A 22-year-old primigravida visits the antepartal clinic in her third month of pregnancy. She has had diabetes mellitus for the past 7 years.
During the visit to the clinic, the nurse and patient discuss diabetes mellitus and pregnancy.Which comment by the patient would indicate a need for further instruction?

I will probably need more insulin as my pregnancy progresses.

I will have to increase my food intake during pregnancy.

Urine testing is the best indication of whether my blood sugar is under control.

Regular exercise will help keep my blood sugar under control.

Answer and Explanation

The Correct Answer is C

The correct answer is choice C. Urine testing is the best indication of whether my blood sugar is under control. This is wrong because urine testing only reflects the blood sugar level at the time of urination, not the current level.

It also does not detect low blood sugar levels (hypoglycemia), which can be dangerous for the mother and the baby.

The best way to monitor blood sugar levels during pregnancy is to use a glucometer, which measures the blood glucose level from a drop of blood.

Choice A is correct because insulin requirements usually increase during pregnancy due to hormonal changes and increased insulin resistance.

The patient may need to adjust her insulin dose according to her blood glucose levels and dietary intake.

Choice B is correct because the patient needs to eat a balanced diet that provides adequate calories and nutrients for herself and the baby.

She may need to consult a dietitian to plan her meals and snacks according to her blood glucose levels and insulin regimen.

Choice D is correct because regular exercise can help lower blood glucose levels, improve insulin sensitivity, and prevent excessive weight gain during pregnancy.

The patient should consult her healthcare provider before starting or changing her exercise routine.

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Correct Answer is C

Explanation

The correct answer is choice C. Remind the patient that the nurse will stay with her during the examination.

This measure would help reduce the patient’s anxiety by providing emotional support and reassurance.

The patient may feel scared, embarrassed, or vulnerable during the pelvic examination, especially since she is young and pregnant.

Having a trusted person with her can help her cope with these feelings.

Choice A is wrong because it may imply that the examination will be painful and increase the patient’s anxiety.

Choice B is wrong because it may make the patient feel like she is not being treated as an individual and that her concerns are not valid.

Choice D is wrong because it may make the patient feel rushed or pressured and not allow her to ask questions or express her feelings.

A. Check the specific gravity of the amniotic fluid. B. Provide dry linens for the patient. C. Auscultate the fetal heart sounds. D. Notify the health care provider.

Correct Answer is C

Explanation

The correct answer is choice C. Auscultate the fetal heart sounds.This is because spontaneous rupture of membranes (SROM) may be associated with fetal distress or cord prolapse, and the nurse should assess the fetal well-being as soon as possible.Fetal heart sounds can indicate the presence of fetal bradycardia, tachycardia, or decelerations, which may require immediate intervention.

Choice A is wrong because checking the specific gravity of the amniotic fluid is not a priority action after SROM.The specific gravity can help differentiate amniotic fluid from urine, but it is not as reliable as other methods such as nitrazine paper test or visual inspection.

Choice B is wrong because providing dry linens for the patient is a comfort measure, but not a priority action after SROM.The nurse should first ensure the safety of the fetus and the mother before attending to their comfort needs.

Choice D is wrong because notifying the health care provider is an important action after SROM, but not the first one.The nurse should gather relevant data such as fetal heart rate, maternal vital signs, and characteristics of the fluid before contacting the provider.

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Naxlex Comprehensive Predictor Exams

A 14-year-old patient visits the antepartal clinic because she has missed three menstrual periods.The patient is to have a pelvic examination. In addition to explaining the procedure, which measure would best help reduce the patient’s anxiety?

Correct Answer is C

Explanation

A patient states, “My water just broke.” The nurse verifies that her membranes have ruptured spontaneously. Which action should the nurse take next?

Correct Answer is C

Explanation

A baby boy is circumcised on the day of discharge. Which observation should the nurse make prior to the infant’s discharge?.

A patient who is 38 weeks pregnant is admitted to the hospital in active labor. On admission, the patient says, “For the past ten hours, I have been leaking small amounts of urine.” Which action should the nurse take initially?

A client treated for preterm labor is to be discharged to home. Which instruction should a nurse include in this client’s discharge plan? The client should:.

A mother of a 3-hour-old infant requests information concerning breastfeeding. The mother has tested positive for human immunodeficiency virus (HIV).A nurse’s response should be based on which fact?

A nurse is caring for a female client who suspects she is pregnant. Which question, if asked by the nurse, is consistent with signs of early pregnancy?

Question 71. A nurse is caring for a client who has gestational diabetes and is scheduled for an amniocentesis at 37 weeks of gestation due to suspected fetal compromise.

A client who had pregnancy-induced hypertension (PIH) is now postpartum. A nurse should closely monitor this client for which complication?

The nurse suspects drug abuse in a patient admitted with no prenatal care and a diagnosis of abruptio placentae.Which question would elicit the most information from the patient concerning the suspected drug use?