Which of the following is the best test to diagnose pernicious anemia:

Correct Answer: C

Rationale: The Schilling test (C) best diagnoses pernicious anemia measures B12 absorption with/without intrinsic factor (IF), confirming gastric IF loss (e.g., <5% excretion). Marrow (A) shows megaloblasts, nonspecific. Neurologic exam (B) detects neuropathy, late. Smear (D) and indices show macrocytosis (MCV >100 fL), not cause. Schilling's specificity is key in nursing for B12 vs. folate differentiation and lifelong therapy.

Correct Answer: B

Rationale: Chronic lymphocytic leukemia (CLL) lymph nodes show early enlargement (A), discrete (C), diffuse involvement (D), and mobility , but not tender/painful (B) painless growth (e.g., >1 cm) reflects slow B-cell accumulation. Tenderness fits infection or Hodgkin's. CLL's indolent lymphadenopathy is key, guiding nursing for staging and infection watch.

Correct Answer: D

Rationale: Hemolytic anemia RBC destruction occurs in G-6-PD (A drug-induced), thalassemia (B ineffective erythropoiesis), spherocytosis (C spleen lysis), HbC (D mild hemolysis) but not iron deficiency , where low iron reduces RBC production (e.g., Hb <10 g/dL), not lysis. Iron's non-hemolytic nature is key, guiding nursing for iron, not hemolysis workup.

Correct Answer: A

Rationale: Anemia of infection/rheumatoid arthritis chronic disease shows low plasma iron, low TIBC, high stores, low sideroblasts (A), from inflammation (e.g., IL-6) sequestering iron. Erythropoietin (B) fits renal. Normocytic (C) is pattern, not cause. Blood loss (D) is other anemias. Iron block is key, guiding nursing for inflammation control.

Correct Answer: D

Rationale: Juvenile rheumatoid arthritis (JRA) all true : uveitis (A eye inflammation), erythema multiforme (B rash, less common), pericarditis/valvular (C cardiac), lymphadenopathy/hepatosplenomegaly (D systemic JIA). Multisystem involvement is key, guiding nursing for eye exams, steroids, and systemic monitoring.