A pregnant woman in the first trimester of pregnancy has a hemoglobin of 8.6 g/dL (86 g/L) and a hematocrit of 25.1% (0.25 volume fraction). Which food should the practical nurse (PN) encourage this client to include in her diet? Reference Range: Hemoglobin, pregnant female [greater than 11 g/dL (greater than 110 g/L)] Hematocrit, pregnant female [greater than 33% (greater than 0.33 volume fraction)]
Cheese.
Cauliflower.
Carrots.
Chicken.
The Correct Answer is D
Choice A rationale
Cheese is a good source of calcium and protein, but it is not a primary source of iron. Iron is essential for hemoglobin synthesis, and the client's hemoglobin and hematocrit levels are below normal ranges [Hemoglobin, pregnant female > 11 g/dL ( > 110 g/L); Hematocrit, pregnant female > 33% ( > 0.33 volume fraction)], indicating iron deficiency anemia.
Choice B rationale
Cauliflower is a cruciferous vegetable rich in vitamin C and fiber, but its iron content is relatively low. While vitamin C aids in iron absorption, cauliflower itself does not provide a significant amount of dietary iron to effectively address the client's anemic status.
Choice C rationale
Carrots are well-known for their beta-carotene content, a precursor to vitamin A, and provide fiber. However, carrots are not a significant source of iron. To combat iron deficiency anemia during pregnancy, foods rich in heme iron or non-heme iron with good bioavailability are required.
Choice D rationale
Chicken, particularly the dark meat, is a good source of heme iron, which is more readily absorbed by the body compared to non-heme iron found in plant-based foods. Given the client's anemic status, increasing dietary intake of iron-rich foods like chicken is crucial for improving hemoglobin and hematocrit levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
This schedule is incorrect for pertussis (whooping cough) immunization. Pertussis vaccination, usually as part of the DTaP vaccine, is initiated in infancy and requires multiple doses to build adequate immunity, not just a single dose at 1 year or 6 years of age.
Choice B rationale
This schedule is incorrect and deviates from the standard recommendations for pertussis vaccination. The typical primary series of DTaP vaccination begins earlier in infancy and includes specific booster doses at later ages to maintain protection against the disease.
Choice C rationale
This schedule is incorrect for pertussis immunization. While some vaccinations begin at birth, and boosters are given periodically, the specific timing and frequency for pertussis in this option do not align with the established guidelines for the DTaP or Tdap vaccines.
Choice D rationale
This is the recommended immunization schedule for pertussis, typically administered as part of the DTaP vaccine. The primary series at 2, 4, and 6 months establishes foundational immunity, and boosters at 15-18 months and 4-6 years of age are crucial for maintaining long-term protection against the disease.
Correct Answer is A
Explanation
Choice A rationale
Monitoring serum electrolytes is the top priority for an infant with congenital adrenal hyperplasia (CAH). This condition involves an enzymatic defect that impairs cortisol and aldosterone synthesis, leading to salt wasting due to insufficient aldosterone. This can cause life-threatening hyponatremia and hyperkalemia, requiring urgent intervention. Normal ranges are typically sodium 135-145 mEq/L and potassium 3.5-5.0 mEq/L.
Choice B rationale
Checking for hypothermia is important for any neonate or infant, as they have immature thermoregulation. While a general nursing intervention, it is not the most specific or life-threatening concern directly related to the pathophysiology of congenital adrenal hyperplasia, which primarily involves electrolyte imbalances.
Choice C rationale
Assessing for urinary tract infection is a relevant general health assessment, especially in infants with ambiguous genitalia, due to potential anatomical variations. However, while important for overall health, it does not address the immediate, life-threatening metabolic derangements associated with congenital adrenal hyperplasia.
Choice D rationale
Recording daily weights is crucial for assessing fluid balance in infants, particularly those at risk for dehydration or fluid retention. While important for monitoring overall health and fluid status, it is secondary to the critical need to monitor and correct acute electrolyte imbalances that can rapidly become life-threatening in CAH.
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