Author Question: The nurse is reviewing laboratory results for a client with a low level of intrinsic factor. Which ... (Read 26 times)

lbcchick · **on:** Jul 23, 2018

The nurse is reviewing laboratory results for a client with a low level of intrinsic factor. Which blood smear report would help confirm the medical diagnosis of pernicious anemia?

1. Macrocytic and hypochromic red blood cells
2. Macrocytic and normochromic red blood cells
3. Microcytic and hypochromic red blood cells
4. Normocytic and normochromic red blood cells

Question 2

The nurse is reviewing the blood work of a client newly diagnosed with iron-deficiency anemia. Because of the way iron is stored in the body, the nurse pays closest attention to which lab value?

1. Serum ferritin 10 mg/mL
2. Red blood cell count of 5,000,000
3. Hb 10.1 gm/dL
4. Platelet count of 75,000

dantucker · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 2
Rationale 1: In pernicious anemia, the red blood cells are not hypochromic.
Rationale 2: In pernicious anemia, the red blood cells are too few in number, too large (macrocytic), and abnormally shaped, but they have a normal color because they contain a normal amount of hemoglobin.
Rationale 3: In pernicious anemia, the red blood cells are not microcytic or hypochromic.
Rationale 4: In pernicious anemia, the red blood cells are not of normal size. They are of normal color because they contain the normal amount of hemoglobin.
Global Rationale: In pernicious anemia, the red blood cells are too few in number, too large (macrocytic), and abnormally shaped, but they have a normal color because they contain a normal amount of hemoglobin.

Answer to Question 2

Correct Answer: 1
Rationale 1: A serum ferritin value of less than 12 mg/mL indicates iron-deficiency anemia.
Rationale 2: A red blood cell count of 5 million is within normal limits.
Rationale 3: A hemoglobin of 10.1 gm/dL is too low, but it does not differentiate the type of anemia present.
Rationale 4: A platelet count of 75,000 is too low. It might or might not be accompanied by anemia.
Global Rationale: A serum ferritin value of less than 12 mg/mL indicates iron-deficiency anemia. A red blood cell count of 5 million is within normal limits. A hemoglobin of 10.1 gm/dL is too low, but it does not differentiate the type of anemia present. A platelet count of 75,000 is too low. It might or might not be accompanied by anemia.