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 A

Explanation

Choice A reason: Ceftriaxone is a third-generation cephalosporin that is effective against Neisseria gonorrhoeae, the bacteria that causes gonorrhea. It is administered as a single intramuscular injection and has a high cure rate.

Choice B reason: Penicillin G is not the drug of choice for gonorrhea because of the widespread resistance of N. gonorrhoeae to this antibiotic. Penicillin G may be used in combination with other drugs for some cases of gonorrhea, but it is not the first-line treatment.

Choice C reason: Acyclovir is an antiviral drug that is used to treat herpes simplex virus infections, not bacterial infections like gonorrhea. Acyclovir has no effect on N. gonorrhoeae and is not indicated for gonorrhea treatment.

Choice D reason: Tetracycline is a broad-spectrum antibiotic that can be used to treat some bacterial infections, but it is not the drug of choice for gonorrhea. Tetracycline has a lower efficacy and a higher rate of adverse effects than ceftriaxone for gonorrhea treatment.

A. it is a natural pregnancy loss before labor begins. B. it often can be attributed to careless maternal behavior such as poor nutrition or excessive exercise. C. if it occurs before the 12th week of pregnancy, it may manifest only as moderate discomfort and blood loss. D. it occurs in fewer than 5% of all clinically recognized pregnancies.

Correct Answer is A

Explanation

Choice A reason: A miscarriage is defined as a spontaneous abortion of a fetus before the 20th week of gestation. It is a natural pregnancy loss that occurs before labor begins and is usually caused by chromosomal abnormalities, infections, or maternal health problems.

Choice B reason: A miscarriage is not often attributed to careless maternal behavior such as poor nutrition or excessive exercise. These factors may affect the quality of life of the mother and the fetus, but they are not the main causes of miscarriage. Most miscarriages are not preventable and are not the fault of the mother.

Choice C reason: A miscarriage that occurs before the 12th week of pregnancy may manifest only as moderate discomfort and blood loss, but this is not always the case. Some women may experience severe cramping, bleeding, and tissue passing from the vagina. Others may have no symptoms at all and only discover the miscarriage during a routine ultrasound.

Choice D reason: A miscarriage occurs in more than 5% of all clinically recognized pregnancies. The actual rate of miscarriage is estimated to be 10% to 20%, but many women may not realize they are pregnant or may not report the loss to their health care provider.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The drug of choice for treatment of gonorrhea is:

Correct Answer is A

Explanation

As related to the care of the patient with miscarriage, nurses should be aware that:

Correct Answer is A

Explanation

How is fetal well-being during labor assessed?

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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:

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:

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