A nurse is caring for a client who is pregnant.
Exhibits

Select the 3 actions that the nurse should plan to take

Encourage the client to limit carbohydrate intake to 40% of their daily calories.

Instruct the client to check a random blood glucose level once daily

Anticipate a prescription for metformin.

Conduct a non-stress test twice per week.

Answer and Explanation

Correct Answer : A,C,D

A. Encourage the client to limit carbohydrate intake to 40% of their daily calories. For clients with gestational diabetes, dietary modifications are a critical intervention. Limiting carbohydrate intake to 40% of daily calories can help regulate blood glucose levels.

B. Instruct the client to check a random blood glucose level once daily. The client should check fasting and postprandial blood glucose levels regularly (usually multiple times per day) to manage glucose control more effectively.

C. Anticipate a prescription for metformin. Given the elevated fasting blood glucose levels and high HbA1C (12%), this client may require pharmacological management to control blood sugar levels. Metformin is a common oral hypoglycemic agent used during pregnancy when diet and lifestyle changes are insufficient.

D. Conduct a non-stress test twice per week. Clients with uncontrolled gestational diabetes or poorly controlled blood sugar levels are at increased risk of fetal complications such as macrosomia, stillbirth, and preterm labor. A non-stress test (NST) twice a week helps monitor fetal well-being and detect early signs of distress.

E. Tell the client to refrain from exercise until after delivery. Exercise is generally recommended for clients with gestational diabetes unless contraindicated. Regular physical activity can help lower blood glucose levels and improve insulin sensitivity.

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Correct Answer is A

Explanation

A. Facial edema: Facial edema, especially in the second or third trimester, can be a sign of preeclampsia, a serious condition that requires prompt medical attention.

B. Urinary frequency: Urinary frequency is common in pregnancy, particularly during the first and third trimesters, and is not usually a sign of a complication.

C. Mood swings: Mood swings are common due to hormonal changes during pregnancy and are typically not a cause for concern unless they are severe or accompanied by other symptoms like depression.

D. Decreased energy: Feeling fatigued or having decreased energy is common during pregnancy, especially in the first trimester, and does not typically require medical intervention unless accompanied by other concerning symptoms.

A. "Initiate depot medroxyprogesterone 14 days after the client's first day of her menstrual cycle." B. "Administer depot medroxyprogesterone every 6 to 8 weeks." C. "Give the medication intramuscularly. D. "Massage the site after you administer the medication."

Correct Answer is C

Explanation

A. "Initiate depot medroxyprogesterone 14 days after the client's first day of her menstrual cycle." Depot medroxyprogesterone (Depo-Provera) is usually initiated within the first 5 days of a client’s menstrual cycle to ensure the client is not pregnant. Initiating it 14 days after may not provide immediate contraceptive coverage.

B. "Administer depot medroxyprogesterone every 6 to 8 weeks." Depot medroxyprogesterone is administered every 12 weeks (3 months), not every 6 to 8 weeks, to maintain contraceptive efficacy.

C. "Give the medication intramuscularly." Depot medroxyprogesterone is administered as an intramuscular injection, typically in the deltoid or gluteal muscle, to ensure proper absorption and contraceptive effectiveness.

D. "Massage the site after you administer the medication." Massaging the injection site is not recommended as it could lead to the faster absorption of the medication, which may reduce its duration of effectiveness.

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A nurse is caring for a client who is pregnant. Exhibits Select the 3 actions that the nurse should plan to take

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has just learned that she is pregnant. The nurse should reinforce with the client to call her provider if she experiences which of the following manifestations?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a newly licensed nurse about the administration of depot medroxyprogesterone. Which of the following instructions should the nurse include in the teaching?

Correct Answer is C

Explanation

A nurse is assisting with the admission of a client who is at 10 weeks of gestation and reports abdominal pain and moderate vaginal bleeding. Incomplete abortion is the initial diagnosis. Which of the following actions should the nurse contribute to the client's plan of care?

A nurse is reinforcing teaching with a newly licensed nurse about the purpose of an indirect Coombs test. Which of the following statements should the nurse include in the teaching?

A nurse is reinforcing teaching with a newly licensed nurse about the complications associated with maternal gestational diabetes. Which of the following complications should the nurse include?

A nurse is assisting with monitoring a client who has preeclampsia and is receiving magnesium sulfate. The client’s respiratory rate is 8/min. Which of the following should the nurse administer?

A nurse is reviewing contraception options for four clients. The nurse should identify which of the following clients as having a contraindication to oral contraceptives?

A nurse is reinforcing teaching with a client who is at 30 weeks of gestation and scheduled for a nonstress test (NST). Which of the following statements by the client indicates a need for further teaching?

A nurse is reinforcing teaching with a client who is pregnant and has a prescription for Rho(D) immune globulin/ RhoGAM. Which of the following information should the nurse include?

A nurse is caring for a client who is at 38 weeks of gestation and has a positive contraction stress test. Which of the following actions should the nurse take?

A nurse is caring for a client who is pregnant.
Exhibits

Select the 3 actions that the nurse should plan to take