Author Question: A client with a diagnosis of atrophic gastritis and consequent pernicious anemia is receiving high ... (Read 77 times)

Mr3Hunna · **on:** Jun 25, 2018

A client with a diagnosis of atrophic gastritis and consequent pernicious anemia is receiving high oral doses of vitamin B12. Which of the following changes would be most likely expected by his care provider at the completion of his treatment?

A)
Decreased mean corpuscular volume
B)
Increased serum bilirubin
C)
Increased folic acid levels
D)
Decreased free heme levels

Question 2

Two nursing students are attempting to differentiate between the presentations of immune thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP).

Which of the students' following statements best captures an aspect of the two health problems?
A)
Both diseases can result from inadequate production of thrombopoietin by megakaryocytes.
B)
ITP can be either inherited or acquired, and if it's acquired, it involves an enzyme deficiency.
C)
Both of them involve low platelet counts, but in TTP, there can be more, not less, hemostasis.
D)
TTP can be treated with plasmapheresis, but ITP is best addressed with transfusion of fresh frozen plasma.

triiciiaa · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Ans:
A

Feedback:

Increased red cell size is associated with vitamin B12 deficiency, and MCV would decrease with treatment. Increased bilirubin and folic acid levels would not be associated with resolution of pernicious anemia, and heme is not normally present or measured in a free circulatory form.

Answer to Question 2

Ans:
C

Feedback:

TTP is marked by sudden and severe thrombotic involvement. Neither disease has an etiology of low thrombopoietin production, and TTP, not ITP, is rooted in an enzyme deficiency. ITP is normally treated with corticosteroids and/or immunoglobulins.