NURS 223: Exam 4 (All possible questions with 100% verified answers)

The nurse is caring for a client who is a strict vegetarian; the client is at greatest risk for the development of: a) Folic acid deficiency anemia b) Blood loss anemia c) Microcytic anemia d) Vitamin B12 deficiency anemia correct answers d) Vitamin B12 deficiency anemia Vitamin B12 is found in all foods of animal origin. Dietary deficiency is rare and usually found only in strict vegetarians who avoid all dairy products as well as meat and fish. The hallmark of vitamin B12 deficiency is megaloblastic anemia. The other options are not affected by the client being a vegetarian. The nurse is caring for a client diagnosed with sickle cell disease. Select the most important factor for the nurse to be aware of that may cause the cells to sickle. a) Rapid administration of intravenous fluids b) Reduced oxygen tension while the client sleeps c) Acute chest syndrome d) Presence of pain in the client's joints correct answers b) Reduced oxygen tension while the client sleeps Factors associated with sickling include cold, stress, physical exertion, infection, dehydration and illnesses that cause hypoxia, dehydration, or acidosis. Even such trivial incidents as reduced oxygen tension induced by sleep may contribute to the sickling process. Pain and acute chest syndrome are complications of sickle cell disease When an Rh-negative mother gives birth to an Rh-positive infant, the mother usually produces antibodies that will attack any subsequent pregnancies in which the fetus is Rh positive. When subsequent babies are Rh positive, erythroblastosis fetalis occurs. What is another name for erythroblastosis fetalis? a) Microcytic disease of the newborn b) Macrocytic disease of the newborn c) Hemolytic disease of the newborn d) Hemolytic iron deficiency anemia correct answers c) Hemolytic disease of the newborn Erythroblastosis fetalis, or hemolytic disease of the newborn, occurs in Rh-positive infants of Rh-negative mothers who have been sensitized. The Rh-negative mother usually becomes sensitized during the first few days after delivery, when fetal Rh-positive red cells from the placental site are released into the maternal circulation. Because the antibodies take several weeks to develop, the first Rh-positive infant of an Rh-negative mother usually is not affected. There is no such thing as microcytic or macrocytic disease of the newborn, nor is there a hemolytic iron deficiency anemia An adult client with good overall health has reported headaches and dizziness in recent weeks. The nurse's assessment reveals blood pressure of 158/99 mm Hg, which is unprecedented for the client. On observation, the client's skin appears reddened, though he denies feeling warm. The nurse should anticipate what further diagnostic finding?