The nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement made by the client indicates a need for further teaching?

"I need to stay on the diabetic diet."

"I need to be aware of any infections and report signs of infection immediately to my primary health care provider (PHCP)."

"I would avoid exercise because of the negative effects on insulin production."

"I need to perform glucose monitoring at home."

Answer and Explanation

The Correct Answer is C

A. "I need to stay on the diabetic diet." Dietary management is the first-line treatment for GDM and helps maintain blood glucose levels within the target range.

B. "I need to be aware of any infections and report signs of infection immediately to my primary health care provider (PHCP)." Infections can increase insulin resistance and lead to hyperglycemia. Clients with GDM should monitor for signs of infection (e.g., fever, urinary symptoms) and seek prompt treatment.

C. "I would avoid exercise because of the negative effects on insulin production." Regular exercise improves insulin sensitivity and helps control blood glucose levels. Clients with GDM are encouraged to engage in moderate physical activity unless contraindicated.

D. "I need to perform glucose monitoring at home." Home glucose monitoring is essential for assessing glycemic control and guiding treatment decisions.

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Correct Answer is D

Explanation

A. A client who has a history of preterm labor. A history of preterm labor is not an indication for MSAFP screening. MSAFP is primarily used to detect neural tube defects (e.g., spina bifida) and chromosomal abnormalities (e.g., Down syndrome).

B. A client who has been exposed to AIDS. HIV/AIDS exposure does not impact MSAFP levels and is not an indication for the test. The focus in these clients is viral load monitoring and antiretroviral therapy.

C. A client who has mitral valve prolapse. Mitral valve prolapse does not affect fetal development in a way that would require MSAFP screening.

D. All of the clients. It is a standard screening test offered to all pregnant clients during the second trimester. The test is recommended for detecting fetal neural tube defects and certain chromosomal abnormalities, typically offered between 15-20 weeks of gestation.

A. A client who is experiencing fetal death at 32 weeks of gestation B. A client who is experiencing Braxton-Hicks contractions at 36 weeks of gestation C. A client who is experiencing preterm labor at 26 weeks of gestation D. A client who has a post-term pregnancy at 42 weeks of gestation

Correct Answer is C

Explanation

A. A client who is experiencing fetal death at 32 weeks of gestation: Tocolytic therapy delays preterm labor to improve fetal outcomes. If fetal death has already occurred, there is no benefit in delaying labor.

B. A client who is experiencing Braxton-Hicks contractions at 36 weeks of gestation: Braxton-Hicks contractions are false labor contractions that do not cause cervical changes. Tocolytics are not needed for false labor.

C. A client who is experiencing preterm labor at 26 weeks of gestation: Tocolytic therapy is appropriate for preterm labor before 34 weeks of gestation, especially in very preterm pregnancies (before 28 weeks) to allow for fetal lung maturation and steroid administration.

D. A client who has a post-term pregnancy at 42 weeks of gestation: Tocolytics are used to delay preterm labor, not to stop contractions in post-term pregnancies. A 42-week pregnancy requires induction of labor, not suppression.

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The nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement made by the client indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a clinic is reviewing the medical records of a group of clients who are pregnant. The nurse should anticipate the provider will order a maternal serum alpha-fetoprotein (MSAFP) screening for which of the following clients?

Correct Answer is D

Explanation

A nurse is caring for several clients. The nurse should recognize that it is safe to administer tocolytic therapy to which of the following clients?

Correct Answer is C

Explanation

Which of the following statements about pyelonephritis in pregnancy is correct?

A nurse is caring for a client having contractions every 8 min that are 30 to 40 seconds in duration. The client's cervix is 2 cm dilated, 50% effaced, and the fetus is at a -2 station with a FHR around 140/min. Which of the following stages and phases of labor is the client experiencing?

The home care nurse visits a pregnant client who has a diagnosis of mild preeclampsia. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the primary health care provider (PHCP)?

A nurse is caring for a client who is at 22 weeks of gestation and has been unable to control her gestational diabetes mellitus with diet and exercise. The nurse should anticipate a prescription from the provider for which of the following medications for the client?

A nurse is caring for a client who is in the first stage of labor, undergoing external fetal monitoring, and receiving IV fluid. The nurse observes variable decelerations in the fetal heart rate on the monitor strip. Which of the following is a correct interpretation of this finding?

A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client?

A nurse is caring for a client who is in labor and has an external fetal monitor. The nurse observes late decelerations on the monitor strip and interprets them as indicating which of the following?