.9%.
A.Anemia of chronic disease
B.Folate deficiency anemia
C.Iron deficiency anemia
D.Vitamin B12 deficiency anemia
A. Anemia of chronic disease
The MCV of this patient with anemia reveals a normocytic anemia. Iron deficiency anemia is a
microcytic anemia, while folic acid and vitamin B12 deficiencies result in the production of RBCs
that are larger in size than normal cells, macrocytic anemia.
What is the most likely diagnosis for a patient with the following CBC findings?: WBC: 8.8 ×
103/µl; RBC: 3.01 × 103/µl; Hgb: 10.3 g/dL; Hct: 32.2%; MCV: 74 fL; MCHC: 28.3 g/dL; Plt: 400 ×
103/µl; RDW: 18.4%; Reticulocytes: 2.1%.
A.Anemia of chronic disease
B.Folate deficiency anemia
C.Iron deficiency anemia
D.Vitamin B12 deficiency anemia
C. Iron deficiency anemia
The MCV of this patient with anemia reveals a microcytic anemia. Anemia of chronic disease is
most commonly a normocytic anemia, while folic acid and vitamin B12 deficiencies result in the
production of RBCs that are larger in size than normal cells, which is called macrocytic anemia.
The FNP is seeing a patient who has been taking ferrous sulfate. Which statement by the patient
demonstrates a need for additional education?
A."I should take my medication with orange juice to increase absorption."
B."I should take one tablet twice a day."
C."It is best to take the iron on an empty stomach."
D."It is recommended that I take enteric coated iron with meals."
D. "It is recommended that I take enteric coated iron with meals."
Iron is best absorbed when taken on an empty stomach, but does have GI effects that limit
tolerability (i.e., nausea and epigastric discomfort); taking iron supplementation with food can
decreased absorption by two-thirds and the use of enteric-coated preparations limits the
absorption in the duodenum. Ascorbic acid does enhance iron absorption in the GI tract.
Which of the following is the leading cause of death in individuals with sickle cell anemia?
A.Bacterial infection
B.Heart failure
C.Kidney failure
D.Stroke
A.Bacterial infection
NUR 6121 Advanced Nursing II 2024 – 2025 NUR 612
Adv Nursing 2 Exam 1 Unit 1, 2 and 3 Review
Questions and Answers with Detailed Rationales |
100% Pass Guaranteed | Graded A+ |
Which of the following conditions is associated with normocytic anemia?
A.A deficiency in vitamin B12 intake or absorption
B.Chronic blood loss
C.Concurrent chronic illness (i.e., chronic kidney disease)
D.Inadequate globin synthesis
C.Concurrent chronic illness (i.e., chronic kidney disease)
Normocytic anemia, with an MCV of 80-100fL, correlates with anemia of chronic disease. Chronic
blood loss is associated with iron deficiency anemia, a microcytic anemia. Deficiency in vitamin
B12 results in the development of macrocytic anemia. Inadequate globin synthesis occurs in beta
thalassemia, a microcytic anemia.
The FNP is following up with a patient previously diagnosed with anemia who complains of a sore
tongue and numbness and tingling of the hands and feet. The FNP recognizes that she needs to
address the patient's response to:
A.Administration of erythropoietin.
B.Ferrous sulfate supplementation.
C.Folic acid supplementation.
D.Vitamin B12 supplementation.
D. Vitamin B12 supplementation.
The case presentation is that of vitamin B12 deficiency. Although glossitis may occur with folic
acid deficiency, parasthesias of the hands and feet in a stocking/glove distribution are
characteristic of pernicious anemia; thus, it is important to evaluate the patient's response to
vitamin B12 supplementation.
The FNP is following up with a young adult woman previously diagnosed with microcytic,
hypochromic anemia. The FNP recognizes that it is important to rule out:
A.Abnormal uterine bleeding.
,2|Page
B.Gastrointestinal bleeding.
C.Inadequate intake of folic acid.
Low carbohydrate diet fads
A. Abnormal uterine bleeding.
In young adult women, abnormal uterine bleeding is a common cause of iron deficiency anemia,
a microcytic, hypochromic anemia. Bleeding from the GI tract is a more common cause of IDA in
older adults. Inadequate intake of folic acid would result in macrocytic anemia. Low carbohydrate
diets still allow for adequate intake of iron from meats and green leafy vegetables.
When interpreting findings in an individual with leukocytosis, the FNP recognizes that a "left
shift" is represented by an increase in the proportion of:
A.Eosinophils.
B.Lymphocytes.
C.Monocytes.
D.Neutrophils.
D. Neutrophils.
The term "left shift" is almost always associated with neutrophils. The left shift means that the
population of cells is shifted toward most immature cells, with an increased percentage of
immature neutrophils (i.e., bands, metamyeloctyes, and myelocytes) being present to fight
infection.
What organ system is responsible for the majority of the body's production of erythropoietin?
