A nurse is providing care for a pregnant patient.

The patient’s medical history includes Gravida 4 Para 3, 32 weeks of gestation, and a BMI of 32. The patient has a history of two newborns weighing over 4.5 kg (10 lb) and a family history of type one diabetes mellitus (maternal). The fetal heart tones are 140/min via doppler.

Which of the following provider prescriptions should the nurse plan to implement? Select the three actions the nurse should plan to take.

Conduct a non-stress test twice per week.

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

Instruct the patient to check a random blood glucose level once daily.

Anticipate a prescription for metformin.

Answer and Explanation

Correct Answer : A,B,D

Choice A rationale

A nonstress test (NST) is a test during pregnancy that measures the baby’s heart rate and response to movement. It is designed to ensure the baby is doing well and getting enough oxygen. Your provider might order it during the third trimester if you’re experiencing certain complications.

Choice B rationale

During pregnancy, women need nutrient-rich sources of carbohydrate, in the right amounts. Restriction of simple carbohydrates has been shown to reduce postprandial hyperglycemia, fetal glucose exposure, and fetal overgrowth. Therefore, encouraging the patient to limit carbohydrate intake to 40% of their daily calories could be beneficial.

Choice C rationale

Checking a random blood glucose level once daily is not typically recommended during pregnancy. Instead, blood glucose levels are usually checked at specific times, such as fasting (before breakfast), before other meals, and 1 hour after meals. This helps to provide more accurate information about how the body is managing blood glucose levels throughout the day.

Choice D rationale

Metformin is generally considered safe for use during pregnancy. It can also be used to treat women with gestational diabetes mellitus (diabetes that develops during pregnancy)7. Given the patient’s history and risk factors, it would be reasonable to anticipate a prescription for metformin.

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Correct Answer is C

Explanation

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.

A. Chorioamnionitis B. Preeclampsia C. Gestational diabetes D. Preterm labor

Correct Answer is A

Explanation

Choice A rationale

Chorioamnionitis. Based on the information provided, the patient is at risk of developing chorioamnionitis, which is an infection of the membranes surrounding the fetus.

Choice B rationale

Preeclampsia. There is no information provided that would indicate the patient is at risk of developing preeclampsia.

Choice C rationale

Gestational diabetes. There is no information provided that would indicate the patient is at risk of developing gestational diabetes.

Choice D rationale

Preterm labor. There is no information provided that would indicate the patient is at risk of developing preterm labor.

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Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is C

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

A nurse is providing care for a patient who is in labor. After reviewing the patient’s medical history, vital signs, nurse’s notes, and diagnostic results, which of the following complications should the nurse identify that the patient is at risk of developing?

Correct Answer is A

Explanation

Choice B rationale

Choice C rationale

Choice D rationale

A nurse is attending to a newborn 2 hours after birth. Which four observations should the nurse report to the healthcare provider?

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A nurse is caring for a newborn who is 4 hours old. Which condition poses the greatest risk to the newborn?

A nurse is caring for a client who is suspected to have an ectopic pregnancy at 8 weeks of gestation. What symptoms should the nurse expect to observe that are consistent with this diagnosis?

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