A nurse in the prenatal clinic is reinforcing teaching to a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which statement by the client indicates a need for further teaching?
"I should limit my carbohydrates to 50% of caloric intake.”
"I will take my glyburide daily with breakfast.”
"I will reduce my exercise schedule to 3 days a week.”
"I know I am at increased risk to develop type 2 diabetes."
The Correct Answer is C
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The nurse should check the client's fundus first, as this is the most likely source of bleeding and clots in the postpartum period. The fundus is the upper part of the uterus that contracts and involutes after delivery to prevent hemorrhage. The nurse should palpate the fundus for firmness, height, and position, and massage it gently if it is boggy or displaced. A soft, high, or deviated fundus may indicate uterine atony or retained placental fragments, which can cause excessive bleeding and clots.
Correct Answer is B
Explanation
The nurse should tell the client that the recommendation for her is about 15 to 25 pounds, as this is the range of weight gain that is considered healthy and appropriate for a pregnant woman who has a BMI of 26.5, which falls in the overweight category (BMI of 25 to 29.9). The weight gain should be gradual and consistent, with an average of
0.6 pounds per week in the second and third trimesters.
a. The nurse should not tell the client that a gain of about 25 to 35 pounds is best for her and for her baby, as this is the range of weight gain that is recommended for a pregnant woman who has a normal BMI (18.5 to 24.9). Gaining more weight than necessary can increase the risk of gestational diabetes, hypertension, preeclampsia, cesarean delivery, and postpartum weight retention.
c. The nurse should not tell the client that she should gain 11 to 20 pounds, as this is the range of weight gain that is advised for a pregnant woman who has a BMI of 30 or higher, which falls in the obese category. Gaining less weight than needed can compromise fetal growth and development, and increase the risk of preterm birth, low birth weight, and intrauterine growth restriction.
d. The nurse should not tell the client that it really doesn't mater exactly how much weight she gains, as long as her diet is healthy, as this is a vague and inaccurate statement that does not provide any guidance or education to the client. The amount of weight gain during pregnancy does mater, as it affects both maternal and fetal health and outcomes. A healthy diet is important, but it is not the only factor that influences weight gain. The nurse should also consider the client's pre-pregnancy weight, physical activity level, medical history, and gestational age.
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