A nurse is reinforcing teaching to a client who is pregnant regarding a 1-hr glucose tolerance test (GTT). Which of the following statements by the client indicates an understanding of the test?
"This test is to check if my baby has diabetes.”
"If the result is higher than normal, I will need to be on insulin the rest of my life.”
"If I forget and eat before the test, then I won't be able to have the test done.”
"If the results are high, then I need another test to see if I have gestational diabetes.”
The Correct Answer is D
Choice A reason:
The client stating, "This test is to check if my baby has diabetes,” indicates a misunderstanding of the purpose of the 1-hr glucose tolerance test (GTT). The test is performed to screen for gestational diabetes in the mother, not to check the baby's diabetes status. Rationale: Gestational diabetes is a condition where high blood sugar levels develop during pregnancy, and it can affect both the mother and the baby's health.
Choice B reason:
The client mentioning, "If the result is higher than normal, I will need to be on insulin the rest of my life,” demonstrates a misconception about the implications of the 1-hr GTT. The 1-hr GTT is a preliminary screening test, and if the results are higher than normal, it indicates the need for further evaluation, but it does not immediately mean a lifetime dependence on insulin. Rationale: Insulin therapy may be required for managing gestational diabetes in some cases, but not necessarily for the rest of the mother's life.
Choice C reason:
The client saying, "If I forget and eat before the test, then I won't be able to have the test done,” indicates a misunderstanding of the test procedure. The 1-hr GTT requires fasting before the test, typically for 8 to 14 hours, to get accurate results. However, if the client mistakenly eats before the test, it doesn't mean they cannot have the test done at all; they may need to reschedule it after an appropriate fasting period. Rationale: Fasting is crucial for accurate glucose level measurement during the test.
Choice D reason:
The client stating, "If the results are high, then I need another test to see if I have gestational diabetes,” demonstrates a correct understanding of the 1-hr GTT. If the initial screening test shows elevated glucose levels, further testing, such as the 3-hour glucose tolerance test (GTT), is required to confirm the diagnosis of gestational diabetes. Rationale: The 3-hour GTT is a more comprehensive diagnostic test used to confirm or rule out gestational diabetes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
"I will reinforce the patch edges with clear tape if they don't lie flat.".
Choice A reason:
Placing a heat pack on the patch to improve adhesion is not recommended. Heat can potentially increase the absorption of the medication and lead to adverse effects. Applying additional heat to the patch can be dangerous and may cause an overdose or other complications.
Choice B reason:
Placing the patch on the back side of the child's arm is not the correct application site for a methylphenidate transdermal patch. The appropriate site for application is typically the hip or the top of the buttocks. The back of the arm may not provide proper absorption and can result in suboptimal medication delivery.
Choice C reason:
This statement indicates an understanding of the teaching. Reinforcing the patch edges with clear tape if they don't lie flat is a recommended step to ensure proper adhesion of the patch. If the edges of the patch lift or don't stick properly, using clear tape can help keep the patch securely in place, ensuring continuous and consistent drug delivery.
Choice D reason:
Leaving the patch in place for no more than 9 hours is incorrect. The duration of wear for a methylphenidate transdermal patch varies depending on the specific brand and formulation. Typically, these patches are designed for 9 to 12 hours of wear, and leaving them on for a shorter duration may result in inadequate symptom control.
Correct Answer is D
Explanation
Choice D reason: The nurse should report the laboratory result of 2+ proteinuria (Choice D) to the healthcare provider. Proteinuria is the presence of excess protein in the urine, which can indicate a potential kidney problem or a complication related to pregnancy, such as preeclampsia. Preeclampsia is a serious condition characterized by high blood pressure and damage to organs like the liver and kidneys. Therefore, this result needs immediate attention to assess the client's condition properly and take appropriate actions to ensure the safety and well-being of both the mother and the baby.
Choice A reason:
The 2-hour postprandial glucose level of 105 mg/dL (Choice A) is within the normal range. During pregnancy, glucose levels are carefully monitored to check for gestational diabetes. In this case, the result falls within the acceptable range, indicating that the client's glucose levels are stable, and gestational diabetes is not a concern at this time.
Choice B reason:
A negative group B streptococcus (GBS) B-hemolytic result (Choice B) is actually a positive finding. It means that the client does not have an active infection with group B streptococcus, which is essential information for the management of labor and delivery. Therefore, there is no need to report this result to the provider as it indicates a favorable condition.
Choice C reason:
The hemoglobin (Hgb) level of 13 g/dL (Choice C) is within the normal range for a non- pregnant adult female. During pregnancy, blood volume increases, and hemoglobin levels can naturally decrease. However, the provided value is still within the acceptable range, indicating that the client's blood oxygen-carrying capacity is adequate and there is no immediate concern.
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