The client is a 32-year-old multigravida at 28 weeks' gestation, who presents to the obstetrician's office for a routine has given burn three times; once at 35 weeks (twins), once at 38 weeks (singleton) and once at 41 weeks (singleton). All of these children are alive and well. She had one spontaneous abortion at 10 weeks' gestation. Her fourth child weighed 9 pounds (4.08 kg) at 41 weeks gestation.
The client is at 28 weeks. She has been receiving prenatal care since 8 weeks gestation. Her fasting 1-hour glucose screening level, which was done 1 week prior, is 164 mg/dL (9.1 mmol/L). Her 3-hour oral glucose tolerance test results reveal a fasting blood sugar of 168 mg/dL (9.3 mmol and a two-hour postprandial of 220 mg/dL (12...mol/L).
Scheduled the client to meet with the obstetrician, Diabetic Nurse Educator, and a Registered Dietician for the next day. After a discussion about gestational diabetes and seeking the client's input, a suggested plan of care is outlined, which includes dietary control and glucose self-monitoring.
The registered dietician (RD) discusses the need to
Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided.
The diabetic nurse educator instructs the client to perform fingerstick blood glucose (FSBG) monitoring Select Response
of the night at bedtime and in the middle
prior to each meal
every two hours throughout the day
during the middle of the night
The Correct Answer is B
A) Incorrect- While bedtime monitoring is important, the frequency described in this choice is not consistent with FSBG monitoring before meals.
B) Correct- Performing FSBG monitoring before each meal helps the client track her blood glucose levels before consuming food, allowing her to adjust her diet or insulin regimen if necessary.
C) Incorrect- Monitoring every two hours may be excessive and not necessary for managing gestational diabetes.
D) Incorrect- Monitoring during the night is important for glycemic control, but it doesn't specifically address the need to monitor before meals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","E"]
Explanation
The level of hypoxemia that the child may have experienced during the submersion depends on several factors, but the most important ones are:
- The **temperature of water**: Cold water can induce a diving reflex, which lowers the heart rate and oxygen consumption, and may protect the brain from hypoxic injury¹². Cold water can also cause laryngospasm, which prevents water aspiration but also impairs gas exchange.
- The **amount of time the child was submerged**: The longer the submersion, the more severe the hypoxemia and the higher the risk of brain damage and death. The survival rate decreases significantly after 5 minutes of submersion³.
The other factors are less relevant or not directly related to the level of hypoxemia:
- The **weight of the child**: This may affect the buoyancy and the ability to float or swim, but not the oxygen consumption or gas exchange during submersion¹.
- The **oxygen concentration of the ambient air**: This may affect the pre-submersion oxygen saturation, but not the rate of oxygen depletion or gas exchange during submersion¹.
- The **witnessing of the fall into the pool**: This may affect the time to rescue and resuscitation, but not the level of hypoxemia during submersion.
Correct Answer is B
Explanation
A) Incorrect- Liver enzymes are important for assessing liver function, but they are not the primary concern when a client with chronic kidney disease is feeling increasingly tired. Epoetin alfa injections are used to stimulate red blood cell production, so the nurse should review a laboratory value related to anemia.
B) Correct- Epoetin alfa is a medication that stimulates the production of red blood cells and is often used to treat anemia associated with chronic kidney disease. A complete blood count (CBC) would provide information about red blood cell levels, hemoglobin, and hematocrit, which are essential for assessing the effectiveness of the treatment.
C) Incorrect- Serum electrolytes are important for assessing overall kidney function and electrolyte balance, but the primary concern here is the client's increasing fatigue. Reviewing a value related to anemia and red blood cell production would be more appropriate.
D) Incorrect- Platelet count is important for assessing blood clotting function, but it's not directly related to the client's increasing fatigue. Anemia-related laboratory values should be the focus.
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