1. The nurse is conducting an admission assessment of a client with vitamin B12 deficiency.

Which of the following would

the nurse include in the physical assessment?
f Palpate the spleen
Take the blood pressure
n Examine the feet for petechiae
Examine the tongue
Answer D is correct. The tongue is smooth and beefy red in the client with vitamin B12 deficiency, so examining the tongue should
be included in the physical assessment. Bleeding, splenomegaly, and blood pressure changes do not occur, making answers A, B,
and C incorrect.

2. An African American female comes to the outpatient clinic. The physician suspects vitamin B12 deficiency anemia.
Because jaundice is often a clinical manifestation of this type of anemia, what body part would be the best indicator?
f Conjunctiva of the eye
Soles of the feet
n Roof of the mouth
Shins
Answer C is correct. The oral mucosa and hard palate (roof of the mouth) are the best indicators of jaundice in dark-skinned
persons. The conjunctiva can have normal deposits of fat, which give a yellowish hue; thus, answer A is incorrect. The soles of the
feet can be yellow if they are calloused, making answer B incorrect; the shins would be an area of darker pigment, so answer D is
incorrect.

3. The nurse is conducting a physical assessment on a client with anemia. Which of the following clinical manifestations
would be most indicative of the anemia?
f BP 146/88
Respirations 28 shallow
n Weight gain of 10 pounds in 6 months
Pink complexion
Answer B is correct. When there are fewer red blood cells, there is less hemoglobin and less oxygen. Therefore, the client is often
short of breath, as indicated in answer B. The client with anemia is often pale in color, has weight loss, and may be hypotensive.
Answers A, C, and D are within normal and, therefore, are incorrect.

4. The nurse is teaching the client with polycythemia vera about prevention of complications of the disease. Which of the
following statements by the client indicates a need for further teaching?
f " will drink 500mL of fluid or less each day."
" will wear support hose when am up."
n " will use an electric razor for shaving."
" will eat foods low in iron."
Answer A is correct. The client with polycythemia vera is at risk for thrombus formation. Hydrating the client with at least 3L of fluid
per day is important in preventing clot formation, so the statement to drink less than 500mL is incorrect. Answers B, C, and D are
incorrect because they all contribute to the prevention of complications. Support hose promotes venous return, the electric razor
prevents bleeding due to injury, and a diet low in iron is essential to preventing further red cell formation.

5. A 33-year-old male is being evaluated for possible acute leukemia. Which of the following would the nurse inquire about
as a part of the assessment?
f The client collects stamps as a hobby.
The client recently lost his job as a postal worker.
n The client had radiation for treatment of Hodgkin's disease as a teenager.
The client's brother had leukemia as a child.
Answer C is correct. Radiation treatment for other types of cancer can result in leukemia. Some hobbies and occupations involving
chemicals are linked to leukemia, but not the ones in these answers; therefore, answers A and B are incorrect. Answer D is incorrect
because the incidence of leukemia is higher in twins than in siblings.