A patient presents with fatigue, pallor, and spoon-shaped nails. Laboratory results reveal low RBC's, hemoglobin/hematocrit, and ferritin. Which type of anemia is most likely present?

• Iron deficiency anemia

• Vitamin B12 deficiency anemia

• Aplastic anemia

• Sickle cell anemia

Answer explanation

The patient's symptoms of fatigue, pallor, and spoon-shaped nails, along with low RBCs, hemoglobin, and ferritin, indicate iron deficiency anemia, which is characterized by these findings.

Which of the following symptoms is most commonly associated with vitamin B12 deficiency anemia?

• Glossitis and peripheral neuropathy

• Petechiae and ecchymosis

• Jaundice and splenomegaly

• Hematuria and hypertension

Answer explanation

Vitamin B12 deficiency anemia commonly presents with glossitis (inflammation of the tongue) and peripheral neuropathy (nerve damage), making these symptoms the most characteristic of this condition.

Aplastic anemia is best characterized by which of the following laboratory findings?

• Low erythrocyte, Leukocyte, and thrombocyte counts

• Microcytic, hypochromic red blood cells

• Elevated reticulocyte count

• Increased white blood cell count

Answer explanation

Aplastic anemia is characterized by a failure of the bone marrow to produce blood cells, leading to low counts of erythrocytes, leukocytes, and thrombocytes. Thus, the correct choice is low counts of all three cell types.

Which of the following is a classic symptom of polycythemia vera?

• vein distention

• Night sweats

• Petechiae

• Weight loss

Answer explanation

Vein distention is a classic symptom of polycythemia vera due to increased blood volume and viscosity. Night sweats, petechiae, and weight loss are not specific to this condition.

Which of the following is the most appropriate initial treatment for iron deficiency anemia?

• Oral ferrous sulfate supplementation

• Intravenous immunoglobulin

• Bone marrow transplant

• Vitamin B12 injections

Answer explanation

Oral ferrous sulfate supplementation is the first-line treatment for iron deficiency anemia, as it effectively increases iron levels in the body. Other options listed are not appropriate for this specific condition.

A patient with vitamin B12 deficiency anemia is started on therapy. Which of the following outcomes would best indicate effective treatment?

• Resolution of paresthesia and improved hemoglobin levels

• Decreased platelet count

• Increased bilirubin levels

• Onset of hematuria

Answer explanation

The best indicator of effective treatment for vitamin B12 deficiency anemia is the resolution of paresthesia and improved hemoglobin levels, as these reflect both neurological recovery and correction of anemia.

A patient with aplastic anemia is at increased risk for which of the following complications?

• Infections due to neutropenia

• Hypercalcemia

• Deep vein thrombosis

• Hyperglycemia

Answer explanation

Aplastic anemia leads to decreased production of blood cells, including neutrophils, resulting in neutropenia. This condition significantly increases the risk of infections, making 'Infections due to neutropenia' the correct answer.

Which of the following laboratory findings would you expect in a patient with polycythemia vera?

• Elevated hematocrit and hemoglobin

• Decreased erythropoietin levels

• Increased mean corpuscular volume (MCV)

• Low platelet count

Answer explanation

In polycythemia vera, there is an overproduction of red blood cells, leading to elevated hematocrit and hemoglobin levels. This condition is characterized by increased blood viscosity, not low platelet counts or increased MCV.

A patient with iron deficiency anemia is not responding to oral iron therapy. Which of the following should the nurse assess for as a possible cause?

• Ongoing gastrointestinal blood loss

• Excessive sun exposure

• High calcium intake

• Frequent exercise

Answer explanation

Ongoing gastrointestinal blood loss can lead to continued iron deficiency despite oral iron therapy, as it prevents adequate iron absorption and replenishment. This is a critical factor to assess in non-responsive patients.

A patient with aplastic anemia is being considered for a bone marrow transplant. What is the most important factor in determining eligibility for this treatment?

• Availability of a human leukocyte antigen (HLA)-matched donor

• Patient’s age

• Severity of anemia

• Duration of illness

Answer explanation

The most critical factor for bone marrow transplant eligibility in aplastic anemia is the availability of an HLA-matched donor, as this significantly impacts the success of the transplant and the patient's outcome.