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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Cheese is a good source of calcium, protein, and vitamin B12, but not folates. Folate is a water-soluble vitamin that is essential for the synthesis of DNA and the prevention of neural tube defects in the fetus.
Choice B reason: Potatoes are a good source of carbohydrates, potassium, and vitamin C, but not folates. Folate is found mainly in plant-based foods, especially dark green vegetables.
Choice C reason: Chicken is a good source of protein, iron, and zinc, but not folates. Folate is more abundant in legumes, nuts, and seeds than in animal products.
Choice D reason: Green leafy vegetables are a good source of folates, as well as vitamin A, vitamin K, and fiber. Folate is also known as folic acid when it is added to fortified foods or supplements. Pregnant women need at least 600 micrograms of folate per day.
Correct Answer is B
Explanation
Choice A reason: Braxton Hicks contractions are irregular, painless uterine contractions that occur throughout pregnancy. They are a probable sign of pregnancy, not a positive sign.
Choice B reason: Fetal movement palpated by the nurse-midwife is a positive sign of pregnancy, as it confirms the presence of a living fetus in the uterus. It can be detected as early as 16 to 20 weeks of gestation.
Choice C reason: A positive pregnancy test is a probable sign of pregnancy, as it indicates the presence of human chorionic gonadotropin (hCG) in the urine or blood. However, it is not a definitive sign, as other conditions can cause elevated hCG levels.
Choice D reason: Quickening is the first perception of fetal movement by the mother, which usually occurs between 16 and 20 weeks of gestation. It is a presumptive sign of pregnancy, not a positive sign.
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