A nurse is teaching a client about iron supplementation during pregnancy.
Which of the following client statements indicates an understanding of the teaching?
"I will take this supplement with 8 ounces of milk.”.
"I will double my dose if I forget to take my supplement.”.
"I will be certain to consume 28 grams of fiber daily.”.
"I will take 100 milligrams of vitamin K per day while taking this supplement.”.
The Correct Answer is C
Choice A rationale
Consuming milk with iron supplements significantly inhibits iron absorption due to the high calcium content in milk. Calcium competes with iron for absorption sites in the small intestine, forming insoluble complexes that reduce the bioavailability of iron. This would counteract the intended therapeutic effect of the iron supplementation, leading to suboptimal iron levels.
Choice B rationale
Doubling an iron dose can lead to iron toxicity, which is dangerous, especially during pregnancy. Excessive iron intake can cause gastrointestinal distress, liver damage, and metabolic acidosis. Adhering to the prescribed dosage is crucial for safe and effective supplementation, preventing adverse effects while achieving therapeutic iron levels.
Choice C rationale
Maintaining adequate fiber intake (normal range 25-30 grams daily) is crucial during iron supplementation. Iron often causes constipation due to its effect on gastrointestinal motility. Dietary fiber adds bulk to stool, promoting regular bowel movements and alleviating constipation, which is a common and uncomfortable side effect of iron therapy.
Choice D rationale
Vitamin K is essential for blood coagulation, but taking 100 milligrams daily during pregnancy without a specific medical indication is excessive and potentially harmful. The normal recommended daily allowance for vitamin K during pregnancy is much lower, around 90 micrograms. High doses could interfere with anticoagulant medications or have unknown fetal effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
Choice A rationale
Routine use of intubation equipment during a cesarean birth is not standard practice. Intubation is typically reserved for general anesthesia or respiratory compromise. Most cesarean births are performed under regional anesthesia, such as a spinal or epidural block, which allows the mother to remain awake and avoid the need for invasive airway management, minimizing associated risks.
Choice B rationale
Delay in initiating breastfeeding after a cesarean birth is not a universal or recommended practice. While there may be a slight delay due to recovery from anesthesia, early skin-to-skin contact and breastfeeding are encouraged as soon as the mother is stable and alert. This promotes maternal-infant bonding and successful lactation establishment, supporting newborn nutrition and development.
Choice C rationale
Early ambulation post-surgical procedure, including cesarean birth, is highly advantageous for preventing complications such as deep vein thrombosis and promoting recovery. Movement stimulates circulation, reduces gas accumulation in the intestines, and aids in the restoration of normal bowel function. This active recovery approach significantly improves patient outcomes and comfort.
Choice D rationale
Management of postpartum pain is a critical topic for clients undergoing a cesarean birth. Effective pain control is essential for the mother's comfort, ability to ambulate, and capacity to care for her newborn. Education should cover various pharmacological and non-pharmacological pain relief methods, including medication schedules, side effects, and when to request additional pain relief.
Choice E rationale
The need for an indwelling urinary catheter is a common aspect of cesarean birth. A catheter is typically inserted before the procedure to keep the bladder empty, reducing the risk of bladder injury during surgery and allowing for accurate monitoring of urine output post-operatively. It is usually removed within 12 to 24 hours postpartum as ambulation is initiated.
Correct Answer is D
Explanation
Choice A rationale
Uterine contractions every 15 minutes are characteristic of the latent phase of labor, not the active phase. In the active phase, contractions typically become stronger, more frequent, and more regular, occurring every 2 to 5 minutes, signifying progressive cervical dilation.
Choice B rationale
A fetal heart rate (FHR) baseline of 166/min with minimal variability is concerning. While a baseline up to 160/min is generally normal, 166/min is slightly elevated, and minimal variability (5 bpm or less) can indicate fetal hypoxia or acidosis, necessitating further assessment and intervention. Normal FHR baseline is 110-160 bpm.
Choice C rationale
Late decelerations in FHR are non-reassuring findings indicative of uteroplacental insufficiency, meaning inadequate oxygen transfer to the fetus. These decelerations suggest potential fetal distress and require immediate intervention and reporting to the provider, not an expected finding in active labor.
Choice D rationale
Contraction duration of 75 seconds is an expected finding in the active phase of labor. During this phase, contractions typically last 45 to 90 seconds. This duration contributes to effective cervical effacement and dilation, signifying adequate uterine activity for labor progression.
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