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. Arrange for her to meet the staff who will be caring for her during labor and delivery.This measure can help reduce the anxiety and fear of the unknown that a primigravida may have in the last month of pregnancy.Meeting the staff can also help establish rapport and trust, which are essential for a positive birth experience.

Choice A is wrong because an increase in fetal activity does not necessarily require an increase in the need to rest.

Fetal activity is normal and expected, and the mother should monitor it regularly.Resting may help with some discomforts of pregnancy, but it is not directly related to fetal activity.

Choice B is wrong because back labor is not likely for a primigravida with an uncomplicated pregnancy.

Back labor occurs when the fetus is in an occiput posterior position, which puts pressure on the mother’s spine and causes intense pain in the lower back.This position is more common in multiparous women than primigravidas.

Choice D is wrong because testing urine for glucose is not a routine measure for a primigravida with an uncomplicated pregnancy.

Urine glucose testing is done for women who have gestational diabetes or are at risk of developing it.It is not necessary for women who have normal blood glucose levels.

A. Urine estriol levels. B. Serum bilirubin levels. C. Urine toxicology studies. D. Lecithin-sphingomyelin ratio.

Correct Answer is C

Explanation

This is because urine toxicology studies can detect the presence of cocaine and other drugs in the body of the pregnant woman and her unborn baby.Cocaine use during pregnancy can have serious consequences for both the mother and the baby, such as high blood pressure, premature labor, low birth weight, and developmental problems.

Choice A is wrong because urine estriol levels are used to measure the activity of the placenta and the fetal adrenal glands.They are not related to cocaine use.

Choice B is wrong because serum bilirubin levels are used to assess the liver function and the risk of jaundice in newborns.They are not related to cocaine use.

Choice D is wrong because lecithin-sphingomyelin ratio is used to evaluate the fetal lung maturity and the risk of respiratory distress syndrome.It is not related to cocaine use.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a 16-year-old primigravida who is in the last month of an uncomplicated pregnancy. Which measure is most appropriate to include in the patient’s plan of care?

Correct Answer is C

Explanation

When a client reports using cocaine during her current pregnancy, which laboratory study should a nurse anticipate?

Correct Answer is C

Explanation

On her second postpartum day, the mother of a newborn says, “The doctor says the baby has physiologic jaundice. Even though it is supposed to be normal, I don’t understand why it occurs.” Which fact regarding physiologic jaundice should form the basis of the nurse’s response?

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

Which measure should be the nurse’s priority when caring for a set of twins delivered by cesarean delivery?

A patient who is attending a family planning clinic is instructed in breast self-examination by a nurse. Which statement by the patient would indicate that she understands the instructions?

A nurse caring for a patient in labor is evaluating the fetal heart monitor.Which finding would indicate fetal distress?

The mother visits her infant in the nursery. The nurse shows the mother how to place her finger in the palm of the baby’s hand so that the baby will squeeze her finger.This behavior on the nurse’s part reflects an understanding of which principle?

The nurse prepares to counsel a 14-year-old patient who is 16 weeks pregnant regarding nutrition. Which action would be appropriate for the nurse to take first?