NUR 8022 EXAM 2 STUDYGUIDE
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) | ALREADY
GRADED A+ 2025
Importance of Vitamin B12 and Folate Correct Answer
Vitamin B12:
▪ Keeps nervous system functioning properly
▪ Necessary in the formation of blood
▪ Involved in metabolism of every cell but especially
affecting DNA synthesis and regulation
Folate:
▪ Essential for RNA and DNA synthesis
Vitamin B12 Deficiency Lab findings Correct Answer
↑MCV
↓Ferritin
↓serum iron
↑ TIBC
↑ MCH
↑RDW (>15)
↓reticulocyte count
** possible pancytopenia if severe **
Folate Deficiency Anemia Correct Answer Type of
Macrocytic-Normochromic Anemia
,Most common cause of deficiency: DIET - alcoholics,
anorexics, overcooked food, diets excluding veg
- Found in plant products and fortified foods; deficient in
alcoholics and chronic malnutrition; associated with neural
tube defects in fetus
Folate Deficiency Anemia Manifestations Correct Answer -
Severe cheilosis (scales and fissures of lips and corners of
mouth)
- Stomatitis
- Dysphagia
- Ulcerations of mouth and tongue
** No neuro symptoms **
Folate Deficiency Anemia Lab Findings Correct Answer -
↑MCV
- ↓ serum folic acid
- Normal MCH
Blood smear: hyper segmented neutrophils, anisocytosis,
poikilocytosis; megaloblastic RBCs
Pancytopenia if severe
** Decreased folic acid is diagnostic difference between
folic acid and B12 deficiency **
Pernicious Anemia Correct Answer Type of Macrocytic-
Normochromic Anemia
,- Most common macrocytic anemia
- B12 deficiency anemia d/t autoimmune destruction of
parietal cells of the stomach that make intrinsic factor
needed for B12 absorption
- Congenital or autoimmune
- Not reversible - even with treatment
- Increased risk: past infection with H. pylori bacteria,
gastrectomy, PPI's
Pernicious Anemia Symptoms Correct Answer - Beefy, red
tongue
- Lemon yellow skin (pallor and icterus)
- Fatigue, weakness
- Weight loss, loss of appetite
- Decreased DTRs
- Abdominal pain
Pernicious Anemia Testing Correct Answer ▪ Schilling test:
localized site of pathology of the B12 deficiency
▪ Give IM B12, PO radioactive B12 - normal pt's with
extrinsic factor should absorb radioactive B12 and excrete
in urine because the receptors would be saturated with IM
B12; if there is a problem with the intrinsic factor then it will
not be present in the urine; test is repeated and
exogenous intrinsic factor is given
, Alcohol Induced Macrocytic Megaloblastic Anemia Correct
Answer Large, immature RBCs
- Alcohol interferes with absorption of folic acid
(megaloblastic); hbg synthesis (sideroblastic anemia);
erythropoiesis (macrocytosis)
- Anemia reverses with abstinence from alcohol within
weeks - self limiting
Normocytic-Normochromic Anemias Correct Answer
Characterized by red cells that are relatively normal in size
and hemoglobin content but insufficient in number
Less frequent then other anemias
Types:
- Aplastic
- Post-hemorrhagic
- Hemolytic
- Paroxysmal Nocturnal Hematuria
- Anemia of Chronic Disease
Aplastic Anemia Correct Answer Type of Normocytic-
Normochromic Anemias
Red bone marrow is replaced with fat; results in
pancytopenia because there are less hematopoietic cells
Most often caused by autoimmune
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) | ALREADY
GRADED A+ 2025
Importance of Vitamin B12 and Folate Correct Answer
Vitamin B12:
▪ Keeps nervous system functioning properly
▪ Necessary in the formation of blood
▪ Involved in metabolism of every cell but especially
affecting DNA synthesis and regulation
Folate:
▪ Essential for RNA and DNA synthesis
Vitamin B12 Deficiency Lab findings Correct Answer
↑MCV
↓Ferritin
↓serum iron
↑ TIBC
↑ MCH
↑RDW (>15)
↓reticulocyte count
** possible pancytopenia if severe **
Folate Deficiency Anemia Correct Answer Type of
Macrocytic-Normochromic Anemia
,Most common cause of deficiency: DIET - alcoholics,
anorexics, overcooked food, diets excluding veg
- Found in plant products and fortified foods; deficient in
alcoholics and chronic malnutrition; associated with neural
tube defects in fetus
Folate Deficiency Anemia Manifestations Correct Answer -
Severe cheilosis (scales and fissures of lips and corners of
mouth)
- Stomatitis
- Dysphagia
- Ulcerations of mouth and tongue
** No neuro symptoms **
Folate Deficiency Anemia Lab Findings Correct Answer -
↑MCV
- ↓ serum folic acid
- Normal MCH
Blood smear: hyper segmented neutrophils, anisocytosis,
poikilocytosis; megaloblastic RBCs
Pancytopenia if severe
** Decreased folic acid is diagnostic difference between
folic acid and B12 deficiency **
Pernicious Anemia Correct Answer Type of Macrocytic-
Normochromic Anemia
,- Most common macrocytic anemia
- B12 deficiency anemia d/t autoimmune destruction of
parietal cells of the stomach that make intrinsic factor
needed for B12 absorption
- Congenital or autoimmune
- Not reversible - even with treatment
- Increased risk: past infection with H. pylori bacteria,
gastrectomy, PPI's
Pernicious Anemia Symptoms Correct Answer - Beefy, red
tongue
- Lemon yellow skin (pallor and icterus)
- Fatigue, weakness
- Weight loss, loss of appetite
- Decreased DTRs
- Abdominal pain
Pernicious Anemia Testing Correct Answer ▪ Schilling test:
localized site of pathology of the B12 deficiency
▪ Give IM B12, PO radioactive B12 - normal pt's with
extrinsic factor should absorb radioactive B12 and excrete
in urine because the receptors would be saturated with IM
B12; if there is a problem with the intrinsic factor then it will
not be present in the urine; test is repeated and
exogenous intrinsic factor is given
, Alcohol Induced Macrocytic Megaloblastic Anemia Correct
Answer Large, immature RBCs
- Alcohol interferes with absorption of folic acid
(megaloblastic); hbg synthesis (sideroblastic anemia);
erythropoiesis (macrocytosis)
- Anemia reverses with abstinence from alcohol within
weeks - self limiting
Normocytic-Normochromic Anemias Correct Answer
Characterized by red cells that are relatively normal in size
and hemoglobin content but insufficient in number
Less frequent then other anemias
Types:
- Aplastic
- Post-hemorrhagic
- Hemolytic
- Paroxysmal Nocturnal Hematuria
- Anemia of Chronic Disease
Aplastic Anemia Correct Answer Type of Normocytic-
Normochromic Anemias
Red bone marrow is replaced with fat; results in
pancytopenia because there are less hematopoietic cells
Most often caused by autoimmune
