A pregnant client at 22 weeks’ gestation has a hematocrit of 35%. Pre-pregnancy hematocrit was 40%. Which of the following statements by the nurse best explains this change?

Because of your pregnancy, you’re not eating enough iron-rich foods.

Because of your pregnancy, you’re developing a serious problem.

Because of your pregnancy, you’re making more blood.

Because of your pregnancy, you’re not making enough new blood cells.

Answer and Explanation

The Correct Answer is C

Choice A rationale
While iron-rich foods are important, the decrease in hematocrit is primarily due to hemodilution rather than inadequate iron intake. Hemodilution occurs as plasma volume increases more than red cell mass.
Choice B rationale
Hematocrit changes in pregnancy are typically not indicative of a serious problem but a normal physiological adaptation. Hemodilution reduces hematocrit without indicating a pathological condition.
Choice C rationale
During pregnancy, plasma volume increases by approximately 50%, while red cell mass increases by about 30%, leading to hemodilution. This physiological change results in a lower hematocrit value.
Choice D rationale
Although hematocrit decreases due to hemodilution, it does not mean that there is a deficiency in red blood cell production. It reflects the dilution effect of increased plasma volume during pregnancy.

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Correct Answer is A

Explanation

Choice A rationale
Fetal sleep cycles cause temporary decreased variability in FHR, typically lasting 20 minutes or less. FHR baseline remains normal. Normal FHR variability is 6-25 bpm.
Choice B rationale
Head compression during contractions leads to early decelerations in FHR, not decreased variability. Early decelerations are a normal response to pressure on the fetal head.
Choice C rationale
Fetal hypoxemia causes decreased variability but usually persists for longer than 20 minutes. It indicates compromised oxygen supply, requiring immediate intervention.
Choice D rationale
Umbilical cord compression leads to variable decelerations in FHR rather than decreased variability. These decelerations vary in onset, duration, and intensity.

A. Administer a Rhogam injection. B. Teach about iron-rich foods in her diet. C. Notify the midwife to start PO antibiotics to treat the GBS. D. Teach about avoiding exposure to rubella.

Correct Answer is B

Explanation

Choice A rationale
Administering a Rhogam injection is not indicated because the patient is Rh-positive (blood type B) and Rhogam is for Rh-negative individuals to prevent sensitization.
Choice B rationale
Teaching about iron-rich foods is appropriate, given her hemoglobin level of 10.5 gm/dL and hematocrit of 32%, indicating mild anemia; iron-rich foods help increase hemoglobin.
Choice C rationale
Starting PO antibiotics for GBS is unnecessary at this stage; antibiotics are administered during labor to prevent neonatal infection, not during prenatal care.
Choice D rationale
Avoiding exposure to rubella is important, but there is no indication in her current prenatal labs that she needs immediate teaching about this infection.

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A pregnant client at 22 weeks’ gestation has a hematocrit of 35%. 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

The most common cause of decreased variability in the FHR that lasts 20 minutes or less is:

Correct Answer is A

Explanation

Correct Answer is B

Explanation

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