A nurse is caring for a patient who is at 22 weeks of gestation and has been unable to control her gestational diabetes mellitus with diet and exercise. Which of the following medications should the nurse anticipate the provider will prescribe for the patient?
Repaglinide
Glipizide
Insulin
Acarbose
The Correct Answer is C
Choice A rationale
Repaglinide is an oral diabetes medication that helps control blood sugar levels by causing the pancreas to produce insulin. However, it is not typically the first choice for treating gestational diabetes. It is usually used for type 2 diabetes and is not commonly recommended during pregnancy.
Choice B rationale
Glipizide is another oral diabetes medication that works by stimulating the pancreas to produce insulin. Like repaglinide, it is not typically used as a first-line treatment for gestational diabetes and is not commonly recommended during pregnancy.
Choice C rationale
Insulin is the most common treatment for gestational diabetes. It does not cross the placenta and thus does not cause hypoglycemia in the baby. It can be used safely during pregnancy and is effective in controlling blood glucose levels.
Choice D rationale
Acarbose is an alpha-glucosidase inhibitor, which works by slowing the absorption of carbohydrates from the intestine. It is not typically used in pregnancy due to lack of safety data.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A rapid decline in human chorionic gonadotropin (hCG) levels is not typically associated with a hydatidiform mole. In fact, hCG levels are usually abnormally high with this condition.
Choice B rationale
Profuse, clear vaginal discharge is not a typical finding in a client with a hydatidiform mole. The client may experience vaginal bleeding, but it is often described as resembling ‘prune juice’ or 'grape clusters’56.
Choice C rationale
An irregular fetal heart rate is not a typical finding in a client with a hydatidiform mole, as this condition involves the abnormal growth of placental tissue, often without the development of a viable fetus.
Choice D rationale
Excessive uterine enlargement is a common finding in a client with a hydatidiform mole. This is due to the overgrowth of the placental tissue.
Correct Answer is D
Explanation
Choice A rationale
Tilt the client onto her right side with her legs elevated to at least 30 degrees. This action is not the most immediate step to take. While it can help improve venous return and thus cardiac output, it does not directly address the issue of postpartum hemorrhage.
Choice B rationale
Administer oxytocin by continuous IV infusion. Oxytocin is a medication that can stimulate uterine contractions and help control postpartum bleeding. However, it should be administered after the nurse has assessed the uterus and determined that it is not contracting effectively on its own.
Choice C rationale
Insert an indwelling urinary catheter. While a full bladder can inhibit effective uterine contractions and contribute to bleeding, inserting a catheter is not the first step in managing a postpartum hemorrhage.
Choice D rationale
Massage the client’s fundus to promote contractions. This is the correct answer. Fundal massage stimulates the uterus to contract, which can help control postpartum bleeding. It is a first-line intervention for a boggy uterus and postpartum hemorrhage.
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