1
, NUR 6121 Exam 2 | (2026) Nursing Exam
Questions | Practice II (PDF)
1. A 56-year-old male presents with fatigue. Labs show
Hgb 10.5 g/dL, Hct 32%, MCV 72 fL. What is the most
appropriate next step?
A. Serum B12 and folate levels
B. Ferritin level and stool occult blood
C. Reticulocyte count only
D. Coagulation profile
Answer: B
Rationale: Microcytic anemia (low MCV) in an older adult
male is iron deficiency until proven otherwise, usually
from GI blood loss. Ferritin assesses iron stores; stool
occult blood screens for bleeding.
2. A patient with iron deficiency anemia started iron
supplements 4 weeks ago. Which lab finding indicates a
therapeutic response?
2
,A. Decreased reticulocyte count
B. Increased reticulocyte count
C. Decreased hemoglobin
D. Marked leukocytosis
Answer: B
Rationale: Reticulocytes are immature RBCs. A rise in
reticulocyte count is the earliest sign of bone marrow
response to iron (days 7-10), before hemoglobin rises.
3. A 36-year-old female with fad dieting presents with
fatigue and pallor. Labs: Hgb 10.2, MCV 110 fL. Most
likely cause?
A. Folate and B12 deficiency
B. Iron deficiency
C. Thalassemia trait
D. Anemia of chronic disease
Answer: A
Rationale: High MCV (>100) = macrocytic anemia. Fad
3
, diets often lack B vitamins (B12, folate) found in animal
k k k k k k k k k
k products and leafy greens. k k k
4. A patient has macrocytic anemia, distal paresthesia,
k k k k k k
k and a sore tongue. Which deficiency is most likely?
k k k k k k k k
A. Iron
B. Folate
C. Vitamin B12 k
D. VitaminC k
k Answer: C k
Rationale: Neurologic symptoms (paresthesia, ataxia) are
k k k k k
k specific to B12 deficiency (pernicious anemia). Folate
k k k k k k
k deficiency causes anemia but no neurologic issues.
k k k k k k
5. What lab test confirms pernicious anemia when serum
k k k k k k k
k B12 is borderline?
k k
A. Serum folate k
B. Methylmalonic acid (MMA) k k
4
, NUR 6121 Exam 2 | (2026) Nursing Exam
Questions | Practice II (PDF)
1. A 56-year-old male presents with fatigue. Labs show
Hgb 10.5 g/dL, Hct 32%, MCV 72 fL. What is the most
appropriate next step?
A. Serum B12 and folate levels
B. Ferritin level and stool occult blood
C. Reticulocyte count only
D. Coagulation profile
Answer: B
Rationale: Microcytic anemia (low MCV) in an older adult
male is iron deficiency until proven otherwise, usually
from GI blood loss. Ferritin assesses iron stores; stool
occult blood screens for bleeding.
2. A patient with iron deficiency anemia started iron
supplements 4 weeks ago. Which lab finding indicates a
therapeutic response?
2
,A. Decreased reticulocyte count
B. Increased reticulocyte count
C. Decreased hemoglobin
D. Marked leukocytosis
Answer: B
Rationale: Reticulocytes are immature RBCs. A rise in
reticulocyte count is the earliest sign of bone marrow
response to iron (days 7-10), before hemoglobin rises.
3. A 36-year-old female with fad dieting presents with
fatigue and pallor. Labs: Hgb 10.2, MCV 110 fL. Most
likely cause?
A. Folate and B12 deficiency
B. Iron deficiency
C. Thalassemia trait
D. Anemia of chronic disease
Answer: A
Rationale: High MCV (>100) = macrocytic anemia. Fad
3
, diets often lack B vitamins (B12, folate) found in animal
k k k k k k k k k
k products and leafy greens. k k k
4. A patient has macrocytic anemia, distal paresthesia,
k k k k k k
k and a sore tongue. Which deficiency is most likely?
k k k k k k k k
A. Iron
B. Folate
C. Vitamin B12 k
D. VitaminC k
k Answer: C k
Rationale: Neurologic symptoms (paresthesia, ataxia) are
k k k k k
k specific to B12 deficiency (pernicious anemia). Folate
k k k k k k
k deficiency causes anemia but no neurologic issues.
k k k k k k
5. What lab test confirms pernicious anemia when serum
k k k k k k k
k B12 is borderline?
k k
A. Serum folate k
B. Methylmalonic acid (MMA) k k
4
