A nurse in a prenatal clinic is caring for a client who is at 24 weeks of gestation. Which of the following findings is a potential indication the client has gestational diabetes mellitus?

A. Encourage the client to participate in a diabetes mellitus support group: While support groups are beneficial for emotional support and ongoing education, this intervention is not the priority during the initial home visit. It is more appropriate once the client’s knowledge and self-care skills have been assessed.

B. Determine the client's level of health literacy: Assessing health literacy is the first priority because it guides the nurse in tailoring education and interventions. Understanding the client’s ability to comprehend and apply health information ensures that teaching about diabetes management, such as glucose monitoring and medication administration, is effective and safe.

C. Verify the client's comfort level regarding how to use a glucometer: Ensuring the client can correctly use a glucometer is important, but this step should follow the assessment of health literacy. Tailoring instruction to the client’s literacy level improves comprehension and accuracy in self-monitoring.

D. Provide low-carbohydrate recipes for the client: Providing dietary resources supports diabetes management but is secondary to assessing the client’s understanding and ability to implement self-care. Without first evaluating literacy and comprehension, these resources may not be effectively utilized.

A. Refrain from using a tether strap on the car seat for children under 1 year of age: Tether straps are generally used for forward-facing car seats to reduce forward movement in a crash. Infants under 1 year should be in rear-facing seats, where tethers are not typically applicable, but the focus should be on proper rear-facing installation rather than avoiding tethers altogether.

B. Manual shoulder belts in the front seat are acceptable for school-age children over 8 years of age: Children under 13 years should ride in the back seat whenever possible, as front-seat placement increases the risk of injury from airbags and seat belts. Using front seats is not recommended solely based on age.

C. Restrict using rear-facing car seats for children after 1 year of age: Current guidelines recommend keeping children in rear-facing seats as long as possible, typically until at least age 2 or until they reach the height and weight limits of the rear-facing seat. Restricting rear-facing use at 1 year is outdated and unsafe.

D. Booster seats with belt-positioning should be used for school-age children until 8 years of age: Booster seats help position the seat belt correctly over a child’s shoulder and lap, reducing the risk of injury in a crash. This is consistent with current safety guidelines and supports proper seat belt use until the child is tall enough and meets weight requirements for adult seat belts.