A nurse is collecting data from a client who is at 34 weeks of gestation and has hyperglycemia.
Which of the following manifestations should the nurse expect?
Decreased urination.
Shallow respirations.
Thirst.
Hunger.
The Correct Answer is C
Choice A rationale
Hyperglycemia in gestational diabetes typically leads to increased urination, or polyuria, not decreased urination. Elevated blood glucose levels overwhelm the renal tubules' reabsorption capacity, leading to glucose spilling into the urine, which then draws water osmotically, increasing urine output.
Choice B rationale
Shallow respirations are not a direct manifestation of hyperglycemia in this context. While severe diabetic ketoacidosis (DKA), a complication of uncontrolled diabetes, can lead to Kussmaul respirations (deep, rapid breathing) due to metabolic acidosis, hyperglycemia alone typically does not cause shallow respirations.
Choice C rationale
Thirst, or polydipsia, is a classic manifestation of hyperglycemia. High blood glucose levels increase the osmolality of the blood, stimulating osmoreceptors in the hypothalamus, which then trigger the sensation of thirst as the body attempts to dilute the excess glucose and restore fluid balance.
Choice D rationale
While hunger (polyphagia) is a common symptom in uncontrolled type 1 diabetes due to cellular inability to utilize glucose, in gestational diabetes with hyperglycemia, hunger is not a predominant or consistent symptom. The body typically has sufficient insulin, but there is insulin resistance or insufficient production.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Wearing the lap belt high across the abdomen is incorrect and potentially dangerous. The lap belt should be positioned low, across the pelvic bones (hips) and under the pregnant abdomen. This ensures that the force of a collision is distributed across the strong pelvic bones, minimizing direct pressure on the uterus and fetus, thereby reducing the risk of placental abruption or direct fetal trauma.
Choice B rationale
Disabling the vehicle's driver-side airbags is strongly discouraged and unsafe. Airbags are designed to provide crucial protection in a collision by deploying rapidly to cushion the occupant. While pregnant individuals should maintain a safe distance from the steering wheel to mitigate airbag impact on the uterus, disabling the airbag removes a vital safety feature and significantly increases the risk of severe injury to both the mother and the fetus in an accident.
Choice C rationale
Moving the seat as far away as possible from the steering wheel, while still maintaining control of the vehicle, is a crucial safety measure for pregnant individuals. This provides a greater crumple zone and reduces the risk of the steering wheel or dashboard impacting the gravid uterus in the event of a collision. Maintaining a distance of at least 10 inches between the sternum and the steering wheel is generally recommended to maximize safety and minimize potential fetal injury from airbag deployment.
Choice D rationale
Placing the shoulder harness across the gravid uterus is incorrect. The shoulder harness should be positioned snugly between the breasts and across the collarbone. It should never be placed directly over the abdomen or the uterus. Proper placement ensures that the upper body is restrained effectively, preventing forward motion and distributing impact forces across the chest and shoulder, thus protecting the gravid uterus from direct trauma.
Correct Answer is A
Explanation
Choice A rationale
Iron absorption is significantly enhanced by ascorbic acid (vitamin C), which is abundant in orange juice. Vitamin C converts ferric iron to ferrous iron, the more absorbable form, thereby improving bioavailability and mitigating common gastrointestinal side effects by increasing absorption efficiency in the duodenum.
Choice B rationale
Taking ferrous sulfate with breakfast, or any meal, can decrease its absorption due to interactions with certain food components like phytates in grains or calcium in dairy. Optimal absorption occurs on an empty stomach to avoid chelation or competition for absorption pathways.
Choice C rationale
Similar to breakfast, taking ferrous sulfate with a midday meal can also reduce its absorption efficiency. Food components can bind with iron, forming insoluble complexes that are not readily absorbed in the gastrointestinal tract, thereby diminishing therapeutic efficacy.
Choice D rationale
Milk contains calcium, which can significantly inhibit the absorption of iron. Calcium ions compete with iron for absorption sites in the small intestine, forming insoluble complexes that reduce iron bioavailability and diminish the effectiveness of the ferrous sulfate supplement.
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