ANCC AGACNP BARKLEY REVIEW
2024 TEST LATEST 2025 REVISED
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
COMPLETE SOLUTION) ALREADY
PASSED SCORE A+
Hemoglobin (Hgb)
Main component of RBC's and the essential protein that combines with and
transports O2 to the body.
Males: 14-18 g/100 mL
Females: 12-16 g/100 mL
Hematocrit (Hct)
Measures the percentage of a given volume of whole blood that is occupied by
erythrocytes: the amount of plasma to total RBC mass (RBC concentration).
Females: 37-47%
Males: 40-54%
Total Iron Binding Capacity (TIBC)
Increased levels indicate iron deficiency (the greater their TIBC, the greater their
need for iron).; Decreased levels may indicate anemia, hemorrhage, hemolysis.
,Normal: 250-450 mcg/dL
Serum iron
Normal: 50-150 ug/dL
Mean Corpuscular Volume (MCV)
Expression of the average volume and size of individual erythrocytes.
"cytic"
Normal: 80-100 um3
Microcytic = < 80, Normocytic = 80-100, and Macrocytic = > 100.
Mean Corpuscular Hemoglobin (MCH)
Expression of the average amount and weight of Hgb contained in a single
erythrocyte.
Normal: 26-34 pg
Mean Corpuscular Hemoglobin Concentration (MCHC)
Expression of the average Hgb concentration or proportion of each RBC occupied
by Hgb as a percentage and is a more accurate measure than MCH.
"Chromic"
Normal: 32-36%
Hypochromic < 32%, normochromic 32-36%, hyperchromic > 36%
Differential for low mean corpuscular volume (MCV)
Iron deficiency anemia and thalassemia. Microcytic Anemia!
Differential for high mean corpuscular volume (MCV)
B12 or folate deficiency (Megaloblastic anemia), alcoholism, liver failure, and drug
effects. Macrocytic anemia!
,Differential for normal mean corpuscular volume (MCV)
Anemia of chronic disease, sickle cell, renal failure, blood loss, and hemolysis.
Normocytic!
Iron deficiency anemia is what type if anemia?
Microcytic, Hypochromic.
Iron deficiency anemia
A microcytic-hypochromic type of anemia characterized by iron deficiency that
affects the production of hemoglobin and is characterized by small red blood cells
containing low amounts of hemoglobin.
- Most common cause of anemia (not elderly!)
- Caused by most commonly acute blood loss, 2nd inadequate iron absorption,
and 3rd impaired iron absorption (rare)
Signs and symptoms of iron deficiency anemia
- Usually few symptoms if Hct is greater than 30.
- As Hct decreases, symptoms present: pica, dyspnea and mild fatigue with
exercise, HA, palpitations, weakness, tachycardia, postural hypotension, and
pallor.
Laboratory findings in iron deficiency anemia
Low Hgb, low Hct, low MCV, low MCHC, low RBC, low serum iron, low serum
ferritin (iron storage), high TIBC, *high RDW (red cell distribution width).
*Indicates there is a large difference in size from the largest to smallest RBC.
What labs are the most helpful to confirm iron deficiency anemia?
Low serum ferritin & high total iron binding capacity (TIBC)
How is iron deficiency anemia treated
Ferrous sulfate orally 300-325 mg 1-2 hour after meals.
, - Do not take iron supplements with antacids, it can interfere with absorption.
Take with vitamin C containing juices.
Increase iron intake: Raisins, green leafy vegetables, red meats, citrus products,
and iron-fortified bread and cereals.
What type of anemia is thalassemia
Microcytic, hypochromic.
Thalassemia
Genetic inherited disorders resulting in abnormal Hgb production and microcytic,
hypochromic anemia.
- Mostly found in Mediterranean, African American, Middle Eastern, Indian, and
Asian populations.
- Asian with anemia, think thalassemia!
Etiology of thalassemia
There is a decreased production of adult hemoglobin (Hb A);
The global part of Hb A has 4 protein sections called polypeptide chains:
(1) two of these chains are called alpha chains and are identical,
(2) the other two are identical but different from the alpha chains, called beta
chains.
What is the most common type of thalassemia?
Beta thalassemia
What is the cause of beta thalassemia
In a person with beta-thalassemia, there is a reduction or absent production of
beta-globin chains.
Thalassemia Minor
Heterozygous (Eg. Bb or Bb) form of beta thalassemia; they only have one copy of
the beta thalassemia gene with a normal beta chain gene.
