CEA Nursing Practice Exam

When managing a patient with chronic alcoholism, what abnormal CBC result is the nurse practitioner likely to find?

1. Low MCV and MCH

2. Normal MCV and MCH

3. Chronic alcoholism will not affect the differential

4. Elevated MCV and MCH

The correct answer is: Elevated MCV and MCH

In the context of chronic alcoholism, elevated mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) are commonly observed due to the effects of alcohol on the bone marrow and red blood cell production. Chronic alcohol consumption often leads to macrocytic anemia, which is characterized by larger-than-normal red blood cells. This increase in MCV is primarily due to the inhibition of folate metabolism and vitamin B12 absorption, both of which are crucial for proper red blood cell production. Additionally, alcohol can directly suppress bone marrow function, further contributing to this abnormality. The elevation of MCV and MCH reflects changes in the size and hemoglobin content of red blood cells, indicators of macrocytic anemia often seen in patients with a long history of alcohol use. This is a direct association and common finding in clinical practice when monitoring hematological parameters in individuals with chronic alcoholism.