A 25-year-old single woman comes to the gynecologist's office for a follow-up visit related to her abnormal Papanicolaou (Pap) smear. The test revealed that the patient has human papillomavirus (HPV). The patient asks, "What is that? Can you get rid of it?" Your best response is:

Choice A reason: This is a correct statement, as the NST measures the fetal heart rate and its response to fetal movement. The nurse will place two belts around the client's abdomen, one to monitor the heart rate and one to monitor the contractions.

Choice B reason: This is a correct statement, as the NST usually takes 20 to 30 minutes to complete. The nurse will look for at least two accelerations of the fetal heart rate within a 20-minute period.

Choice C reason: This is a correct statement, as the NST is more likely to be reactive (normal) when the baby is active. The client may be asked to eat or drink something before the test to stimulate the baby's movement.

Choice D reason: This is an incorrect statement, as the client does not have to lie on her back during the test. Lying on the back can compress the inferior vena cava and reduce the blood flow to the placenta. The client can lie on her side or sit in a reclining chair during the test.

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.