A pregnant client, at 16 weeks' gestation, has a hematocrit of 34%. Her pre-pregnancy hematocrit was 40%. Which of the following statements by the nurse best explains this change?

Because of your pregnancy, you're not making enough red blood cells.

You're not eating enough iron-rich foods like meat.

This change may indicate a serious problem that might harm your baby.

Because your blood plasma volume has increased, your hematocrit count is lower.

Answer and Explanation

The Correct Answer is D

Choice A rationale

During pregnancy, the body’s production of red blood cells usually increases to meet the increased demands of the growing fetus. Therefore, a drop in hematocrit is not typically due to insufficient red blood cell production.

Choice B rationale

While iron is essential during pregnancy, a reduction in hematocrit levels at 16 weeks' gestation is primarily due to increased plasma volume, rather than iron deficiency. Nutritional counseling may still be beneficial but isn't the primary explanation for this change.

Choice C rationale

A hematocrit level of 34% at 16 weeks is generally not considered indicative of a severe problem. Instead, it is a physiological response to increased plasma volume, known as dilutional anemia of pregnancy.

Choice D rationale

The primary reason for a lower hematocrit count during pregnancy is the increase in blood plasma volume, leading to dilutional anemia. This is a normal adaptation to pregnancy that ensures adequate blood flow to the fetus.

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Correct Answer is A

Explanation

Choice A rationale

Quickening, the first movements of the fetus felt by the mother, typically occurs between 18-20 weeks gestation. At 18 weeks, it's likely the mother will feel a fluttering sensation soon.

Choice B rationale

While fetal movements can sometimes be felt later, it's generally expected that by 18-20 weeks, movements should be noticeable.

Choice C rationale

The baby does move at 18 weeks, but the mother typically begins to feel these movements at this stage, known as quickening.

Choice D rationale

Suggesting the mother should have felt movement by now could cause unnecessary anxiety. Most women feel their baby's movements between 18-20 weeks. .

A. A soft lanugo hair protects the skin from exposure to the amniotic fluid. B. We will apply cream to the baby's skin after delivery to make it smooth and soft. C. The baby's skin is covered with a protective fatty substance called vernix caseosa. D. There is a thick layer of subcutaneous fat on the baby so the water doesn't harm the skin.

Correct Answer is C

Explanation

Choice A rationale

Lanugo is a fine hair that covers the fetus but does not primarily protect the skin from amniotic fluid exposure. It mainly helps in thermoregulation and the adherence of the vernix caseosa.

Choice B rationale

While skin care after birth is important, applying cream post-delivery does not explain why the skin is protected during gestation.

Choice C rationale

Vernix caseosa is a protective, cheese-like coating that covers the fetus's skin. It provides a barrier against the amniotic fluid, preventing maceration of the skin during the pregnancy.

Choice D rationale

Although subcutaneous fat develops in the fetus, it is not responsible for protecting the skin from amniotic fluid. The primary protective mechanism is the vernix caseosa.

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A pregnant client, at 16 weeks' gestation, has a hematocrit of 34%. Her pre-pregnancy hematocrit was 40%. Which of the following statements by the nurse best explains this change?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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