Physiological Adaptation Q 55

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Nurse Marie is caring for a 32-year-old client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client?

  

     A. Pallor, bradycardia, and reduced pulse pressure

     B. Pallor, tachycardia, and a sore tongue

     C. Sore tongue, dyspnea, and weight gain

     D. Angina, double vision, and anorexia

    

    

Correct Answer: B. Pallor, tachycardia, and a sore tongue

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Pallor, tachycardia, and a sore tongue are all characteristic findings in pernicious anemia. Other clinical manifestations include anorexia; weight loss; a smooth, beefy red tongue; a wide pulse pressure; palpitations; angina; weakness; fatigue; and paresthesia of the hands and feet.

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Option A: Tachycardia, instead of bradycardia, and reduced pulse pressure are present in a client with pernicious anemia. The heart may start to beat faster to make up for the reduced number of red blood cells in the body.

Option C: Weight loss, instead of weight gain, is a common symptom of pernicious anemia. A B12 deficiency can be counteracted with a dose of the vitamin, causing energy levels to regulate and the metabolism to work harder to burn up fuel. The result is weight loss when the deficiency is mitigated, but adding B12 to a body with sufficient levels doesn’t really increase natural effects.

Option D: Double vision isn’t a characteristic finding in pernicious anemia. However, vision loss associated with vitamin B12 deficiency can occur even in well-nourished individuals who can’t absorb enough B12 to support healthy vision.

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