anemia Flashcards
1
Q
1. Worldwide, which of the following is the most common type of anemia? A. pernicious anemia B. folate-deficiency anemia C. anemia of chronic disease D. iron-deficiency anemia
A
D. iron-deficiency anemia
2
Q
- Most of the body’s iron is obtained from:
A. animal-based food sources.
B. recycled iron content from aged red blood cells
(RBCs).
C. endoplasmic reticulum production.
D. vegetable-based food sources.
A
B. recycled iron content from aged red blood cells
RBCs
3
Q
- Which of the following is most consistent with irondeficiency
anemia?
A. low mean corpuscular volume (MCV), normal mean
corpuscular hemoglobin (MCH)
B. low MCV, low MCH
C. low MCV, elevated MCH
D. normal MCV, normal MCH
A
B. low MCV, low MCH
4
Q
- One of the earliest laboratory markers in evolving
macrocytic or microcytic anemia is:
A. an increase in RBC distribution width (RDW).
B. a reduction in measurable hemoglobin.
C. a low MCH level.
D. an increased platelet count
A
A. an increase in RBC distribution width (RDW).
5
Q
5. A 48-year-old woman developed iron-deficiency anemia after excessive perimenopausal bleeding, successfully treated by endometrial ablation. Her hematocrit (Hct) level is 25%, and she is taking iron therapy. At 5 days into therapy, one possible observed change in laboratory parameters would include: A. a correction of mean cell volume. B. an 8% increase in Hct level. C. reticulocytosis. D. a correction in ferritin level.
A
C. reticulocytosis.
6
Q
- A healthy 34-year-old man asks whether he should take an iron supplement. You respond that:
A. this is a prudent measure to ensure health.
B. iron-deficiency anemia is a common problem in men of his age.
C. use of an iron supplement in the absence of a documented deficiency can lead to iatrogenic iron
overload.
D. excess iron is easily excreted.
A
C. use of an iron supplement in the absence of a documented deficiency can lead to iatrogenic iron
overload.
7
Q
- Which of the following is the best advice on taking
ferrous sulfate to enhance iron absorption?
A. “Take with other medications.”
B. “Take on a full stomach.”
C. “Take on an empty stomach.”
D. “Do not take with vitamin C.”
A
C. “Take on an empty stomach.”
8
Q
- A 40-year-old woman with pyelonephritis is taking two medications: ciprofloxacin and ferrous sulfate (for iron deficiency anemia). She asks about taking both medications.
You advise that:
A. she should take the medications with a large glass of water.
B. an inactive drug compound is potentially formed if
the two medications are taken together.
C. she can take the medications together to enhance
adherence to therapy.
D. the ferrous sulfate potentially slows gastrointestinal
motility and results in enhanced ciprofloxacin
absorption.
A
B. an inactive drug compound is potentially formed if
the two medications are taken together.
9
Q
- Two months into therapy for pernicious anemia, you
wish to check the efficacy of the intervention. The best
laboratory test to order at this point is a:
A. Schilling test.
B. hemoglobin measurement.
C. reticulocyte count.
D. serum cobalamin.
A
B. hemoglobin measurement.
10
Q
- A woman who is planning a pregnancy should increase
her intake of which of the following to minimize the
risk of neural tube defect in the fetus?
A. iron
B. niacin
C. folic acid
D. vitamin C
A
C. folic acid
11
Q
- Risk factors for folate-deficiency anemia include:
A. menorrhagia.
B. chronic ingestion of overcooked foods.
C. use of nonsteroidal anti-inflammatory drugs.
D. gastric atrophy.
A
B. chronic ingestion of overcooked foods.
12
Q
12. Folate-deficiency anemia causes which of the following changes in the RBC indices? A. microcytic, normochromic B. normocytic, normochromic C. microcytic, hypochromic D. macrocytic, normochromic
A
D. macrocytic, normochromic
13
Q
- Pernicious anemia is usually caused by:
A. dietary deficiency of vitamin B12.
B. lack of production of intrinsic factor by the gastric
mucosa.
