Mod. 1 Disease of RBC Flashcards
application based
A 45-year-old patient with a history of chronic blood loss due to heavy menstruation presents with fatigue, pallor, and a decreased appetite. Blood tests reveal low hemoglobin and hematocrit levels. The nurse suspects iron-deficiency anemia. Which of the following interventions would be most appropriate for this patient?
A. Administer vitamin B12 injections to correct the anemia.
B. Recommend increasing intake of iron-rich foods and begin iron supplementation.
C. Initiate transfusion of packed red blood cells immediately.
D. Provide a high-protein diet to enhance red blood cell production.
B. Recommend increasing intake of iron-rich foods and begin iron supplementation.
Rationale: Iron-deficiency anemia is typically treated by addressing the underlying cause, such as increasing dietary iron and using iron supplements to replenish the body’s iron stores. Vitamin B12 injections are not indicated for this type of anemia, and transfusion is generally reserved for more severe cases.
A patient with pernicious anemia has been receiving regular vitamin B12 injections. The nurse is assessing the patient’s response to therapy. Which finding indicates that the treatment is effective?
A. Decreased jaundice
B. Improved deep tendon reflexes
C. Increased red blood cell count
D. Improved cognitive function and memory
D. Improved cognitive function and memory
Rationale: Pernicious anemia can cause neurological symptoms such as memory loss and cognitive dysfunction due to vitamin B12 deficiency. Improvement in cognitive function and memory after treatment indicates the therapy is effective. While increased red blood cell count and decreased jaundice are also signs of improvement, neurological recovery is a key indicator of successful B12 treatment.
A 7-year-old patient with sickle cell anemia presents to the emergency department with severe bone pain, fatigue, and dyspnea. The nurse suspects a sickle cell crisis. Which of the following actions should the nurse prioritize?
A. Administer oxygen and pain relief measures.
B. Initiate intravenous iron supplementation.
C. Restrict fluids to prevent dehydration.
D. Encourage the child to ambulate to relieve pain.
A. Administer oxygen and pain relief measures.
Rationale: During a sickle cell crisis, oxygen and pain management are the priorities. Oxygen helps alleviate hypoxia and pain relief helps manage the intense discomfort associated with the crisis. Intravenous iron is not appropriate in this situation, as the crisis is related to vaso-occlusion, not iron deficiency. Fluid restriction and ambulation are contraindicated during a crisis.
A patient with thalassemia is scheduled for a blood transfusion. The nurse knows that the patient will also need additional interventions. Which of the following is a priority intervention for this patient?
A. Administer folic acid supplements.
B. Provide iron chelation therapy.
C. Restrict fluid intake to prevent overload.
D. Monitor for signs of anemia.
B. Provide iron chelation therapy.
Rationale: Patients with thalassemia who receive multiple blood transfusions are at risk for iron overload, which can damage organs. Iron chelation therapy is necessary to remove excess iron from the body. Folic acid supplementation may also be required, but managing iron overload is a more immediate concern.
A 12-year-old patient with a history of sickle cell anemia presents with an episode of abdominal pain, fatigue, and fever. The nurse suspects a sickle cell crisis and prepares for immediate interventions. Which of the following should be the nurse’s first action?
A. Administer antibiotics to prevent infection.
B. Assess for signs of acute chest syndrome.
C. Begin hydration and pain management.
D. Prepare for a blood transfusion.
C. Begin hydration and pain management.
Rationale: Hydration and pain management are the first-line interventions for a sickle cell crisis. These help relieve the vaso-occlusion and reduce pain. While antibiotics and transfusions may be necessary later, addressing hydration and pain is the priority during a crisis.
A patient with aplastic anemia is being treated with blood transfusions and oxygen therapy. The nurse is concerned about the risk of infection in this patient. Which of the following interventions is most important to reduce this risk?
