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.

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Correct Answer is C

Explanation

The correct answer is choice C. Reminding her that she should be happy that one child survived and is healthy is the least helpful nursing action in supporting the woman as she copes with her loss.

This statement minimizes her grief and implies that she should not feel sad about the deceased twin.

It also disregards her attachment to both babies and her need to mourn the loss of one of them.

Choice A is wrong because offering her the opportunity for counseling to help her grieve is a helpful nursing action that recognizes her emotional distress and provides her with professional support.

Choice B is wrong because encouraging the woman to hold the deceased twin as well as the living twin is a helpful nursing action that allows her to acknowledge and bond with both babies and to create memories that may facilitate healing.

Choice D is wrong because assisting the woman to take pictures of both babies is a helpful nursing action that provides her with tangible mementos of her twins and honors their

A. She lives with two dogs at home. B. She works as a part-time oncology nurse. C. She is lacto-ova vegetarian. D. She commutes to work on a train.

Correct Answer is B

Explanation

The correct answer is choice B. She works as a part-time oncology nurse.This is because oncology nurses are exposed toteratogenic agents, which are substances that can cause abnormalities in an exposed fetus.Teratogenic agents can cross the placenta and alter fetal morphology or function.Examples of teratogenic agents are lead, methyl mercury, polychlorinated biphenyls, lithium, vitamin K antagonists, tobacco, rubella, cytomegalovirus, ionizing agents, hyperthermia, diabetes, and some drugs.

Choice A is wrong because living with two dogs at home does not pose a high risk for exposure to teratogenic agents.Dogs can be beneficial for pregnant women as they provide companionship and exercise.

Choice C is wrong because being a lacto-ova vegetarian does not pose a high risk for exposure to teratogenic agents.Lacto-ova vegetarians can get adequate nutrition from plant-based foods, dairy products, and eggs.

Choice D is wrong because commuting to work on a train does not pose a high risk for exposure to teratogenic agents.Trains are a safe and convenient mode of transportation for pregnant women.

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Naxlex Comprehensive Predictor Exams

A woman gives birth to twin girls, one of whom is stillborn. Which nursing action would be least helpful in supporting the woman as she copes with her loss?

Correct Answer is C

Explanation

A patient comes to the antepartal clinic for her visit and provides the nurse with information. What piece of information places this patient at high risk for exposure to teratogenic agents?

Correct Answer is B

Explanation

A patient comes to the family planning clinic requesting information.Which information should the nurse obtain initially to determine the patient’s knowledge base?.

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 nurse is caring for a patient who is receiving oxytocin injection intravenously for labor induction.The nurse should monitor this patient for which adverse effect of oxytocin?

The nurse suspects drug abuse in a patient admitted with no prenatal care and a diagnosis of abruptio placentae.Which question would elicit the most information from the patient concerning the suspected drug use?

A patient who is 34 weeks pregnant attends the antepartal clinic and is diagnosed with mild pregnancy-induced hypertension (PIH). The decision is made to treat the patient at home. Which instruction would be most appropriate to give to the patient?

A nurse is caring for a patient who is 40 weeks pregnant. Which finding would indicate the need for a cesarean delivery?

The mother of a 4-hour-old newborn reports to a nurse, “My son is producing breast milk.” The nurse’s response should be based on which understanding about newborn physiology? This is:.