A 22-year-old pregnant woman reports craving and eating non-food items such as ice, clay, and dirt. Which of the following statements by the nurse is correct?

"You should be encouraged to eat more of these items to satisfy cravings.

"This is a normal behavior during pregnancy and does not require intervention."

This behavior, called PICA, may lead to nutritional deficiencies and should be assessed."

"PICA only occurs in the first trimester and will resolve on its own."

Answer and Explanation

The Correct Answer is C

A. "You should be encouraged to eat more of these items to satisfy cravings." is incorrect because consuming non-food items like ice, clay, or dirt can be harmful. These substances may contain toxins or pathogens and can interfere with nutrient absorption. Encouraging this behavior would be unsafe.

B. "This is a normal behavior during pregnancy and does not require intervention." is incorrect because while cravings are common in pregnancy, PICA is an abnormal eating behavior involving non-food items and requires assessment and intervention due to potential health risks.

C. "This behavior, called PICA, may lead to nutritional deficiencies and should be assessed." is correct. PICA is the recurrent consumption of non-nutritive substances and is often associated with iron deficiency anemia and other nutritional deficiencies. The nurse should assess for nutritional status, laboratory abnormalities, and educate the client on potential risks to both mother and fetus.

D. "PICA only occurs in the first trimester and will resolve on its own." is incorrect because PICA can occur at any time during pregnancy and may persist throughout gestation if untreated. It does not resolve spontaneously in all cases.

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Correct Answer is A

Explanation

A. Hypothyroidism is correct. The child’s fatigue, slowed growth, and constipation, along with physical findings such as dry skin, puffy face, and hoarse voice, are classic signs of hypothyroidism, a condition caused by insufficient thyroid hormone production. In children, untreated hypothyroidism can lead to growth retardation, developmental delays, and delayed puberty.

B. Cushing's Syndrome is incorrect because it is characterized by weight gain, truncal obesity, moon face, buffalo hump, and skin changes like striae, often with hypertension and hyperglycemia. Fatigue and constipation are less prominent, and slowed growth is not typically associated with early Cushing's.

C. Hyperthyroidism is incorrect because it usually presents with weight loss, increased appetite, tachycardia, heat intolerance, hyperactivity, and rapid growth, which are opposite to the findings in this child.

D. Type 1 Diabetes Mellitus is incorrect because it is usually presents with polyuria, polydipsia, polyphagia, and weight loss. Constipation, hoarse voice, and dry skin are not characteristic of diabetes.

A. Instruct the parents to administer the iron supplement with vitamin C-rich juice and on an empty stomach to improve absorption, while monitoring for side effects. B. Advise the parents to give the iron supplement with milk to reduce gastrointestinal upset and enhance tolerance. C. Recommend switching to intravenous iron therapy immediately to avoid gastrointestinal side effects and ensure compliance. D. Suggest stopping the iron supplement temporarily until the child's hemoglobin normalizes, then restart to avoid side effects.

Correct Answer is A

Explanation

A. Instruct the parents to administer the iron supplement with vitamin C-rich juice and on an empty stomach to improve absorption, while monitoring for side effects is correct because vitamin C enhances the absorption of non-heme iron, and taking iron on an empty stomach increases bioavailability. While gastrointestinal side effects such as constipation, nausea, and abdominal discomfort may occur, they can be managed through dosing adjustments, timing, and dietary measures rather than discontinuing therapy. Monitoring for side effects ensures safety and adherence.

B. Advise the parents to give the iron supplement with milk to reduce gastrointestinal upset and enhance tolerance is incorrect because milk and dairy products contain calcium, which inhibits iron absorption. Administering iron with milk can significantly reduce the effectiveness of treatment and delay correction of anemia.

C. Recommend switching to intravenous iron therapy immediately to avoid gastrointestinal side effects and ensure compliance is incorrect because oral iron is first-line therapy for children with iron deficiency anemia. IV iron is reserved for cases where oral iron is ineffective, not tolerated, or in malabsorption disorders, due to the risk of serious side effects and cost.

D. Suggest stopping the iron supplement temporarily until the child's hemoglobin normalizes, then restart to avoid side effects is incorrect because interrupting therapy prevents replenishment of iron stores and prolongs anemia. Consistent administration with proper strategies to manage side effects is safer and more effective.

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A 22-year-old pregnant woman reports craving and eating non-food items such as ice, clay, and dirt. Which of the following statements by the nurse is correct?

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Explanation

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