A. Maintain strict isolation precautions.
B. Administer immunosuppressive medications.
C. Educate the patient on proper hand hygiene.
D. Monitor the patient for signs of thrombotic events.
C. Educate the patient on proper hand hygiene.
Rationale: Aplastic anemia leads to pancytopenia, which increases the risk of infections. Teaching proper hand hygiene is essential to reduce the risk of infection. Strict isolation may be required in some cases, but educating the patient on infection prevention is a primary strategy.
A 30-year-old woman with iron-deficiency anemia is diagnosed after presenting with fatigue, dizziness, and pallor. During the patient’s education session, the nurse teaches the patient about the importance of vitamin C in iron absorption. Which of the following instructions should the nurse include in the teaching?
A. “You should take vitamin C with iron supplements to increase absorption.”
B. “Avoid taking vitamin C with iron supplements as it can cause nausea.”
C. “Vitamin C will help cure your anemia on its own.”
D. “You should take vitamin C in the evening to enhance absorption.”
A. “You should take vitamin C with iron supplements to increase absorption.”
Rationale: Vitamin C enhances the absorption of iron from the gastrointestinal tract. It is recommended to take vitamin C with iron supplements to optimize iron absorption.
A patient with thalassemia is scheduled for a splenectomy due to splenomegaly and hemolysis. The nurse knows that this procedure is primarily intended to:
A. Increase red blood cell production.
B. Reduce the amount of iron absorbed by the body.
C. Prevent further damage to the spleen and decrease hemolysis.
D. Correct the genetic mutation causing the disorder.
C. Prevent further damage to the spleen and decrease hemolysis.
Rationale: Splenectomy is performed in thalassemia to prevent further damage to the spleen and reduce hemolysis. It is not a cure for the genetic disorder, but it can improve quality of life by managing some symptoms.
A 65-year-old female patient is diagnosed with iron-deficiency anemia. The nurse explains that the condition is caused by a deficiency in iron, which affects hemoglobin production. Which of the following is a common manifestation of iron-deficiency anemia in this patient?
A. Jaundice
B. Cyanotic sclera
C. Increased appetite
D. Paresthesia
B. Cyanotic sclera
Rationale: Cyanotic sclera is one of the common manifestations of iron-deficiency anemia. This occurs due to inadequate hemoglobin production, leading to poor oxygenation. Jaundice and paresthesia are associated with other anemias such as hemolytic anemia or pernicious anemia, not iron-deficiency anemia. Increased appetite is not typically a manifestation of iron-deficiency anemia.
A patient with pernicious anemia presents with memory loss, unsteady gait, and a positive Babinski’s sign. The nurse knows that these symptoms are related to the deficiency of which of the following?
A. Folate
B. Vitamin B12
C. Iron
D. Vitamin C
B. Vitamin B12
Rationale: Pernicious anemia is caused by a vitamin B12 deficiency, typically due to a lack of intrinsic factor. This leads to impaired DNA synthesis, resulting in neurological symptoms such as memory loss, unsteady gait, and positive Babinski’s sign. Folate deficiency causes similar hematologic symptoms but does not lead to neurological manifestations. Iron and vitamin C deficiencies do not result in these neurological issues.
A 25-year-old male patient with sickle cell anemia is admitted with complaints of severe pain in the abdomen and legs, along with difficulty breathing. The nurse understands that these symptoms are indicative of which condition?
A. Sickle cell crisis
B. Thalassemia
C. Polycythemia vera
D. Iron-deficiency anemia
A. Sickle cell crisis
Rationale: Sickle cell crisis occurs when sickle-shaped red blood cells obstruct blood flow, leading to tissue ischemia, pain, and organ damage. Symptoms such as abdominal and bone pain, difficulty breathing, and fatigue are common during a sickle cell crisis. Thalassemia and polycythemia vera involve different pathophysiological mechanisms, and iron-deficiency anemia typically causes fatigue and pallor rather than severe pain.
A patient with aplastic anemia is being treated with blood transfusions. The nurse is concerned about the potential development of infection due to pancytopenia. Which of the following interventions is the nurse’s priority?
