A nurse teaching a prenatal class is asked why infants of diabetic mothers are often larger than those born to women who do not have diabetes. On what information about pregnant women with diabetes should the nurse base the response?

Consuming more calories covers the insulin secreted by the fetus.

Fetal weight gain increases as a result of the common response of maternal overeating.

Extra circulating glucose causes the fetus to acquire fatty deposits.

Taking exogenous insulin stimulates fetal growth

Answer and Explanation

The Correct Answer is C

A. Consuming more calories covers the insulin secreted by the fetus. The fetus does not secrete insulin to regulate maternal glucose levels. Instead, the maternal pancreas produces insulin in response to blood sugar levels, but in diabetes, maternal insulin resistance leads to excess glucose being transferred to the fetus.

B. Fetal weight gain increases as a result of the common response of maternal overeating. While some women with diabetes may have increased caloric intake, this is not the primary reason for fetal macrosomia (large birth weight). The major factor is maternal hyperglycemia leading to excess fetal insulin production and fat deposition.

C. Extra circulating glucose causes the fetus to acquire fatty deposits. In diabetic pregnancies, excess maternal glucose crosses the placenta, leading to fetal hyperinsulinemia. The increased insulin promotes fat storage and excessive fetal growth, leading to macrosomia, which increases the risk of birth complications such as shoulder dystocia.

D. Taking exogenous insulin stimulates fetal growth. Insulin does not cross the placenta, so maternal insulin therapy does not directly affect fetal growth. Instead, fetal macrosomia results from prolonged exposure to maternal hyperglycemia, which causes the fetus to produce excessive insulin and store extra fat.

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Correct Answer is C

Explanation

A. To prevent uterine atony. Suprapubic pressure is not used to prevent uterine atony. Uterine atony, which leads to postpartum hemorrhage, is managed through uterine massage and medications such as oxytocin.

B. To facilitate the delivery of the baby's head. The baby's head has already been delivered in shoulder dystocia. The emergency arises because the shoulders are stuck behind the pubic bone, requiring specific maneuvers to release them.

C. To facilitate the delivery of the baby's shoulders. Shoulder dystocia occurs when the anterior shoulder becomes impacted behind the maternal pubic bone, preventing delivery. Suprapubic pressure is applied to help dislodge the shoulder by compressing it downward, allowing it to pass under the pubic bone. This maneuver, along with the McRoberts position, is commonly used to resolve the dystocia.

D. To prepare for the third stage of labor. The third stage of labor refers to the delivery of the placenta, which occurs after the baby is born. Suprapubic pressure is specifically used to assist in the second stage of labor when shoulder dystocia occurs.

A. An ectopic pregnancy does not need major treatment and can be delivered vaginally." B. "An ectopic pregnancy involves a fertilized ovum outside the uterus that cannot be transferred to the uterus." C. "An ectopic pregnancy involves a cancerous fertilized ovum in either fallopian tube." D. "An ectopic pregnancy involves a fertilized ovum in the vagina

Correct Answer is B

Explanation

A. "An ectopic pregnancy does not need major treatment and can be delivered vaginally." This statement is incorrect. An ectopic pregnancy involves the fertilized ovum implanting outside the uterus, most commonly in a fallopian tube, which poses serious risks to the mother. The pregnancy cannot be carried to term, and it requires prompt medical intervention, such as medication or surgery, to prevent life-threatening complications.
B. "An ectopic pregnancy involves a fertilized ovum outside the uterus that cannot be transferred to the uterus." This is an accurate explanation of an ectopic pregnancy. The fertilized egg implants outside the uterus, most commonly in the fallopian tubes, and cannot develop into a viable pregnancy. The condition requires immediate treatment to prevent tube rupture and internal bleeding.
C. "An ectopic pregnancy involves a cancerous fertilized ovum in either fallopian tube." This is incorrect. An ectopic pregnancy is not cancerous. It refers to a pregnancy where the fertilized ovum implants in an abnormal location outside the uterus, most commonly the fallopian tubes, not involving cancerous growth.
D. "An ectopic pregnancy involves a fertilized ovum in the vagina." This statement is incorrect. An ectopic pregnancy occurs when the fertilized ovum implants outside the uterus, but it does not implant in the vagina. The condition most commonly involves the fallopian tubes but can also occur in other locations such as the cervix, ovary, or abdominal cavity.

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A nurse teaching a prenatal class is asked why infants of diabetic mothers are often larger than those born to women who do not have diabetes. On what information about pregnant women with diabetes should the nurse base the response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An emergency shoulder dystocia delivery occurred that requires the nurse to apply suprapubic pressure. What is the rationale for this action?

Correct Answer is C

Explanation

A patient has been admitted to the emergency department with a suspected diagnosis of ectopic pregnancy. How should the nurse explain this condition to the patient?

Correct Answer is B

Explanation

The nurse is preparing for the admission of a 30 weeks' gestation patient experiencing vaginal bleeding with a suspected diagnosis of placenta previa. In anticipating the patient's needs, which of the following would be most appropriate for the nurse to include? Select all that apply.

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With regard to systemic analgesics administered during labor, nurses should be aware that:

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A nurse is monitoring the labor of a patient who is receiving IV oxytocin (Pitocin) at 6 ml/hr. Which of the following clinical signs would lead the nurse to stop the infusion?

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