On her first visit, a patient had a baseline hemoglobin of 13.0 gm and a hematocrit of 42.9%.She has been taking ferrous sulfate tablets and eating an iron-rich diet.She returned to the clinic at 30 weeks gestation and has a hemoglobin of 11.0 gm and a hematocrit of 36.3%.She is concerned and confused about why these lab values have gone down.
In responding, which physiological change during pregnancy should the nurse describe to the patient?

The increase in the level of placental hormones tends to result in chelation of maternal iron.

Fetal demand for iron is greater than the maternal intake.

During the latter half of pregnancy, the maternal intestinal absorption of iron is decreased.

The increase in maternal blood volume is greater than the increase in maternal red blood cells.

Answer and Explanation

The Correct Answer is D

The correct answer is choice D. The increase in maternal blood volume is greater than the increase in maternal red blood cells.

This means that the concentration of hemoglobin and hematocrit in the blood is diluted by the extra fluid.

This is a normal physiological adaptation to pregnancy and does not indicate iron deficiency anemia.

Choice A is wrong because placental hormones do not chelate maternal iron.

Chelation is a process of binding metal ions to organic molecules, which is not relevant to this question.

Choice B is wrong because fetal demand for iron is not greater than maternal intake.

The mother can meet the iron needs of the fetus by increasing her dietary intake and taking iron supplements.

Choice C is wrong because maternal intestinal absorption of iron is not decreased during pregnancy.

In fact, it may be increased due to higher levels of estrogen and progesterone.

Nursing Test Bank

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Correct Answer is C

Explanation

The correct answer is choice C. The patient should palpate her breasts using the padded sections of her fingers.This is the recommended technique for breast self-examination, as it allows the patient to feel any changes or lumps in the breast tissue.

Choice A is wrong because the patient should perform breast self-examination at the same time each month, preferably a few days after the menstrual period ends when the breasts are less likely to be swollen or tender.

Choice B is wrong because the patient should not assume that any lumps that are present in both breasts are normal.Some breast cancers can affect both breasts, and any new or unusual lumps should be reported to a doctor.

Choice D is wrong because the patient should look at her breasts while standing in front of the mirror with her arms at her sides, raised overhead, and pressed firmly on her hips.She should also look for any changes in the shape, size, color, or texture of her breasts and nipples.

A. Provide the client with an abdominal binder. B. Provide a rocking chair at the client’s bedside. C. Keep the head of the client’s bed flat for six hours. D. Encourage the client to drink cold, carbonated fluids throughout the day.

Correct Answer is D

Explanation

The correct answer is choice D. Encourage the client to drink cold, carbonated fluids throughout the day.This helps to relieve the shoulder pain caused by the carbon dioxide gas used to inflate the abdomen during laparoscopy.

The gas irritates the diaphragm, which refers pain to the shoulder.Drinking cold, carbonated fluids can help expel the gas and reduce the pain.

Choice A is wrong because an abdominal binder is not necessary for a laparoscopic procedure.It is more commonly used for abdominal surgeries that involve a large incision.

Choice B is wrong because a rocking chair is not helpful for a client who had a laparoscopic BTL.It is more useful for a client who had a vaginal delivery to promote comfort and uterine involution.

Choice C is wrong because keeping the head of the bed flat for six hours is not indicated for a laparoscopic BTL.It may increase the risk of venous thromboembolism and pulmonary embolism due to prolonged immobility.The client should be encouraged to ambulate as soon as possible after surgery.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient who is attending a family planning clinic is instructed in breast self-examination by a nurse. Which statement by the patient would indicate that she understands the instructions?

Correct Answer is C

Explanation

A client had a laparoscopic bilateral tubal ligation (BTL) in the delivery room. Which intervention should a nurse plan to include in this client’s postoperative care?

Correct Answer is D

Explanation

A patient who is 42 weeks pregnant is admitted to the hospital in active labor.The patient is upset and says to the nurse, "I haven't felt the baby move for about three or four hours." The fetal heart rate is ranging between 136 and 143. Which action should the nurse take?

A nurse is explaining physiological jaundice to a nursing student.Which of the following should the nurse include when discussing risk factors for neonatal physiological jaundice?

A patient’s amniotic fluid is meconium-stained. Which action should the nurse plan to take?

A 14-year-old patient is 10 weeks pregnant. In order to plan nutritional counseling for this patient, the nurse should have which understanding about adolescents’ nutritional needs during pregnancy?

A patient with no prenatal care is admitted to the labor and delivery unit.She is placed on an external fetal monitor, and an intravenous infusion is begun. A tentative diagnosis of abruptio placentae is made.Which finding would support this diagnosis?

A patient who is 38 weeks pregnant is admitted to the hospital in active labor. On admission, the patient says, “For the past ten hours, I have been leaking small amounts of urine.” Which action should the nurse take initially?

During a class for women in the second trimester of pregnancy, the nurse discusses methods to alleviate back pain. Which statement by a class member would indicate the need for additional instruction?