2024 TEST LATEST 2025 REVISED
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
COMPLETE SOLUTION) ALREADY
PASSED SCORE A+
Hemoglobin (Hgb)
Main component of RBC's and the essential protein that combines with and
transports O2 to the body.
Males: 14-18 g/100 mL
Females: 12-16 g/100 mL
Hematocrit (Hct)
Measures the percentage of a given volume of whole blood that is occupied by
erythrocytes: the amount of plasma to total RBC mass (RBC concentration).
Females: 37-47%
Males: 40-54%
Total Iron Binding Capacity (TIBC)
Increased levels indicate iron deficiency (the greater their TIBC, the greater their
need for iron).; Decreased levels may indicate anemia, hemorrhage, hemolysis.
,Normal: 250-450 mcg/dL
Serum iron
Normal: 50-150 ug/dL
Mean Corpuscular Volume (MCV)
Expression of the average volume and size of individual erythrocytes.
"cytic"
Normal: 80-100 um3
Microcytic = < 80, Normocytic = 80-100, and Macrocytic = > 100.
Mean Corpuscular Hemoglobin (MCH)
Expression of the average amount and weight of Hgb contained in a single
erythrocyte.
Normal: 26-34 pg
Mean Corpuscular Hemoglobin Concentration (MCHC)
Expression of the average Hgb concentration or proportion of each RBC occupied
by Hgb as a percentage and is a more accurate measure than MCH.
"Chromic"
Normal: 32-36%
Hypochromic < 32%, normochromic 32-36%, hyperchromic > 36%
Differential for low mean corpuscular volume (MCV)
Iron deficiency anemia and thalassemia. Microcytic Anemia!
Differential for high mean corpuscular volume (MCV)
B12 or folate deficiency (Megaloblastic anemia), alcoholism, liver failure, and drug
effects. Macrocytic anemia!
,Differential for normal mean corpuscular volume (MCV)
Anemia of chronic disease, sickle cell, renal failure, blood loss, and hemolysis.
Normocytic!
Iron deficiency anemia is what type if anemia?
Microcytic, Hypochromic.
Iron deficiency anemia
A microcytic-hypochromic type of anemia characterized by iron deficiency that
affects the production of hemoglobin and is characterized by small red blood cells
containing low amounts of hemoglobin.
- Most common cause of anemia (not elderly!)
- Caused by most commonly acute blood loss, 2nd inadequate iron absorption,
and 3rd impaired iron absorption (rare)
Signs and symptoms of iron deficiency anemia
- Usually few symptoms if Hct is greater than 30.
- As Hct decreases, symptoms present: pica, dyspnea and mild fatigue with
exercise, HA, palpitations, weakness, tachycardia, postural hypotension, and
pallor.
Laboratory findings in iron deficiency anemia
Low Hgb, low Hct, low MCV, low MCHC, low RBC, low serum iron, low serum
ferritin (iron storage), high TIBC, *high RDW (red cell distribution width).
*Indicates there is a large difference in size from the largest to smallest RBC.
What labs are the most helpful to confirm iron deficiency anemia?
Low serum ferritin & high total iron binding capacity (TIBC)
How is iron deficiency anemia treated
Ferrous sulfate orally 300-325 mg 1-2 hour after meals.
, - Do not take iron supplements with antacids, it can interfere with absorption.
Take with vitamin C containing juices.
Increase iron intake: Raisins, green leafy vegetables, red meats, citrus products,
and iron-fortified bread and cereals.
What type of anemia is thalassemia
Microcytic, hypochromic.
Thalassemia
Genetic inherited disorders resulting in abnormal Hgb production and microcytic,
hypochromic anemia.
- Mostly found in Mediterranean, African American, Middle Eastern, Indian, and
Asian populations.
- Asian with anemia, think thalassemia!
Etiology of thalassemia
There is a decreased production of adult hemoglobin (Hb A);
The global part of Hb A has 4 protein sections called polypeptide chains:
(1) two of these chains are called alpha chains and are identical,
(2) the other two are identical but different from the alpha chains, called beta
chains.
What is the most common type of thalassemia?
Beta thalassemia
What is the cause of beta thalassemia
In a person with beta-thalassemia, there is a reduction or absent production of
beta-globin chains.
Thalassemia Minor
Heterozygous (Eg. Bb or Bb) form of beta thalassemia; they only have one copy of
the beta thalassemia gene with a normal beta chain gene.
