CEA Nursing Practice Exam

When checking the metabolic profile of a 66-year-old female with ESRD on dialysis, which of the following do you anticipate finding?

1. Normal MCH, Hemoglobin 9.6.

2. Elevated MCH, Hemoglobin 14.5.

3. Low RDW, Elevated MCV.

4. Low MCV, Hemoglobin 13.4.

The correct answer is: Normal MCH, Hemoglobin 9.6.

In the case of a 66-year-old female with end-stage renal disease (ESRD) on dialysis, it's important to understand the typical hematologic profile associated with chronic kidney disease. Patients with ESRD often experience anemia due to several factors such as reduced erythropoietin production, iron deficiency, and the effects of dialysis. It is common to see lower hemoglobin levels in these patients, with values frequently dropping below the normal range. A hemoglobin level of 9.6 grams per deciliter aligns with the expectation for anemia in this population. Mean corpuscular hemoglobin (MCH) can remain normal in individuals with anemia due to chronic disease, though it may also be low depending on iron levels and the underlying cause of the anemia. The presentation of normal MCH combined with a low hemoglobin value points to a typical finding in patients with ESRD who may still have sufficient production of hemoglobin despite their condition. The other choices you mentioned suggest either normal or elevated levels of hemoglobin or alterations in cell indices that do not accurately represent the hematologic changes often seen in patients with ESRD. Elevated MCH and hemoglobin would not be consistent with the common findings in this clinical scenario. Similarly, low MCV