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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
While it is true that preterm newborns have a smaller body surface area than full-term newborns, this is not the primary reason for using an incubator. A smaller body surface area can contribute to heat loss, but the main issue is the lack of adequate temperature control mechanisms.
Choice B rationale
Preterm newborns lack the adequate temperature control mechanisms that full-term newborns have. They have less subcutaneous fat to insulate them and a higher surface area to volume ratio, which increases heat loss. They also lack the ability to shiver to generate heat.
Therefore, an incubator is used to maintain a neutral thermal environment.
Choice C rationale
The heat in the incubator does not rapidly dry the sweat of preterm newborns. In fact, preterm newborns do not sweat as efficiently as full-term newborns or adults, so they are less likely to lose heat through sweating.
Choice D rationale
The statement that the added brown fat layer in preterm newborn reduces his ability to generate heat is incorrect. In fact, preterm newborns have less brown fat than full-term newborns. Brown fat is a type of fat that generates heat when metabolized, and it is an important source of heat for newborns.
Correct Answer is D
Explanation
Choice A rationale
Hemoglobin is an important parameter to monitor in newborns, especially those who have undergone a stressful birth process like an emergency cesarean section due to abruptio placenta and non-reassuring fetal heart rate. However, it is not one of the immediate findings that the nurse should report to the provider in this context.
Choice B rationale
Hematocrit is a measure of the proportion of red blood cells in the blood. While it is an important parameter to monitor in newborns, it is not one of the immediate findings that the nurse should report to the provider in this context.
Choice C rationale
Serum glucose is an important parameter to monitor in newborns, especially those who have undergone a stressful birth process like an emergency cesarean section due to abruptio placenta and non-reassuring fetal heart rate. However, it is not one of the immediate findings that the nurse should report to the provider in this context.
Choice D rationale
A respiratory assessment is crucial for a newborn, especially one that has undergone a stressful birth process like an emergency cesarean section due to abruptio placenta and non- reassuring fetal heart rate. The newborn’s Apgar score was 5 at 1 min, which indicates significant distress, and positive pressure ventilation was given for 1 min followed by free flow oxygen. These factors make respiratory assessment a priority and one of the immediate findings that the nurse should report to the provider.
Choice E rationale
Temperature is an important parameter to monitor in newborns, especially those who have undergone a stressful birth process like an emergency cesarean section due to abruptio placenta and non-reassuring fetal heart rate. However, it is not one of the immediate findings that the nurse should report to the provider in this context.
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