In terms of the incidence and classification of diabetes, maternity nurses should know that:
Type 1 diabetes is most common
Type 2 diabetes often goes undiagnosed
Type 1 diabetes may become type 2 during pregnancy
Gestational diabetes mellitus (GDM) means that the woman will be receiving insulin treatment until 6 weeks after birth
The Correct Answer is B
Choice A rationale
Type 1 diabetes is not the most common type of diabetes. Type 1 diabetes is a condition where the pancreas produces little or no insulin, which is a hormone that regulates the blood glucose level. Type 1 diabetes usually develops in childhood or adolescence and requires lifelong insulin therapy. Type 1 diabetes accounts for about 5% to 10% of all cases of diabetes.
Choice B rationale
Type 2 diabetes often goes undiagnosed. Type 2 diabetes is a condition where the body becomes resistant to the action of insulin or the pancreas produces insufficient insulin. Type 2 diabetes usually develops in adulthood and is associated with obesity, physical inactivity, and family history. Type 2 diabetes can be managed with diet, exercise, oral medications, or insulin. Type 2 diabetes accounts for about 90% to 95% of all cases of diabetes. However, many people with type 2 diabetes do not have any symptoms or are unaware of their condition, which can lead to delayed diagnosis and complications.
Choice C rationale
Type 1 diabetes cannot become type 2 during pregnancy. Type 1 and type 2 diabetes are different conditions with different causes and treatments. Type 1 diabetes is an autoimmune disorder that destroys the insulin-producing cells in the pancreas, while type 2 diabetes is a metabolic disorder that impairs the insulin sensitivity or secretion. Type 1 diabetes cannot be reversed or prevented, while type 2 diabetes can be prevented or delayed with lifestyle changes.
Choice D rationale
Gestational diabetes mellitus (GDM) does not mean that the woman will be receiving insulin treatment until 6 weeks after birth. GDM is a condition where the blood glucose level becomes elevated during pregnancy, usually after 24 weeks of gestation. GDM can cause complications for the mother and the fetus, such as preeclampsia, macrosomia, and neonatal hypoglycemia. GDM can be managed with diet, exercise, oral medications, or insulin. GDM usually resolves after delivery, but the woman should be tested for diabetes 6 to 12 weeks postpartum, as she has a higher risk of developing type 2 diabetes later in life.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Gestational hypertension is not the most likely diagnosis for the client. Gestational hypertension is a condition where the blood pressure is elevated after 20 weeks of gestation, without any signs of proteinuria or end-organ damage. The client has a history of chronic hypertension for 5 years, which means that the hypertension existed before the pregnancy. The client also has proteinuria, which is a sign of preeclampsia.
Choice B rationale
Chronic hypertension with superimposed preeclampsia is the most likely diagnosis for the client. Chronic hypertension with superimposed preeclampsia is a condition where the blood pressure is elevated before 20 weeks of gestation, and the hypertension worsens or the proteinuria develops or increases after 20 weeks of gestation. The client has a history of chronic hypertension for 5 years, and the blood pressure is very high at 34 weeks of gestation. The client also has 3+ proteinuria, which indicates severe preeclampsia.
Choice C rationale
Eclampsia is not the most likely diagnosis for the client. Eclampsia is a condition where the preeclampsia progresses to cause seizures or coma in the pregnant woman. The client has no signs of seizures or coma, but only signs of preeclampsia.
Choice D rationale
HELLP syndrome is not the most likely diagnosis for the client. HELLP syndrome is a condition where the preeclampsia causes hemolysis, elevated liver enzymes, and low platelets in the pregnant woman. The client has no signs of hemolysis, liver damage, or thrombocytopenia, but only signs of preeclampsia.
Correct Answer is A
Explanation
Choice A rationale
Risk for injury related to seizures is an important nursing diagnosis for this client. The client is at risk of seizures due to the severe preeclampsia and the high blood pressure. Seizures can cause injury to the client and the fetus, as well as complications such as aspiration, cerebral hemorrhage, and coma. The nurse should monitor the client's neurological status, administer anticonvulsants as prescribed, and protect the client from injury during a seizure.
Choice B rationale
Impaired gas exchange related to pulmonary edema is an important nursing diagnosis for this client. The client is at risk of pulmonary edema due to the fluid overload and the high blood pressure. Pulmonary edema can impair the gas exchange and oxygen delivery to the client and the fetus, as well as cause respiratory distress, heart failure, and death. The nurse should monitor the client's respiratory status, administer oxygen as prescribed, and restrict the fluid intake.
Choice C rationale
Deficient fluid volume related to diuresis is not an important nursing diagnosis for this client. The client is not at risk of deficient fluid volume, but rather fluid overload. Diuresis is the increased production and excretion of urine, which can cause fluid loss and dehydration. The client does not have any signs of diuresis, such as increased urine output, decreased specific gravity, or weight loss.
Choice D rationale
Ineffective tissue perfusion related to placental abruption is not an important nursing diagnosis for this client. The client is not at risk of placental abruption, but rather uteroplacental insufficiency. Placental abruption is the premature separation of the placenta from the uterine wall, which can cause bleeding, pain, and fetal distress. The client does not have any signs of placental abruption, such as vaginal bleeding, abdominal tenderness, or fetal heart rate abnormalities.
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