A patient who is 26 weeks pregnant has gestational diabetes and is to begin insulin management.
When discussing the patient’s insulin needs, which information should the nurse include?

Insulin amount needs will remain stable during the third trimester.

Insulin amount needs will continue to increase throughout the second and third trimesters.

Insulin amount needs will decrease during the third trimester.

Insulin amount needs will remain stable for the rest of the second and during the third trimesters.

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Insulin amount needs will continue to increase throughout the second and third trimesters. This is because gestational diabetes is a form of diabetes that develops during pregnancy, usually during the 2nd or 3rd trimester. It is caused by hormonal changes that interfere with the action of insulin, leading to high blood sugar levels. As the pregnancy progresses, the placenta produces more hormones that increase insulin resistance, so the mother needs more insulin to keep her blood sugar within normal range.

Choice A is wrong because insulin amount needs will not remain stable during the third trimester. They will increase as the placenta grows and produces more hormones that cause insulin resistance.

Choice C is wrong because insulin amount needs will not decrease during the third trimester. They will increase as the placenta grows and produces more hormones that cause insulin resistance.

Choice D is wrong because insulin amount needs will not remain stable for the rest of the second and during the third trimesters. They will increase as the pregnancy progresses and the placenta produces more hormones that increase insulin resistance.

Normal ranges for blood sugar during pregnancy are: fasting < 95 mg/dL, 1 hour after meal < 140 mg/dL, 2 hours after meal < 120 mg/dL.

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Correct Answer is A

Explanation

Choice A reason:
At 37 weeks, especially in gestational diabetes, fetal lungs may still be immature. Amniocentesis checks lung maturity to ensure the baby can breathe effectively if early delivery is needed due to fetal compromise.

Choice B reason:
Fetal renal function is not typically assessed through amniocentesis at term. Kidney function is monitored via ultrasound, not by analyzing amniotic fluid at 37 weeks.

Choice C reason:
Amniotic fluid glucose levels are not used to manage gestational diabetes. Maternal blood glucose is the standard for monitoring and treatment.

Choice D reason:
Congenital anomalies are usually detected earlier in pregnancy. By 37 weeks, the focus of amniocentesis is on delivery planning, not anomaly detection.

A. Check the specific gravity of the amniotic fluid. B. Provide dry linens for the patient. C. Auscultate the fetal heart sounds. D. Notify the health care provider.

Correct Answer is C

Explanation

The correct answer is choice C. Auscultate the fetal heart sounds.This is because spontaneous rupture of membranes (SROM) may be associated with fetal distress or cord prolapse, and the nurse should assess the fetal well-being as soon as possible.Fetal heart sounds can indicate the presence of fetal bradycardia, tachycardia, or decelerations, which may require immediate intervention.

Choice A is wrong because checking the specific gravity of the amniotic fluid is not a priority action after SROM.The specific gravity can help differentiate amniotic fluid from urine, but it is not as reliable as other methods such as nitrazine paper test or visual inspection.

Choice B is wrong because providing dry linens for the patient is a comfort measure, but not a priority action after SROM.The nurse should first ensure the safety of the fetus and the mother before attending to their comfort needs.

Choice D is wrong because notifying the health care provider is an important action after SROM, but not the first one.The nurse should gather relevant data such as fetal heart rate, maternal vital signs, and characteristics of the fluid before contacting the provider.

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A patient who is 26 weeks pregnant has gestational diabetes and is to begin insulin management. When discussing the patient’s insulin needs, which information should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has gestational diabetes and is scheduled for an amniocentesis at 37 weeks of gestation due to suspected fetal compromise. What is the nurse’s best response to the client’s question as to why the amniocentesis test is being done?

Correct Answer is A

Explanation

A patient states, “My water just broke.” The nurse verifies that her membranes have ruptured spontaneously. Which action should the nurse take next?

Correct Answer is C

Explanation

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A patient who is 26 weeks pregnant has gestational diabetes and is to begin insulin management.
When discussing the patient’s insulin needs, which information should the nurse include?