A nurse is caring for a newborn whose parent had gestational diabetes. The newborn has a blood glucose level of 30 mg/dL (greater than 40 to 45 mg/dL) and is asymptomatic. Which of the following actions should the nurse take?

Encourage an additional feeding.

Recheck blood glucose in 4 hr.

Administer glucagon

Check urine for ketones

Answer and Explanation

The Correct Answer is A

A. Encourage an additional feeding. A blood glucose level of 30 mg/dL is below the normal range for a newborn (>40–45 mg/dL). Since the newborn is asymptomatic, the first-line intervention is to encourage breastfeeding or formula feeding to help raise blood glucose levels naturally. Frequent feeding helps prevent further drops in glucose and stabilizes levels.
B. Recheck blood glucose in 4 hr. Waiting 4 hours to recheck blood glucose is too long and could allow further decline, increasing the risk of symptomatic hypoglycemia. Blood glucose should be reassessed within 30 to 60 minutes after feeding to ensure it has improved.
C. Administer glucagon. Glucagon is reserved for severe hypoglycemia when the newborn is symptomatic (e.g., lethargy, jitteriness, seizures) or unable to feed. Since this newborn is asymptomatic, oral feeding is the preferred initial treatment.
D. Check urine for ketones. Urine ketone testing is not the priority in asymptomatic neonatal hypoglycemia. The focus should be on increasing blood glucose through feeding and monitoring response. Ketone testing is more relevant in cases of prolonged hypoglycemia or metabolic disorders.

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Correct Answer is D

Explanation

A. "You will be prescribed diazepam." Diazepam is a benzodiazepine used for anxiety and seizures, but it is not the recommended treatment for opioid use disorder in pregnancy. Prolonged use can lead to neonatal withdrawal symptoms, respiratory depression, and sedation. Additionally, benzodiazepine dependence can develop, complicating the management of opioid withdrawal.
B. "You will be prescribed naloxone." Naloxone is an opioid antagonist used for reversing opioid overdose, but it is not appropriate for long-term treatment of opioid use disorder. When administered to an opioid-dependent pregnant client, naloxone can induce sudden withdrawal, increasing the risk of fetal distress, uterine contractions, and preterm labor. Instead, opioid agonist therapy with methadone or buprenorphine is preferred.
C. "You will be prescribed aripiprazole." Aripiprazole is an atypical antipsychotic used for conditions such as schizophrenia, bipolar disorder, and depression. It has no role in managing opioid dependence, as it does not reduce opioid cravings or withdrawal symptoms. While some clients with opioid use disorder may have coexisting psychiatric conditions requiring antipsychotics, aripiprazole alone does not address opioid addiction.
D. "You will be prescribed methadone." Methadone is the standard treatment for opioid use disorder in pregnancy because it stabilizes opioid levels, preventing withdrawal symptoms and reducing cravings. This approach minimizes the risks of fetal distress, miscarriage, and preterm labor. Methadone maintenance also lowers the likelihood of illicit opioid use, improving prenatal care engagement and neonatal outcomes.

A. A client who a positive pregnancy test B. A client who smokes one pack of cigarettes per day C. A client who has a history of gallbladder D. A client who is nulliparous

Correct Answer is A

Explanation

A. A client who has a positive pregnancy test. An intrauterine device (IUD) is strictly contraindicated in pregnancy because it increases the risk of complications such as miscarriage, infection, and preterm labor. If a client is already pregnant, an IUD should not be inserted.
B. A client who smokes one pack of cigarettes per day. Smoking increases the risk of cardiovascular complications with estrogen-containing contraceptives, but it is not a contraindication for an IUD. A non-hormonal copper IUD would be a suitable option for a smoker, as it does not increase the risk of blood clots.
C. A client who has a history of gallbladder disease. A history of gallbladder disease is not a contraindication for an IUD. While hormonal contraceptives may slightly increase gallbladder disease risk, a copper IUD does not contain hormones, making it a safe option for these clients.
D. A client who is nulliparous. Being nulliparous (never having given birth) is not a contraindication for an IUD, though insertion may be more uncomfortable in clients who have not previously had a vaginal delivery. Both hormonal and copper IUDs are approved for use in nulliparous individuals.

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A nurse is caring for a newborn whose parent had gestational diabetes. The newborn has a blood glucose level of 30 mg/dL (greater than 40 to 45 mg/dL) and is asymptomatic. Which of the following actions should the nurse take?

Nursing Test Bank

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