A 30-year-old client who donates blood every 3 months
Which client should the nurse practitioner
(NP) recognize as most at risk of developing
iron deficiency anemia?
A 25-year-old client who recently became
pregnant
A 40-year-old client with a history of peptic
ulcers
A 30-year-old client who donates blood
every 3 months
A 50-year-old client with congestive heart
failure
Serum ferritin
The nurse practitioner (NP) reviews a client's
laboratory results. Which laboratory result
best reflects the client's level of iron stores?
Transferrin saturation
Hemoglobin
Serum iron
Serum ferritin
Hematocrit
Total iron-binding capacity
a bloos transfusion
The nurse practitioner (NP) is caring for a
client with beta thalassemia major. The NP
should anticipate the client will require what?
Avoid drinking tea or coffee with meals
Consume lean red meat
The nurse practitioner (NP) is counseling a Consume iron-fortified cereal
client with iron deficiency anemia about Consume vitamin C-rich foods with iron-rich meals
dietary needs. Which instruction(s) should
the NP include? Select all that apply.
Avoid drinking tea or coffee with meals
Consume lean red meat
Increase intake of calcium-rich foods
Consume iron-fortified cereal
Consume vitamin C-rich foods with iron-rich
meals
Refer the couple for genetic counseling.
Explain what it means to be a carrier of thalassemia.
Discuss inheritance patterns of thalassemia.
A nurse practitioner (NP) is providing pre-
conception counseling to a couple, both of
whom are carriers of thalassemia. Which of
the following actions should the NP take?
Select all that apply.
Encourage the couple not to conceive.
Refer the couple for genetic counseling.
Explain what it means to be a carrier of
thalassemia.
Discuss ways to prevent naturally conceiving
a child with thalassemia.
Discuss inheritance patterns of thalassemia.
, Ferritin level
Hemoglobin level
Energy level
The nurse practitioner (NP) assesses the
client on a follow-up visit after the initiation of
treatment for thalassemia including
administration of blood transfusions. What
three (3) assessments should the NP
prioritize to evaluate client outcomes? Select
3.
Dietary intake
Developmental milestones
Ferritin level
Hemoglobin level
Energy level
Adult client who had a vertical sleeve gastrectomy
Which of the following clients should the
nurse practitioner (NP) recognize as being
most at risk for developing vitamin B-12
deficiency anemia?
An infant who is exclusively breastfed
Middle adult client who eats a high-protein
diet
A client who is pregnant
Adult client who had a vertical sleeve
gastrectomy
indicates hemoglobin concentration in RBCs
Mean Corpuscular Hemoglobin
Concentration (MCHC)
Ferritin total iron stores; low levels indicate iron deficiency
small RBC's
-iron deficiency
microlytic anemia -thalassemia
blood transfusion- will increase iron stores
Chelation therapy-deferasirox & deferiprone
Thalassemia beta major treatment bone marrow transplant
Mediated by IgE antibody
Type 1 hypersensitivity Anaphylaxis, allergic rhinitis, asthma
mediated by IgG antibodies and macrophages
Type 2 hypersensitivity HITT reaction, transfusion reaction, Graves Disease
IgG antibodies attach the TSH receptor causing an over production of thyroid
hormones leading the hyperthyroidism
Graves disease tx: beta blockers for tachycardia, methimazole (not for pregnant), propylthiouracil (for
pregnant), radioactive iodine therapy (not for pregnant)
neutrophil mediated reaction
immune complexes activate complement system & neutrophils resulting in tissue
Type 3 hypersensitivity destruction
-Lupus, serum sickness
B&T cells are over reactive causing production of antibodies
DX with ANA antibody
systemic lupus erythematosus TX with NSAIDS for pain
, A 30-year-old client with severe anorexia nervosa
A 27-year-old client who is newly pregnant and breastfeeding their toddler
A 40-year-old client with celiac disease
Which of the following client(s) should the
nurse practitioner (NP) recognize as being at
risk for developing folate deficiency? Select
all that apply.
A 30-year-old client with severe anorexia
nervosa
A 19-year-old client with sickle cell disease
A 27-year-old client who is newly pregnant
and breastfeeding their toddler
A 40-year-old client with celiac disease
A 32-year-old client who had a gastrectomy
one year ago
What medications impact the absorption of Metformin, H2 receptor blockers, PPI
B12
What medications impact the absorption of anticonvulsants and methotrexate
folate
Defective erythropoiesis
A nurse practitioner (NP) evaluates a 45-
year-old client who presents with fatigue and
weakness. The NP diagnoses the client with
anemia of chronic disease. What is the
primary pathophysiological mechanism
causing this normocytic anemia?
Excessive blood loss
Defective erythropoiesis
Impaired iron absorption
Delayed maturation of erythrocyte
precursors
Increased red blood cell destruction
A nurse practitioner (NP) evaluates a 28-
year-old client who presents with fatigue,
jaundice, and dark-colored urine. The NP
diagnoses the client with hemolytic anemia.
What is the most likely pathophysiological
mechanism causing this normocytic
anemia?
