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

Syphilis can be treated with antibiotics, particularly penicillin. It is not true that there is no cure, and immunization against syphilis is not available. Proper treatment can prevent transmission to the fetus.

Choice B rationale

Changing cat litter, even with gloves, is not safe for pregnant women due to the risk of toxoplasmosis. Toxoplasmosis can cause serious complications in the fetus, and direct contact with cat feces should be avoided.

Choice C rationale

The best way to prevent CMV (cytomegalovirus) infection is through thorough and consistent hand hygiene. CMV is a common virus that can cause congenital infections, and hygiene practices are crucial for prevention.

Choice D rationale

RPR (Rapid Plasma Reagin) tests for syphilis, not rubella. A rubella vaccine would be needed if the mother is non-immune, but this would be administered post-delivery. The statement reflects a misunderstanding of the tests and vaccines.

A. You will need to double your intake of iron during pregnancy. B. You will need to increase your calcium intake during breastfeeding. C. Vitamin E requirements decline during pregnancy due to the increase in body fat. D. Prenatal vitamins will meet your need for increased vitamin D during pregnancy.

Correct Answer is A

Explanation

Choice A rationale

Iron needs significantly increase during pregnancy to support the increased blood volume, the formation of the placenta, and the growth of the fetus. Pregnant women often require additional iron to prevent anemia and ensure adequate oxygen transport to the baby.

Choice B rationale

While calcium requirements do increase during breastfeeding to support milk production, this statement is not directly related to the nutritional needs during pregnancy. The focus during pregnancy should be on adequate intake of nutrients that support both maternal and fetal health.

Choice C rationale

Vitamin E requirements do not decline during pregnancy. In fact, the need for antioxidants like vitamin E may increase to protect both the mother and developing fetus from oxidative stress.

Choice D rationale

While prenatal vitamins are important for meeting various nutritional needs during pregnancy, they do not always provide sufficient vitamin D. Some women may need additional supplementation based on their dietary intake, sun exposure, and individual health needs.

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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

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