C. RBC enzyme deficiency.
D. a combination of micronutrient deficiencies caused
by malabsorption.
A
B. lack of production of intrinsic factor by the gastric
mucosa.
14
Q
14. Pernicious anemia causes which of the following changes in the RBC indices? A. microcytic, normochromic B. normocytic, normochromic C. microcytic, hypochromic D. macrocytic, normochromic
A
D. macrocytic, normochromic
15
Q
15. Common physical examination findings in patients with pernicious anemia include: A. hypoactive bowel sounds. B. stocking-glove neuropathy. C. thin, spoon-shaped nails. D. retinal hemorrhages.
A
B. stocking-glove neuropathy.
16
Q
- You examine a 47-year-old man who presents with
difficulty initiating and maintaining sleep and chronic
pharyngeal erythema with the following results on
hemogram:
Hemoglobin (Hgb) = 15 g (normal 14 to 16 g)
Hct = 45% (normal 42% to 48%)
RBC = 4.8 million mm3 (normal 4.7 to 6.1 million mm3)
MCV = 108 fL (normal 81 to 96 fL)
MCHC = 33.2 g/dL (normal 31 to 37 g/dL)
These values are most consistent with:
A. pernicious anemia.
B. alcohol abuse.
C. thalassemia minor.
D. Fanconi disease.
A
B. alcohol abuse.
17
Q
- You examine a 22-year-old woman of Asian ancestry. She has no presenting complaint. Hemogram results are as follows:
Hgb = 9.1 g (normal 12 to 14 g)
Hct = 28% (normal 36% to 43%)
RBC = 5.6 million mm3 (normal 4.2 to 5.4 million mm3)
MCV = 68 fL (normal 81 to 96 fL)
MCHC = 33.2 g/dL (normal 31 to 37 g/dL)
RBC distribution width (RDW) = 13% (normal ≤15%).
Reticulocytes = 1.5% (normal 1% to 2%)
This is most consistent with the laboratory assessment of:
A. iron-deficiency anemia.
B. Cooley anemia.
C. alpha-thalassemia minor.
D. hemoglobin Barts.
A
C. alpha-thalassemia minor.
18
Q
18. A 68-year-old man who is usually healthy presents with new onset of “huffing and puffing” with exercise for the past 3 weeks. Physical examination reveals conjunctiva pallor and a hemic murmur. Hemogram results are as follows: Hgb = 7.6 g Hct = 20.5% RBC = 2.1 million mm3 MCV = 76 fL MCHC = 28 g/dL RDW = 18.4% Reticulocytes = 1.8% The most likely cause of these finding is: A. poor nutrition. B. occult blood loss. C. malabsorption. D. chronic inflammation.
A
B. occult blood loss.
19
Q
- You examine a 57-year-old woman with rheumatoid
arthritis who is on a disease-modifying antirheumatic
drug (DMARD) but continues to have poor disease
control and find the following results on hemogram:
Hgb = 10.5 g
Hct = 33%
RBC = 3.1 million mm3
MCV = 88 fL
MCHC = 32.8 g/dL
RDW = 12.2%
Reticulocytes = 0.8%
The laboratory findings are most consistent with:
A. pernicious anemia.
B. anemia of chronic disease.
C. beta thalassemia minor.
D. folate-deficiency anemia.
A
B. anemia of chronic disease.
20
Q
20. You examine a 27-year-old woman with menorrhagia who is otherwise well and note the following results on hemogram: Hgb = 10.1 g Hct = 32% RBC = 2.9 million mm3 MCV = 72 fL MCHC = 28.2 g/dL RDW = 18.9% Physical examination is likely to include: A. conjunctiva pallor. B. hemic murmur. C. tachycardia. D. no specific anemia-related findings.