A.Bone Marrow
B.Kidneys
C.Liver
D.Spleen
B. Kidneys
90% of the body's erythropoietin is produced by the kidneys; only about 10% is produced in the
liver.
An elevated red cell distribution width (RDW) correlates with which of the following findings on
the peripheral smear?
A.Anisocytosis
B.Microcytosis
C.Poikilocytosis
D.Reticulocytosis
A. Anisocytosis
Anisocytosis describes variance in RBC sizes that is common in anemia as new cells formed are
larger (macrocytic) or smaller (microcytic) than the healthy cells which were formed prior to the
,3|Page
underlying processes that resulted in anemia. This variance in sizes of circulating red blood sizes
correlates with an increased RDW.
Women of childbearing age should have an adequate intake of what micronutrient to decrease
the risk of fetal neural tube defects?
A.Folic acid
B.Iron
C.Vitamin B6
D.Vitamin B12
A. Folic acid
Folic acid deficiency in early pregnancy has been linked to the teratogenic effect of neural tube
defects.
The most appropriate additional diagnostic test for the patient with decreased WBCs, RBCs, and
platelets is a:
A.Bone marrow biopsy.
B.Direct Coombs' test.
C.Hemoglobin electrophoresis.
Serum haptoglobin
A. Bone marrow biopsy.
Pancytopenia (a deficiency in all three cellular components of the blood) is indicative of aplastic
anemia. A bone marrow aspiration biopsy is needed to rule out myelodysplastic syndrome and
metastatic tumor deposits. The hypoplastic bone marrow of aplastic anemia will have fatty
replacement which is often accompanied by a relative increase in nonhematopoietic elements
(i.e., mast cells).
The FNP is educating an anemic patient about the procedure(s) for a Schilling test. The
practitioner recognizes that a Schilling test involves:
A.An early morning, fasting lab draw.
B.Collecting urine for 24 hours.
C.Endoscopic sampling of the gastric mucosa.
D.Serial collections of serum vitamin B12 levels.
B. Collecting urine for 24 hours.
The Schilling test is used to determine whether the body absorbs vitamin B12 normally. Patients
undergoing testing receive two doses of vitamin B12: The first is an oral radioactive form; an
intramuscular injection of non-radioactive vitamin B12 is administered one hour later. The patient
then collects urine over the next 24 hours, and the specimen is evaluated to determine how
much vitamin B12 is excreted in the urine.
What is the most likely diagnosis for a patient with the following CBC findings?: WBC: 7.1 ×
103/µl; RBC: 3.32 × 103/µl; Hgb: 11.3 g/Dl; Hct: 34.4%; MCV: 91 fL; MCHC: 32 g/dL;Plt: 364 ×
, 4|Page
103/µl; RDW: 13.4%; Reticulocytes: 0.9%.
A.Anemia of chronic disease
B.Folate deficiency anemia
C.Iron deficiency anemia
D.Vitamin B12 deficiency anemia
A. Anemia of chronic disease
The MCV of this patient with anemia reveals a normocytic anemia. Iron deficiency anemia is a
microcytic anemia, while folic acid and vitamin B12 deficiencies result in the production of RBCs
that are larger in size than normal cells, macrocytic anemia.
What is the most likely diagnosis for a patient with the following CBC findings?: WBC: 8.8 ×
103/µl; RBC: 3.01 × 103/µl; Hgb: 10.3 g/dL; Hct: 32.2%; MCV: 74 fL; MCHC: 28.3 g/dL; Plt: 400 ×
103/µl; RDW: 18.4%; Reticulocytes: 2.1%.
A.Anemia of chronic disease
B.Folate deficiency anemia
C.Iron deficiency anemia
D.Vitamin B12 deficiency anemia
C. Iron deficiency anemia
The MCV of this patient with anemia reveals a microcytic anemia. Anemia of chronic disease is
most commonly a normocytic anemia, while folic acid and vitamin B12 deficiencies result in the
production of RBCs that are larger in size than normal cells, which is called macrocytic anemia.
The FNP is seeing a patient who has been taking ferrous sulfate. Which statement by the patient
demonstrates a need for additional education?
A."I should take my medication with orange juice to increase absorption."
B."I should take one tablet twice a day."
C."It is best to take the iron on an empty stomach."
D."It is recommended that I take enteric coated iron with meals."
D. "It is recommended that I take enteric coated iron with meals."
Iron is best absorbed when taken on an empty stomach, but does have GI effects that limit
tolerability (i.e., nausea and epigastric discomfort); taking iron supplementation with food can
decreased absorption by two-thirds and the use of enteric-coated preparations limits the
absorption in the duodenum. Ascorbic acid does enhance iron absorption in the GI tract.
Which of the following is the leading cause of death in individuals with sickle cell anemia?
A.Bacterial infection
B.Heart failure
C.Kidney failure
D.Stroke
A.Bacterial infection
