A nurse in a prenatal clinic is teaching a patient who is in her second trimester and has a new diagnosis of gestational diabetes.
Which of the following statements by the patient indicates a need for further teaching?
“I will reduce my exercise schedule to 3 days a week.”.
“I will take my glyburide daily with breakfast.”.
“I know I am at increased risk to develop type 2 diabetes.”.
“I should limit my carbohydrates to 50% of caloric intake.”.
“I should limit my carbohydrates to 50% of caloric intake.”.
The Correct Answer is A
Choice A rationale
Regular physical activity plays a key role in managing gestational diabetes. The American College of Obstetricians and Gynecologists (ACOG) recommends aiming for 150 minutes of moderate-level exercise each week during pregnancy. Reducing the exercise schedule to 3 days a week may not provide the recommended amount of physical activity needed to manage gestational diabetes effectively.
Choice B rationale
Glyburide is an oral medication that can be used to manage gestational diabetes when diet and exercise are not enough. It is usually taken before breakfast or the first main meal of the day.
Choice C rationale
This statement is correct. Women who have had gestational diabetes have an increased risk of developing type 2 diabetes later in life.
Choice D rationale
This statement is correct. A diet that includes about 40% to 45% carbohydrates is recommended for managing gestational diabetes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Perinatal asphyxia refers to a lack of oxygen flow to the fetus around the time of birth. This can lead to multiple organ dysfunction and neurological issues, but it is not a common cause of a newborn being small for gestational age.
Choice B rationale
Preterm delivery can result in a newborn being small for their gestational age simply because they have not had the full amount of time to grow in the womb. However, preterm babies are typically compared to other preterm babies when assessing size, not to full-term babies.
Choice C rationale
Fetal hyperinsulinemia, or an excess of insulin in the fetus, can lead to excessive growth and a larger-than-average baby size (macrosomia), not a smaller size.
Choice D rationale
Placental insufficiency, where the placenta does not work as well as it should, can limit the amount of oxygen and nutrients the fetus receives. This can restrict the baby’s growth, leading to a small size for gestational age.
Correct Answer is C
Explanation
Choice A rationale:
Perineal pad clots are not the greatest risk for this patient. While it’s important to monitor the amount and type of lochia, the nurse’s notes indicate that the patient has a moderate amount of lochia rubra, which is normal within the first few days postpartum. Large clots could indicate a problem such as a retained placental fragment, but this is not mentioned in
the scenario.
Choice B rationale:
Pelvic pain is a common complaint after childbirth due to uterine contractions, especially during breastfeeding, and usually resolves within a few days. The patient’s pain is rated as 4 on a scale of 0 to 10, which is considered moderate. While it’s important to manage the patient’s pain, it’s not the greatest risk in this scenario.
Choice C rationale:
A boggy uterus poses the greatest risk for this patient. A boggy or soft uterus indicates uterine atony, which is a lack of normal muscle tone that can lead to excessive bleeding. This is a serious condition that can lead to postpartum hemorrhage if not treated promptly. The nurse’s notes indicate that the patient’s fundus is boggy and located above the umbilicus, which is a concern. The fundus should be firm and gradually descend into the pelvis within the first few days postpartum.
Choice D rationale:
Breast engorgement is a common discomfort that occurs when the breasts are overly full with milk. It typically occurs within the first week postpartum as the milk supply increases. The nurse’s notes indicate that the patient’s breasts are soft, warm, and tender to touch, which is normal. While it’s important to manage the patient’s comfort, breast
engorgement is not the greatest risk in this scenario.
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