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 B

Explanation

A transverse lie means that the baby is lying sideways across the uterus, instead of head-down or breech.

This position makes vaginal delivery impossible and increases the risk of umbilical cord prolapse, which can compromise fetal oxygen supply.Therefore, a cesarean delivery is indicated for a fetus in a transverse lie.

Choice A is wrong because having extremely slender hips does not necessarily mean that a woman cannot deliver vaginally.

The size and shape of the pelvis, not the external appearance, determines the adequacy of the birth canal.A trial of labor may be attempted for women with borderline pelvic measurements.

Choice C is wrong because fetal hyperactivity is not a reason for a cesarean delivery.

Fetal movements may vary depending on the time of day, maternal activity, maternal blood sugar level, and other factors.Fetal well-being can be assessed by fetal heart rate monitoring and biophysical profile.

Choice D is wrong because having a posterior cervix does not indicate the need for a cesarean delivery.

A posterior cervix means that the cervix is tilted toward the back of the uterus, which may make cervical dilation slower and more painful.However, with adequate contractions and maternal pushing, the cervix can move to an anterior position and allow vaginal delivery.

A. Sustained uterine hypertonicity. B. Strong uterine contractions every 3-4 minutes. C. Bile-colored vomitus. D. Fetal heart rate acceleration with fetal activity.

Correct Answer is A

Explanation

This means that the uterus is constantly contracted and does not relax between contractions.This can cause the placenta to separate from the uterine wall, which is called placental abruption or abruptio placentae.Placental abruption can deprive the baby of oxygen and nutrients and cause heavy bleeding in the mother.

Choice B is wrong because strong uterine contractions every 3-4 minutes are normal during labor and do not indicate placental abruption.

Choice C is wrong because bile-colored vomitus is not a sign of placental abruption, but rather a sign of hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy.

Choice D is wrong because fetal heart rate acceleration with fetal activity is a normal finding and indicates a healthy baby.Placental abruption can cause fetal distress and a decrease in fetal heart rate.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who is 40 weeks pregnant. Which finding would indicate the need for a cesarean delivery?

Correct Answer is B

Explanation

A patient with no prenatal care is admitted to the labor and delivery unit.She is placed on an external fetal monitor, and an intravenous infusion is begun. A tentative diagnosis of abruptio placentae is made.Which finding would support this diagnosis?

Correct Answer is A

Explanation

A patient who is 42 weeks pregnant is admitted to the hospital in active labor.The patient is upset and says to the nurse, "I haven't felt the baby move for about three or four hours." The fetal heart rate is ranging between 136 and 143. Which action should the nurse take?

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?

A client is at the antepartal clinic for a pregnancy test.Which finding, if present, would be considered a positive sign of pregnancy?

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?

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

A patient is receiving magnesium sulfate.Which side effect should the nurse monitor for with this patient?

A patient diagnosed with preeclampsia is admitted to the hospital and prescribed magnesium sulfate therapy. What is the purpose of administering magnesium sulfate to this patient?

A patient who is 33 weeks pregnant has been experiencing Braxton-Hicks contractions.Which information should the nurse include in responding to this patient?