A
D. no specific anemia-related findings.
21
Q
21. Results of hemogram in a person with anemia of chronic disease include: A. microcytosis. B. anisocytosis. C. reticulocytopenia. D. macrocytosis.
A
C. reticulocytopenia.
22
Q
- When prescribing erythropoietin supplementation, the nurse practitioner (NP) considers that:
A. the adrenal glands are its endogenous source.
B. the addition of micronutrient supplementation
needed for erythropoiesis is advisable.
C. its use is as an adjunct in treating thrombocytopenia.
D. with its use, the RBC life span is prolonged.
A
B. the addition of micronutrient supplementation
needed for erythropoiesis is advisable.
23
Q
23. In the first weeks of anemia therapy with parenteral vitamin B12 in a 68-year-old woman with hypertension who is taking a thiazide diuretic, the patient should be carefully monitored for: A. hypernatremia. B. dehydration. C. hypokalemia. D. acidemia.
A
C. hypokalemia.
24
Q
24. Which of the following conditions is unlikely to result in anemia of chronic disease? A. rheumatoid arthritis B. peripheral vascular disease C. chronic renal insufficiency D. osteomyelitis
A
B. peripheral vascular disease
25
Q
25. In health, the ratio of hemoglobin to hematocrit is usually: A. 1:1. B. 1:2. C. 1:3. D. 1:4.
A
C. 1:3.
26
Q
26. An increase in the normal variation of RBC size is known as: A. poikilocytosis. B. granulation. C. anisocytosis. D. basophilic stippling.
A
C. anisocytosis.
27
Q
27. Erythropoietin is a glycoprotein that influences a stem cell to become a: A. lymphocyte. B. platelet. C. neutrophil. D. red blood cell.
A
D. red blood cell.
28
Q
28. Intervention in anemia of chronic disease most often includes: A. oral vitamin B12. B. treatment of the underlying cause. C. transfusion. D. parenteral iron.
A
B. treatment of the underlying cause.
29
Q
29. Poikilocytosis refers to alterations in a red blood cell’s: A. thickness. B. color. C. shape. D. size.
A
C. shape.
30
Q
- Which of the following is not consistent with anemia of chronic disease (ACD)?
A. NL RDW
B. NL MCHC
C. Hct less than 24%
D. NL to slightly elevated serum ferritin
A
C. Hct less than 24%
31
Q
- In children younger than age 6 years, accidental overdose of iron-containing products is:
A. easily treated.
B. a source of significant gastrointestinal (GI) upset.
C. worrisome but rarely causes significant harm.
D. a leading cause of fatal poisoning in the age-group.
A
D. a leading cause of fatal poisoning in the age-group.
32
Q
- When counseling a patient about the neurological alterations often associated with vitamin B12 deficiency, the NP advises that:
A. these usually resolve within days with appropriate
therapy.
B. if present for longer than 6 months, these changes
are occasionally permanent.
C. the use of parenteral vitamin B12 therapy is needed
to ensure symptom resolution.
D. cognitive changes associated with vitamin B12 deficiency
are seldom reversible even with appropriate
therapy.
A
B. if present for longer than 6 months, these changes
are occasionally permanent.
33
Q
33. When the cause of a macrocytic anemia is uncertain, the most commonly recommended additional testing includes which of the following? A. haptoglobin and reticulocyte count. B. Schilling test and gastric biopsy. C. methylmalonic acid and homocysteine. D. transferrin and prealbumin.
A
C. methylmalonic acid and homocysteine.
34
Q
- Anemia in children is potentially associated
with poorer school performance. T/F
A
True
35
Q
- During pregnancy, folic acid requirements
increase twofold to fourfold. T/F
A
True
36
Q
- The red blood cell content is approximately
90% hemoglobin T/F
A
True
37
Q
- Approximately 90% of the body’s erythropoietin
is produced by the kidney. T/F
A
True
38
Q
- The body’s normative response to anemia is
reticulocytopenia. T/F
A
False
