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.

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.

To reverse anaphylactic shock, the nurse first should administer epinephrine, a potent bronchodilator as prescribed.

Option A: The physician is likely to order additional medications, such as antihistamines and corticosteroids; if these medications don’t relieve the respiratory compromise associated with anaphylaxis, the nurse should prepare to intubate the client.
Option C: No antidote for penicillin exists; however, the nurse should continue to monitor the client’s vital signs. A client who remains hypotensive may need fluid resuscitation and fluid intake and output monitoring; however, administering epinephrine is the first priority.
Option D: An indwelling catheter is not needed in a client experiencing anaphylactic shock; however, IV fluids may be ordered by the physician after.

Prolonged use of aspirin and other salicylates sometimes causes bilateral hearing loss of 30 to 40 decibels. Usually, this adverse effect resolves within 2 weeks after the therapy is discontinued.

Option A: Aspirin does not cause weight gain. Weight only influenced the relationship between aspirin and long-term risks of colorectal cancer, with benefits lost at higher body weights.
Option B: Aspirin doesn’t lead to fine motor tremors. In a study, the proportion of aspirin users did not differ in essential tremor cases or controls.
Option C: Large or toxic salicylate doses may cause respiratory alkalosis, not respiratory acidosis. Direct stimulation of the cerebral medulla causes hyperventilation and respiratory alkalosis.

The lymphocyte provides adaptive immunity — recognition of a foreign antigen and formation of memory cells against the antigen. Adaptive immunity is mediated by B and T lymphocytes and can be acquired actively or passively.

Option A: The neutrophil is crucial to phagocytosis. Phagocytosis is a process by which certain living cells called phagocytes ingest or engulf other cells or particles.
Option B: The basophil plays an important role in the release of inflammatory mediators. Basophils play a role in preventing blood clotting because they contain heparin. This is a naturally occurring blood-thinning substance.
Option C: The monocyte functions in phagocytosis and monokine production. Monocytes are bone marrow-derived leukocytes that circulate in the blood and spleen.

Sjogren’s syndrome is an autoimmune disorder leading to progressive loss of lubrication of the skin, GI tract, ears, nose, and vagina. Moisture replacement is the mainstay of therapy.

Option B: Electrolyte balance is not the priority problem in Sjögren’s syndrome. Electrolyte abnormalities, particularly hypokalemia, must be considered in patients presenting with generalized weakness.
Option C: Though malnutrition may occur as a result of Sjogren’s syndrome effect on the GI tract, it isn’t the predominant problem. An estimated 90% of people with Sjogren’s syndrome have problems related to eating, enough to cause malnutrition.
Option D: Arrhythmias aren’t a problem associated with Sjogren’s syndrome. However, there is a new study that showed a significantly increased risk of heart attack in patients with Sjogren’s syndrome, particularly in the first year following diagnosis.