Review Question - QID 109700

A 32-year-old woman presents to her primary care physician for constant fatigue. The patient states that she is always tired. She claims she is too tired to exercise and has gained 7 pounds recently. She complains of constipation and a decrease in libido as well. She states that she hasn't felt herself lately and is struggling with her relationships. The patient has a past medical history of obesity and diabetes. Her current medications include insulin, lisinopril, metformin, and sodium docusate. Her temperature is 99.5°F (37.5°C), blood pressure is 147/98 mmHg, pulse is 90/min, respirations are 17/min, and oxygen saturation is 98% on room air. Laboratory values are obtained and shown below.

Hemoglobin: 10.0 g/dL
Hematocrit: 30%
MCV: 88 fL
Leukocyte count: 7,500/mm^3 with normal differential
Platelet count: 192,000/mm^3

Serum:
Na+: 139 mEq/L
Cl-: 100 mEq/L
K+: 4.3 mEq/L
HCO3-: 25 mEq/L
BUN: 20 mg/dL
Glucose: 129 mg/dL
Creatinine: 1.1 mg/dL
Ca2+: 10.2 mg/dL
AST: 12 U/L
ALT: 10 U/L

A peripheral blood smear is performed as seen in Figure A. Which of the following is the most appropriate next step in management?