Safe sex practices include avoiding the exchange of body fluids. The most essential component of counseling related to the prevention of sexually transmitted infections and human immunodeficiency virus is discussion of condom use. Nurses can help motivate clients to use condoms by initiating a discussion about which of the following?

Choice A reason: Human papillomavirus is incorrect because it is not caused by a bacterium, but by a virus. It can cause genital warts and cervical cancer, but it cannot be cured with antibiotics.

Choice B reason: Gonorrhea is correct because it is caused by a bacterium called Neisseria gonorrhoeae, often produces no symptoms, but can be treated with antibiotics. If symptoms occur, they may include painful urination and discharge from the penis or vagina. If left untreated, the infection can result in more serious long-term problems, including infertility, pain, and joint problems.

Choice C reason: Herpes simplex virus is incorrect because it is not caused by a bacterium, but by a virus. It can cause genital herpes, which is marked by painful blisters and sores in the genital area. It cannot be cured with antibiotics, but antiviral medications can help reduce the frequency and severity of outbreaks.

Choice D reason: Cytomegalovirus is incorrect because it is not caused by a bacterium, but by a virus. It usually causes mild or no symptoms in healthy people, but can be serious in people with weakened immune systems or unborn babies. It cannot be cured with antibiotics, but antiviral medications can help treat the symptoms.

Choice A reason: This is incorrect. Decreased production of erythrocytes (red blood cells) is a consequence, not a cause, of iron deficiency anemia. Iron is needed to make hemoglobin, the protein that carries oxygen in the red blood cells. Without enough iron, the body cannot produce enough hemoglobin or red blood cells¹.

Choice B reason: This is correct. Inadequate intake of iron is the most common cause of iron deficiency anemia during pregnancy. Pregnant women need more iron than nonpregnant women to support the increased blood volume and the fetal growth. If the dietary intake of iron is not sufficient, the body will use up its iron stores, leading to iron deficiency anemia.

Choice C reason: This is incorrect. Dilution of hemoglobin concentration is a normal physiological change during pregnancy, not a cause of iron deficiency anemia. The blood volume increases by 20% to 30% during pregnancy, while the red blood cell mass increases by only 15% to 20%. This results in a lower concentration of hemoglobin in the blood, but not necessarily a lower amount of hemoglobin or iron³.

Choice D reason: This is incorrect. The fetus establishing iron stores is not a cause of iron deficiency anemia during pregnancy, although it can contribute to it. The fetus needs iron for its own development and growth, and it obtains iron from the mother through the placenta. The fetal iron demand increases in the second and third trimesters, when the fetus accumulates iron in its liver and other tissues. This can deplete the maternal iron stores, especially if the mother does not consume enough iron.