A. Administer prescribed antibiotics
B. Implement strict isolation precautions
C. Provide pain management therapy
D. Monitor for signs of thrombocytopenia
B. Implement strict isolation precautions
Rationale: Aplastic anemia leads to pancytopenia, which significantly increases the risk of infection due to a decrease in white blood cells. Implementing strict isolation precautions helps protect the patient from external infections. While antibiotics may be used if an infection is suspected, isolation is the priority. Pain management and monitoring for thrombocytopenia are important but do not directly address the infection risk.
A patient with polycythemia vera is being treated with phlebotomy to decrease the viscosity of their blood. Which of the following complications is the nurse most concerned about in this patient?
A. Anemia
B. Stroke
C. Hypertension
D. Hemorrhage
B. Stroke
Rationale: Polycythemia vera causes increased erythrocyte production, leading to thicker blood and increased risk for thrombosis, which can result in a stroke. While hypertension and hemorrhage are also potential complications, stroke is a significant concern due to the increased blood viscosity. Anemia would not be a concern in polycythemia vera, as the primary issue is an excess of red blood cells.
A nurse is educating the parents of a child diagnosed with sickle cell anemia about the triggers of sickle cell crisis. Which of the following factors should be emphasized as potential triggers?
A. High-fat diet
B. Dehydration and fever
C. Excessive iron intake
D. Prolonged sleep
B. Dehydration and fever
Rationale: Dehydration and fever are known triggers of sickle cell crisis, as they can cause further sickling of red blood cells, leading to blocked blood flow and tissue ischemia. A high-fat diet, excessive iron intake, and prolonged sleep are not typically triggers for sickle cell crisis.
A 30-year-old male with thalassemia presents with jaundice, fatigue, and hepatomegaly. Laboratory results show a low MCV and MCHC. Which of the following is the most appropriate treatment for this patient?
A. Blood transfusion and iron chelation therapy
B. Folic acid supplementation and dietary iron restriction
C. Vitamin B12 supplementation and bone marrow transplant
D. Phlebotomy and chemotherapy
A. Blood transfusion and iron chelation therapy
Rationale: Thalassemia is characterized by abnormal hemoglobin and ineffective erythropoiesis. Treatment often involves blood transfusions to manage anemia and iron chelation therapy to prevent iron overload. Folic acid may be needed to support erythropoiesis, but iron chelation is crucial due to the frequent need for blood transfusions. Vitamin B12 supplementation is used for pernicious anemia, not thalassemia. Phlebotomy and chemotherapy are used for polycythemia vera, not thalassemia.
A nurse is monitoring a patient who has recently been diagnosed with iron-deficiency anemia. The patient is receiving supplemental iron and vitamin C. Which of the following is the most important instruction to provide to the patient regarding their medication regimen?
A. “Take the iron supplement with milk to reduce stomach irritation.”
B. “Take the iron supplement with orange juice to enhance absorption.”
C. “Take the iron supplement with a high-fat meal to improve absorption.”
D. “Take the iron supplement at bedtime to prevent nausea.”
B. “Take the iron supplement with orange juice to enhance absorption.”
Rationale: Vitamin C enhances the absorption of iron, so taking the supplement with orange juice (a source of vitamin C) is recommended. Milk and high-fat meals can reduce iron absorption. Taking iron at bedtime is not ideal, as it may cause gastrointestinal discomfort, and vitamin C should be included to improve absorption.
A 45-year-old woman presents with fatigue, weakness, pale skin, and brittle nails. She mentions that she has had a history of heavy menstrual periods and is experiencing frequent headaches. Lab results reveal low hemoglobin, hematocrit, and serum ferritin levels. What type of anemia is this patient most likely experiencing?
A. Pernicious anemia
B. Iron-deficiency anemia
C. Aplastic anemia
D. Hemolytic anemia
B. Iron-deficiency anemia
Rationale: This patient’s symptoms of fatigue, weakness, pale skin, brittle nails, and heavy menstrual periods are classic signs of iron-deficiency anemia. Low hemoglobin, hematocrit, and ferritin levels further support this diagnosis. Pernicious anemia is related to a vitamin B12 deficiency, aplastic anemia involves bone marrow suppression, and hemolytic anemia involves excessive red blood cell destruction.
