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.
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
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A. Maintaining the infants’ airways is the nurse’s priority when caring for a set of twins delivered by cesarean delivery.This is because twins are more likely to be born early and need special care after birth than single babies.They may have breathing difficulties or low oxygen levels and require oxygen therapy or ventilation.
The nurse should assess the infants’ respiratory status and intervene as needed.
Choice B is wrong because keeping the infants in a warm, draft-free environment is important but not as urgent as ensuring their airways are clear and they are breathing well.Premature twins may have trouble regulating their body temperature and need to be kept warm, but this can be done after their airways are secured.
Choice C is wrong because placing identification bands on the infants is a standard procedure but not a priority.
The nurse should make sure the infants are correctly identified and matched with their mother, but this can be done after their vital signs are stable.
Choice D is wrong because monitoring the infants’ vital signs is also important but not as urgent as maintaining their airways.
The nurse should check the infants’ heart rate, blood pressure, temperature and blood sugar levels regularly, but this can be done after their respiratory status is assessed and managed.
Normal ranges for vital signs in newborns are:
• Heart rate: 100 to 160 beats per minute
• Blood pressure: 50 to 75 mm Hg systolic and 30 to 45 mm Hg diastolic
• Temperature: 36.5 to 37.5°C (97.7 to 99.5°F)
• Blood sugar: 40 to 80 mg/dL
Correct Answer is C
Explanation
The correct answer is choice C. Empty your bladder prior to the test.This is because a full bladder can interfere with the insertion of the needle and increase the risk of complications.Amniocentesis is a test that involves removing and testing a small sample of cells from amniotic fluid, the fluid that surrounds the baby in the womb.It is done to check for genetic or chromosomal conditions, such as Down’s syndrome, Edwards’ syndrome or Patau’s syndrome.
Choice A is wrong because there is no need to remain flat in bed for six hours after the test.You can resume your normal activities after a few hours of rest.
Choice B is wrong because vaginal bleeding is not a normal outcome of amniocentesis.If you experience any bleeding, leaking of fluid, fever or severe pain after the test, you should contact your doctor immediately.
Choice D is wrong because there is no restriction on eating before the test.You can have your normal meals and drinks before amniocentesis.
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