The nurse assesses a patient with pernicious anemia. Which ...

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The nurse assesses a patient with pernicious anemia. Which assessment finding would the nurse expect?
 
  a. Yellow-tinged sclerae
  b. Shiny, smooth tongue
  c. Numbness of the extremities
  d. Gum bleeding and tenderness

Question 2

A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest. Which action would be important for the nurse to take after the procedure?
 
  a. Elevate the head of the bed to 45 degrees.
  b. Apply a sterile 2-inch gauze dressing to the site.
  c. Use a half-inch sterile gauze to pack the wound.
  d. Have the patient lie on the left side for 1 hour.

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Answer to Question 1

ANS: C
Extremity numbness is associated with cobalamin (vitamin B12) deficiency or pernicious anemia. Loss of the papillae of the tongue occurs with chronic iron deficiency. Yellow-tinged sclera is associated with hemolytic anemia and the resulting jaundice. Gum bleeding and tenderness occur with thrombocytopenia or neutropenia.

Answer to Question 2

ANS: D
To decrease the risk for bleeding, the patient should lie on the left side for 30 to 60 minutes. After a bone marrow biopsy, the wound is small and will not be packed with gauze. A pressure dressing is used to cover the aspiration site. There is no indication to elevate the patient's head.