A nurse is reviewing laboratory results from a client who is at 28 weeks of gestation and has gestational diabetes. The nurse notes that blood glucose levels taken 1 hr following a meal range from 145 mg/dL to 162 mg/dL over the past week. Which of the following actions should the nurse take?

Schedule a 3-hr oral glucose tolerance test.

Tell the client to increase carbohydrates to 65% of daily nutritional intake.

Obtain an HbA1c.

Reinforce instruction about insulin administration.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

The nurse should schedule a 3-hour oral glucose tolerance test (OGTT) for the client because the blood glucose levels taken 1 hour following a meal are higher than the expected range for gestational diabetes. This test will help to diagnose and assess the client's glucose tolerance and determine if there is gestational diabetes or any other potential glucose regulation issues.

Choice B rationale:

Increasing carbohydrates to 65% of daily nutritional intake is not the appropriate action in this situation. It may lead to further elevation of blood glucose levels, which can be detrimental for a client with gestational diabetes. The goal is to manage blood glucose levels and prevent complications, so recommending a higher carbohydrate intake would be counterproductive.

Choice C rationale:

Obtaining an HbA1c (glycated hemoglobin) is not the most suitable action in this scenario. HbA1c provides an average of the blood glucose levels over the past few months, which is more helpful for diagnosing and monitoring chronic diabetes, rather than gestational diabetes, which is temporary and occurs during pregnancy. An OGTT is a more appropriate test for gestational diabetes assessment.

Choice D rationale:

Reinforcing instruction about insulin administration is not warranted at this point since there is no information indicating that the client is currently on insulin therapy. Additionally, using insulin as the first step in the management of gestational diabetes is not common practice. Lifestyle modifications, dietary changes, and other measures are usually attempted first.

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Correct Answer is C

Explanation

Choice A rationale :

Vitamin K decreases the newborn's risk of jaundice. Rationale: This statement is incorrect. Vitamin K plays no direct role in reducing the risk of jaundice in newborns. Jaundice is primarily caused by the accumulation of bilirubin in the blood, which is a different issue than hemorrhagic disorders.

Choice B rationale

Vitamin K decreases the newborn's risk of healthcare-associated infections. Rationale: This statement is incorrect. Vitamin K is not related to reducing the risk of healthcare-associated infections. Its main function is related to blood clotting and preventing hemorrhagic disorders.

Choice C rationale

Vitamin K decreases the newborn's risk of hemorrhagic disorders. Rationale: This statement is correct. Vitamin K is essential for the production of clotting factors in the blood, which helps prevent bleeding or hemorrhagic disorders in newborns. Newborns are born with low levels of vitamin K, so administering a vitamin K injection at birth is a common practice to prevent potential bleeding issues.

Choice D rationale

Vitamin K decreases the newborn's risk of complications from the Hepatitis B vaccine. Rationale: This statement is incorrect. Vitamin K is not directly related to reducing the risk of complications from the Hepatitis B vaccine. The vaccine is designed to protect against Hepatitis B infection, and vitamin K is not involved in its efficacy or safety.

A. Dysuria. B. Dependent edema. C. Polyuria. D. Hematuria. E. Urinary frequency.

Correct Answer is ["A","D","E"]

Explanation

Dysuria - Dysuria refers to painful or difficult urination. In a client with a urinary tract infection (UTI), this symptom is commonly present. The rationale behind this finding is that the infection irritates the urinary tract, causing discomfort and pain during urination. The client may experience a burning sensation or pressure while passing urine.

Choice D rationale

Hematuria - Hematuria refers to the presence of blood in the urine. In the case of a UTI, inflammation of the urinary tract can lead to tiny blood vessels rupturing, resulting in blood in the urine. This can cause the urine to appear pink, red, or brownish.

Choice E rationale:

Urinary frequency - Urinary frequency is another common symptom of a UTI. The infection can irritate the bladder lining, leading to an increased urge to urinate even when the bladder is not full. The client may feel the need to urinate frequently throughout the day and night.

Choice B rationale

Dependent edema - Dependent edema is not typically associated with a urinary tract infection. Edema is the accumulation of fluid in tissues, often causing swelling in the lower extremities due to gravity (dependent). This symptom is more commonly related to issues such as heart, kidney, or liver problems.

Choice C rationale

Polyuria - Polyuria refers to excessive urination, usually producing abnormally large volumes of urine. While frequent urination is a symptom of a UTI, polyuria, in this context, is not accurate. UTIs tend to cause frequent but smaller volumes of urine due to the irritation and inflammation of the bladder.

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A nurse is reviewing laboratory results from a client who is at 28 weeks of gestation and has gestational diabetes. The nurse notes that blood glucose levels taken 1 hr following a meal range from 145 mg/dL to 162 mg/dL over the past week. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

A nurse reinforcing teaching about vitamin K with a client who is postpartum. Which of the following statements should the nurse include?

Correct Answer is C

Explanation

A nurse is collecting data from a client who has a urinary tract infection. Which of the following findings should the nurse expect? (Select all that apply)

Correct Answer is ["A","D","E"]

Explanation

A nurse is assisting with the monitoring of a client who is in the first stage of labor, with an external fetal monitor in place and IV fluids infusing. Which of the following factors will cause variable decelerations in the fetal heart rate?

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