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 C

Explanation

Choice A rationale

Lie on back when counting kicks is incorrect. It is recommended to lie on the side, preferably the left side, as lying on the back can compress major blood vessels and affect circulation to the fetus.

Choice B rationale

You can begin counting fetal movements at 8 weeks gestation is incorrect. Fetal movements are typically felt by the mother starting around 18-20 weeks of gestation, not as early as 8 weeks.

Choice C rationale

Call healthcare provider if at least 3 movements are not felt over an hour. This is an important guideline as decreased fetal movements can indicate potential issues and should be reported to the healthcare provider for further evaluation.

Choice D rationale

Count movements at the same time each day is a good practice but it is not the most critical instruction. While consistency is beneficial, the immediate action for decreased movements is more urgent.

A. "Smoking and a large alcohol intake can affect the quantity of sperm.”. B. "Smoking or heavy alcohol use has no effect.”. C. "After your first semen analysis, we will see if there will be any difficulty.”. D. "Only if you smoke more than one pack a day will you have difficulty.”.

Correct Answer is A

Explanation

Choice A rationale

Smoking and heavy alcohol intake can indeed affect the quantity of sperm. Both substances can reduce sperm count and motility, leading to lower fertility rates in men.

Choice B rationale

This statement is incorrect. Both smoking and heavy alcohol use negatively impact fertility by reducing sperm quality and quantity.

Choice C rationale

Waiting for a semen analysis without addressing the known effects of smoking and alcohol is not the best approach. Immediate lifestyle changes can improve fertility outcomes.

Choice D rationale

Any amount of smoking can affect sperm quality and fertility. It's not limited to smoking more than one pack a day. Reducing or eliminating smoking can improve fertility.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching a pregnant client how to perform daily fetal movement counts.Which instruction must be included in the teaching?

Correct Answer is C

Explanation

During the initial visit with the nurse at the fertility clinic, the patient asks what effect cigarette smoking or heavy alcohol intake has on the ability to conceive.What is the nurse's best response?

Correct Answer is A

Explanation

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