Impaired iron absorption
Excessive blood loss
Defective erythropoiesis
Increased red blood cell destruction
Which client should the nurse practitioner
(NP) recognize as most at risk of developing
iron deficiency anemia?
A 25-year-old client who recently became
pregnant
A 40-year-old client with a history of peptic
ulcers
A 30-year-old client who donates blood
every 3 months
A 50-year-old client with congestive heart
failure
Serum ferritin
The nurse practitioner (NP) reviews a client's
laboratory results. Which laboratory result
best reflects the client's level of iron stores?
Transferrin saturation
Hemoglobin
Serum iron
Serum ferritin
Hematocrit
Total iron-binding capacity
a bloos transfusion
The nurse practitioner (NP) is caring for a
client with beta thalassemia major. The NP
should anticipate the client will require what?
Avoid drinking tea or coffee with meals
Consume lean red meat
The nurse practitioner (NP) is counseling a Consume iron-fortified cereal
client with iron deficiency anemia about Consume vitamin C-rich foods with iron-rich meals
dietary needs. Which instruction(s) should
the NP include? Select all that apply.
Avoid drinking tea or coffee with meals
Consume lean red meat
Increase intake of calcium-rich foods
Consume iron-fortified cereal
Consume vitamin C-rich foods with iron-rich
meals
Refer the couple for genetic counseling.
Explain what it means to be a carrier of thalassemia.
Discuss inheritance patterns of thalassemia.
A nurse practitioner (NP) is providing pre-
conception counseling to a couple, both of
whom are carriers of thalassemia. Which of
the following actions should the NP take?
Select all that apply.
Encourage the couple not to conceive.
Refer the couple for genetic counseling.
Explain what it means to be a carrier of
thalassemia.
Discuss ways to prevent naturally conceiving
a child with thalassemia.
Discuss inheritance patterns of thalassemia.
, Ferritin level
Hemoglobin level
Energy level
The nurse practitioner (NP) assesses the
client on a follow-up visit after the initiation of
treatment for thalassemia including
administration of blood transfusions. What
three (3) assessments should the NP
prioritize to evaluate client outcomes? Select
3.
Dietary intake
Developmental milestones
Ferritin level
Hemoglobin level
Energy level
Adult client who had a vertical sleeve gastrectomy
Which of the following clients should the
nurse practitioner (NP) recognize as being
most at risk for developing vitamin B-12
deficiency anemia?
An infant who is exclusively breastfed
Middle adult client who eats a high-protein
diet
A client who is pregnant
Adult client who had a vertical sleeve
gastrectomy
indicates hemoglobin concentration in RBCs
Mean Corpuscular Hemoglobin
Concentration (MCHC)
Ferritin total iron stores; low levels indicate iron deficiency
small RBC's
-iron deficiency
microlytic anemia -thalassemia
blood transfusion- will increase iron stores
Chelation therapy-deferasirox & deferiprone
Thalassemia beta major treatment bone marrow transplant
Mediated by IgE antibody
Type 1 hypersensitivity Anaphylaxis, allergic rhinitis, asthma
mediated by IgG antibodies and macrophages
Type 2 hypersensitivity HITT reaction, transfusion reaction, Graves Disease
IgG antibodies attach the TSH receptor causing an over production of thyroid
hormones leading the hyperthyroidism
Graves disease tx: beta blockers for tachycardia, methimazole (not for pregnant), propylthiouracil (for
pregnant), radioactive iodine therapy (not for pregnant)
neutrophil mediated reaction
immune complexes activate complement system & neutrophils resulting in tissue
Type 3 hypersensitivity destruction
-Lupus, serum sickness
B&T cells are over reactive causing production of antibodies
DX with ANA antibody
systemic lupus erythematosus TX with NSAIDS for pain
, A 30-year-old client with severe anorexia nervosa
A 27-year-old client who is newly pregnant and breastfeeding their toddler
A 40-year-old client with celiac disease
Which of the following client(s) should the
nurse practitioner (NP) recognize as being at
risk for developing folate deficiency? Select
all that apply.
A 30-year-old client with severe anorexia
nervosa
A 19-year-old client with sickle cell disease
A 27-year-old client who is newly pregnant
and breastfeeding their toddler
A 40-year-old client with celiac disease
A 32-year-old client who had a gastrectomy
one year ago
What medications impact the absorption of Metformin, H2 receptor blockers, PPI
B12
What medications impact the absorption of anticonvulsants and methotrexate
folate
Defective erythropoiesis
A nurse practitioner (NP) evaluates a 45-
year-old client who presents with fatigue and
weakness. The NP diagnoses the client with
anemia of chronic disease. What is the
primary pathophysiological mechanism
causing this normocytic anemia?
Excessive blood loss
Defective erythropoiesis
Impaired iron absorption
Delayed maturation of erythrocyte
precursors
Increased red blood cell destruction
A nurse practitioner (NP) evaluates a 28-
year-old client who presents with fatigue,
jaundice, and dark-colored urine. The NP
diagnoses the client with hemolytic anemia.
What is the most likely pathophysiological
mechanism causing this normocytic
anemia?
Impaired iron absorption
Excessive blood loss
Defective erythropoiesis
Increased red blood cell destruction
