Which factor is known to increase the risk of gestational diabetes mellitus?

Choice A reason: Vibroacoustic stimulation is a technique that uses sound to stimulate the fetus and elicit a response. It is sometimes used in conjunction with the nonstress test (NST), not the CST. The NST measures the fetal heart rate (FHR) in response to fetal movement, while the CST measures the FHR in response to uterine contractions.

Choice B reason: A negative CST result means that the FHR does not show any late decelerations during at least three contractions in a 10-minute period. Late decelerations are decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends. They indicate uteroplacental insufficiency, which means that the placenta is not delivering enough oxygen and nutrients to the fetus. A negative CST result is reassuring and suggests that the fetus is well-oxygenated and can tolerate labor².

Choice C reason: The CST is not an invasive test, as it does not involve inserting any instruments or devices into the uterus or the fetus. However, it does require stimulating contractions, either by giving the pregnant woman oxytocin (a hormone that causes uterine contractions) or by having her rub her nipples (which also releases oxytocin). The contractions can be uncomfortable and may trigger preterm labor in some cases.

Choice D reason: The CST is not more effective than the NST if the membranes have already been ruptured. In fact, the CST is contraindicated (not recommended) in women who have ruptured membranes, as it can increase the risk of infection and bleeding. The NST is a safer and simpler alternative to the CST, as it does not require stimulating contractions. However, the NST may not be as reliable as the CST in detecting fetal compromise.

Choice A reason: This is incorrect because providing the patient with handouts is not enough to ensure effective communication. The handouts may not be in the patient's preferred language or may use unfamiliar words or concepts. The nurse should also use other methods, such as interpreters, translators, or visual aids, to convey information to the patient.

Choice B reason: This is incorrect because speaking quickly and efficiently may hinder the patient's comprehension and increase the risk of misunderstanding. The nurse should speak slowly and clearly, using simple and common words, and allow time for the patient to ask questions or clarify information.

Choice C reason: This is correct because assessing whether the patient understands the discussion is essential for effective communication and patient education. The nurse should use techniques such as teach-back, ask-me-3, or show-me to verify the patient's understanding and address any gaps or misconceptions.

Choice D reason: This is incorrect because using maternity jargon may confuse the patient and create barriers to communication. The nurse should avoid using medical terms, abbreviations, or slang that the patient may not be familiar with. The nurse should explain any necessary terms in plain language and use examples or analogies to illustrate them.