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Original Question

06/01/20XX​ Amrit Agarwal, 65 years old​ Subjective: Amrit (pronouns she/her/hers) reports persistent fatigue, weakness, and shortness of breath over the past several weeks. She notes occasional nausea and difficulty maintaining balance. Reports tingling and numbness in the extremities. Denies recent illnesses or major changes in diet. Reports constipation. Expresses concern about declining cognitive function. Reports taking omeprazole and lisinopril. Reports having ileal resection for adenocarcinoma 5 years ago and splenectomy 20 years ago.​ Objective: ​ Vital Signs: Within normal limits​ General Appearance: Appears fatigued and pale Neurological Examination: Mild difficulty walking, especially on heel-to-toe walk. Positive findings for tingling and numbness in the hands and feet. Memory test reveals mild forgetfulness Skin: No jaundice noted Gastrointestinal Examination: Mild tenderness on palpation of the epigastric region Drag the findings that the nurse practitioner (NP) should recognize as risk factors for vitamin B-12 deficiency anemia to the box on the right. Findings Risk Factors for Vitamin B-12 Deficiency Anemia Client age Client takes lisinopril Client takes omeprazole History of splenectomy History of ileal resection

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