Certified Neuroscience Registered Nurse (CNRN) Practice Exam

Which clinical finding is least likely in a patient with megaloblastic anemia?

1. Pallor

2. Neurological symptoms

3. Deep vein thrombosis

4. Glossitis

The correct answer is: Deep vein thrombosis

Megaloblastic anemia is primarily characterized by the presence of large, abnormal red blood cells (megaloblasts) stemming from impaired DNA synthesis, often due to deficiencies in vitamin B12 or folate. Common clinical findings associated with megaloblastic anemia include pallor due to anemia, neurological symptoms—such as paresthesias or cognitive disturbances—resulting from vitamin B12 deficiency, and glossitis, which refers to inflammation of the tongue that can manifest as a smooth, painful surface. Deep vein thrombosis (DVT), while it can be associated with a variety of medical conditions, is not typically a direct result of megaloblastic anemia. DVT often occurs due to situations that involve prolonged immobility, venous stasis, or hypercoagulable states, none of which are central features of megaloblastic anemia. Consequently, this choice represents a finding least likely associated with the condition, as the other symptoms directly relate to the hematological and neurological manifestations of megaloblastic anemia. Thus, identifying DVT as the least likely finding emphasizes the distinctive features of megaloblastic anemia and differentiates it from other potential causes of anemia or other conditions that may involve clotting or venous issues.