Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for:

low birth weight.

preterm birth.

macrosomia.

congenital anomalies of the central nervous system.

Answer and Explanation

The Correct Answer is C

Choice A reason: Low birth weight is not a common complication of GDM, as the fetus tends to grow larger than normal due to the excess glucose and insulin in the blood. Low birth weight is more likely to occur in infants of mothers with preexisting diabetes or other conditions that affect placental function.

Choice B reason: Preterm birth is a possible complication of GDM, as the increased fetal size and the risk of maternal hypertension or infection may induce labor before term. However, it is not the greatest risk for the fetus, as preterm infants can survive with proper care and treatment.

Choice C reason: Macrosomia is the greatest risk for the fetus of a mother with GDM, as it is defined as a birth weight of more than 4000 g or 8 lb 13 oz. Macrosomia can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, or cesarean birth. It can also increase the risk of neonatal hypoglycemia, jaundice, or respiratory distress.

Choice D reason: Congenital anomalies of the central nervous system are not a common complication of GDM, as they usually occur in the first trimester of pregnancy, before GDM is diagnosed or develops. Congenital anomalies are more likely to occur in infants of mothers with preexisting diabetes or other genetic or environmental factors.

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Correct Answer is B

Explanation

Choice A reason: Genetic changes and anomalies are not the most dangerous effect, as they are rare and not directly caused by smoking. Smoking can increase the risk of some birth defects, such as cleft lip and cleft palate, but these are not genetic changes and can be corrected by surgery. Smoking can also cause chromosomal abnormalities in the eggs, but these usually result in miscarriage or stillbirth, not live births.

Choice B reason:Maternal smoking is a significant risk factor for intrauterine growth restriction (IUGR). Nicotine and carbon monoxide from cigarettes reduce oxygen supply to the fetus, leading to lower birth weights and smaller body lengths.

Choice C reason: Fetal addiction to the substance inhaled is not the most dangerous effect, as it is not permanent and can be treated by medication and supportive care. Smoking can expose the fetus to nicotine, carbon monoxide, and other harmful chemicals, which can cross the placenta and affect the fetal brain and nervous system. Smoking can also cause withdrawal symptoms in the newborn, such as irritability, tremors, and difficulty feeding.

Choice D reason:Although prenatal exposure to smoking can affect neurodevelopment and is associated with behavioral issues, extensive central nervous system damage is not the most immediate or dangerous effect. The most critical concern remains intrauterine growth restriction.

A. fetal sleep cycles. B. umbilical cord compression. C. altered cerebral blood flow. D. fetal hypoxemia.

Correct Answer is A

Explanation

Choice A reason: Fetal sleep cycles are a normal physiological cause of decreased variability in the FHR, which is the fluctuation of the baseline FHR above and below 2 cycles per minute. Fetal sleep cycles usually last 20 to 40 minutes and do not affect the fetal well-being.

Choice B reason: Umbilical cord compression is an abnormal cause of decreased variability in the FHR, as it reduces the blood flow and oxygen delivery to the fetus. It can also cause variable decelerations, which are abrupt decreases in the FHR below the baseline.

Choice C reason: Altered cerebral blood flow is an abnormal cause of decreased variability in the FHR, as it indicates a compromise in the fetal central nervous system. It can also cause late decelerations, which are gradual decreases in the FHR after the peak of a contraction.

Choice D reason: Fetal hypoxemia is an abnormal cause of decreased variability in the FHR, as it reflects a severe lack of oxygen in the fetal blood. It can also cause sinusoidal pattern, which is a smooth, undulating waveform in the FHR.

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Naxlex Comprehensive Predictor Exams

What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant?

Correct Answer is B

Explanation

The most common cause of decreased variability in the fetal heart rate (FHR) that lasts 30 minutes or less is:

Correct Answer is A

Explanation

During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic patient with limited English proficiency. It is important for the nurse to:

What is the most important factor for successful teaching of the pregnant client by the maternity nurse?

Magnesium sulfate is given to women with preeclampsia and eclampsia to:

The nurse caring for a woman hospitalized for hyperemesis gravidarum should expect that initial treatment will involve:

A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks she has a vaginal infection and has been using an over-the-counter cream for the past 2 days to treat it. The nurse's initial response should be to:

A pregnant woman presents to the emergency department complaining of persistent nausea and vomiting. She is diagnosed with hyperemesis gravidarum. The nurse should include which information when teaching about diet for hyperemesis? (Select all that apply)

A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates an understanding of the nurse's instructions if she states that a positive sign of pregnancy is:

Which finding meets the criteria of a reassuring fetal heart rate (FHR) pattern?