A 28-year-old male with a family history of sickle cell disease presents with complaints of pain in his legs and abdomen, as well as fatigue and shortness of breath. His blood work shows sickle-shaped erythrocytes and elevated bilirubin levels. Which type of anemia is he most likely diagnosed with?
A. Sickle cell anemia
B. Thalassemia
C. Iron-deficiency anemia
D. Polycythemia vera
A. Sickle cell anemia
Rationale: The presence of sickle-shaped erythrocytes, along with symptoms of pain, fatigue, and shortness of breath, indicates sickle cell anemia. This inherited condition leads to the formation of abnormally shaped red blood cells that can obstruct blood flow. Thalassemia, iron-deficiency anemia, and polycythemia vera have different pathophysiologies and do not present with sickle-shaped erythrocytes.
A 60-year-old patient is admitted with fatigue, dyspnea, and a smooth, beefy-red tongue. Laboratory tests reveal low serum vitamin B12 levels, and an intrinsic factor antibody test is positive. What type of anemia is this patient likely experiencing?
A. Pernicious anemia
B. Iron-deficiency anemia
C. Aplastic anemia
D. Hemolytic anemia
A. Pernicious anemia
Rationale: Pernicious anemia is caused by a deficiency of vitamin B12, usually due to an autoimmune lack of intrinsic factor. Symptoms such as fatigue, dyspnea, and a smooth, beefy-red tongue are characteristic of this condition. The positive intrinsic factor antibody test further confirms this diagnosis. Iron-deficiency anemia and aplastic anemia involve different etiologies, and hemolytic anemia is characterized by excessive red blood cell destruction.
A 4-year-old child of African descent presents with severe pain in the legs, abdominal pain, and jaundice. Blood tests show a high number of sickled erythrocytes and an increased reticulocyte count. Which type of anemia is this child most likely suffering from?
A. Sickle cell anemia
B. Thalassemia
C. Aplastic anemia
D. Iron-deficiency anemia
A. Sickle cell anemia
Rationale: The child’s symptoms of severe pain, abdominal pain, jaundice, and the presence of sickled erythrocytes point to sickle cell anemia. Sickle cell anemia is common in individuals of African descent and is characterized by the presence of abnormal hemoglobin S, leading to sickling of the red blood cells. Thalassemia, aplastic anemia, and iron-deficiency anemia would present differently.
A 30-year-old female presents with fatigue, pallor, and a history of frequent infections. Blood tests show pancytopenia, with reduced red blood cells, white blood cells, and platelets. Bone marrow biopsy confirms bone marrow depression. What type of anemia is this patient likely experiencing?
A. Sickle cell anemia
B. Aplastic anemia
C. Iron-deficiency anemia
D. Polycythemia vera
B. Aplastic anemia
Rationale: Aplastic anemia is characterized by pancytopenia, which involves a decrease in all blood cell types (red blood cells, white blood cells, and platelets). Bone marrow depression is the underlying cause. This condition can result from an autoimmune response, viral infection, or genetic factors. Sickle cell anemia, iron-deficiency anemia, and polycythemia vera do not cause pancytopenia.
A patient from the Mediterranean region presents with fatigue, jaundice, and hepatosplenomegaly. Blood work shows microcytic hypochromic anemia with a low MCV and MCHC. What type of anemia does this patient likely have?
A. Thalassemia
B. Iron-deficiency anemia
C. Polycythemia vera
D. Pernicious anemia
A. Thalassemia
Rationale: Thalassemia, particularly common in people of Mediterranean descent, leads to microcytic hypochromic anemia. Symptoms like fatigue, jaundice, and hepatosplenomegaly are also associated with thalassemia. The low MCV and MCHC confirm the diagnosis. Iron-deficiency anemia is more commonly associated with low ferritin, while polycythemia vera and pernicious anemia have different manifestations.
