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.”

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A reason:

Ibuprofen - Ibuprofen belongs to the nonsteroidal anti-inflammatory drugs (NSAIDs) class, which includes aspirin. Since the client reports an allergy to aspirin, there is a risk of cross- reactivity, leading to a potential allergic reaction. Therefore, Ibuprofen should be avoided.

Choice B reason:

Acetaminophen - Acetaminophen is not an NSAID, and it works differently from aspirin. It is a safe option for the client in the postpartum period to manage pain without causing a cross- reaction with their aspirin allergy. Acetaminophen primarily acts on the central nervous system to reduce pain and fever, making it suitable for the client.

Choice C reason:

Naproxen - Naproxen is also an NSAID, and like Ibuprofen, it carries the risk of cross-reactivity in someone allergic to aspirin. Therefore, Naproxen should be avoided in this client.

Choice D reason:

Celecoxib - Celecoxib is a type of NSAID known as a selective cyclooxygenase-2 (COX-2) inhibitor. Although it is a bit more selective and generally considered to have a lower risk of causing cross-reactions, it is still an NSAID and not recommended for someone with a known aspirin allergy. Hence, Celecoxib should not be administered to the client in this scenario.

A. "I should add 500 calories per day to my diet.” B. "I will use antibacterial soap and warm water to wash my breasts.” C. "Breastfeeding is a reliable method of birth control.” D. "If my nipples become cracked and red, I will apply hydrocortisone cream.”

Correct Answer is B

Explanation

Choice A reason:

The client stating, "I should add 500 calories per day to my diet,” is not an accurate understanding of breastfeeding. While it is true that breastfeeding mothers require additional calories to support lactation, the specific amount of calories needed varies depending on individual factors and should be discussed with a healthcare professional. Simply adding 500 calories per day may not be appropriate for every woman and could lead to excessive weight gain.

Choice B reason:

This choice indicates an understanding of proper breast hygiene during breastfeeding. Using antibacterial soap and warm water to wash the breasts helps to prevent infection and maintain good breast health, reducing the risk of complications for both the mother and the baby.

Choice C reason:

The statement, "Breastfeeding is a reliable method of birth control,” is incorrect. While breastfeeding can provide some natural contraceptive effects, it is not a foolproof method of birth control. This concept is known as the lactational amenorrhea method (LAM), and specific criteria must be met for it to be considered a reliable form of contraception. Relying solely on breastfeeding as birth control can lead to an unintended pregnancy.

Choice D reason:

The statement, "If my nipples become cracked and red, I will apply hydrocortisone cream,” is not advisable. While hydrocortisone cream may provide temporary relief from irritation, it is not recommended for breastfeeding mothers. Ingestion of the cream by the baby can be harmful. Instead, the client should seek guidance from a healthcare professional to address and resolve any breastfeeding-related nipple issues.

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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?

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