Review Screening and Diagnosis

Gestational Diabetes > Maternal & Newborn

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Screening and Diagnosis

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Total Questions : 6

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Question 1:

A nurse is providing education to a pregnant client about the screening test for gestational diabetes.

The nurse explains that the test involves measuring blood sugar levels at different time points.

Which of the following blood sugar level readings would confirm a diagnosis of gestational diabetes?

A. Fasting: 88 mg/dL, 1 hour: 150 mg/dL, 2 hours: 135 mg/dL. B. Fasting: 95 mg/dL, 1 hour: 175 mg/dL, 2 hours: 140 mg/dL C. Fasting: 90 mg/dL, 1 hour: 185 mg/dL, 2 hours: 160 mg/dL D. Fasting: 98 mg/dL, 1 hour: 165 mg/dL, 2 hours: 145 mg/dL

Answer and Explanation

Choice A:

These blood sugar levels are within the normal ranges.

Choice B:

Only the fasting blood sugar level is slightly above the normal range, but not enough to confirm a diagnosis of gestational diabetes

Choice C:

These blood sugar levels exceed the normal ranges for a pregnant woman undergoing a screening test for gestational diabetes.

Choice D:

Only the 1 hour and 2 hours blood sugar levels are slightly above the normal ranges, but not enough to confirm a diagnosis of gestational diabetes

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Question 2:

A client undergoes the screening test for gestational diabetes.

The nurse reviews the client's blood sugar level results.

The fasting blood sugar level is 89 mg/dL, the 1-hour level is 178 mg/dL, and the 2-hour level is 150 mg/dL.

Based on these results, the nurse would interpret them as indicating:.

A. Normal glucose tolerance B. Impaired glucose tolerance C. Gestational diabetes D. Pre-existing diabetes

Answer and Explanation

Choice A:

Normal glucose tolerance means that the blood sugar levels are within the normal range after drinking the glucose solution.

The client’s 1-hour and 2-hour levels are above the normal range

Choice B:

This means that the client’s blood sugar levels are higher than normal but not high enough to be diagnosed with diabetes.According to the Mayo Clinic, a normal blood glucose level two hours after drinking the glucose solution is lower than 140 mg/dL (7.8 mmol/L).

A level between 140 and 199 mg/dL (7.8 and 11 mmol/L) indicates impaired glucose tolerance, and a level of 200 mg/dL (11.1 mmol/L) or higher indicates diabetes

Choice C:

Gestational diabetes means that the blood sugar levels are too high during pregnancy and can cause complications for the mother and the baby.

The client’s fasting blood sugar level is within the normal range,

Choice D:

N/A

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Question 3:

A nurse is preparing to perform the glucose tolerance test for a pregnant client.

Which of the following statements by the client indicates a need for further clarification?

A. "I should not eat or drink anything after midnight.". B. "I will need to have blood drawn at fasting and after drinking the sugary drink.". C. "The sugary drink may taste sweet and cause some temporary discomfort.". D. "I will be required to stay in the clinic for several hours during the test.".

Answer and Explanation

Choice A:

It is correct that the client should not eat or drink anything after midnight before the test.

Choice B:

It is correct that the client will need to have blood drawn at fasting and after drinking the sugary drink.

Choice C:

It is correct that the sugary drink may taste sweet and cause some temporary discomfort.

Choice D:

This statement indicates a need for further clarification because the glucose tolerance test for a pregnant client usually takes 1 hour, not several hours.The client should be informed that she will need to have blood drawn at fasting and 1 hour after drinking the sugary drink.

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Question 4:

A client is scheduled to undergo the glucose tolerance test for gestational diabetes screening.

The nurse provides instructions to the client.

Which statement by the client indicates an understanding of the procedure?

A. "I should avoid any high-sugar foods for a week before the test.". B. "I can drink water during the test to stay hydrated.". C. "I need to fast for 12 hours before the test.". D. "I should avoid physical activity on the day of the test.".

Answer and Explanation

Choice A:

This statement is incorrect because the client only needs to avoid eating or drinking anything except water for at least eight hours before the test.

Avoiding high-sugar foods for a week before the test is unnecessary and may alter the results.

Choice B:

This statement indicates an understanding of the procedure because water does not affect the blood glucose level and can help prevent dehydration during the test.

Choice C:

This statement is incorrect because the client only needs to fast for eight hours before the test.

Fasting for longer than eight hours may cause hypoglycemia (low blood sugar) or ketosis (high levels of ketones in the blood).

Choice D:

This statement is incorrect because moderate physical activity does not affect the blood glucose level and may help reduce stress during the test.

However, strenuous exercise should be avoided as it may lower the blood glucose level too much.

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Question 5:

A pregnant client has just completed the glucose tolerance test for gestational diabetes.

The nurse reviews the client's blood sugar level results.

The fasting blood sugar level was 95 mg/dL, the 1-hour level was 175 mg/dL, and the 2-hour level was 145 mg/dL.

Based on these results, the nurse would interpret them as indicating:.

A. Normal glucose tolerance B. Impaired glucose tolerance C. Gestational diabetes D. Pre-existing diabetes

Answer and Explanation

Choice A:

Normal glucose tolerance means that the blood sugar levels are within the normal range for all three measurements.

Choice B:

This means that the blood sugar levels are higher than normal, but not high enough to diagnose gestational diabetes.The normal ranges for the glucose tolerance test for gestational diabetes are:

• Fasting blood sugar level: less than 95 mg/dL (5.3 mmol/L)

• 1-hour level: less than 180 mg/dL (10 mmol/L)

• 2-hour level: less than 155 mg/dL (8.6 mmol/L)

The client’s fasting blood sugar level was within the normal range, but the 1-hour and 2-hour levels were above the normal range, indicating impaired glucose tolerance.

Choice C:

Gestational diabetes means that the blood sugar levels are above the diagnostic threshold for all three measurements:

• Fasting blood sugar level: 92 mg/dL (5.1 mmol/L) or higher

• 1-hour level: 180 mg/dL (10 mmol/L) or higher

• 2-hour level: 153 mg/dL (8.5 mmol/L) or higher

Choice D:

Pre-existing diabetes means that the blood sugar levels are above the diagnostic threshold for diabetes before pregnancy:

• Fasting blood sugar level: 126 mg/dL (7 mmol/L) or higher

• Random blood sugar level: 200 mg/dL (11.1 mmol/L) or higher

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Question 6:

A nurse is reviewing the antenatal care plan for a pregnant woman who has no risk factors for gestational diabetes.

The nurse should expect the woman to have which of the following tests to screen for gestational diabetes?

A. Fasting blood glucose test at 16 weeks of gestation B. Random blood glucose test at 20 weeks of gestation C. Glucose tolerance test at 24 to 28 weeks of gestation D. Hemoglobin A1c test at 32 weeks of gestation

Answer and Explanation

Choice A:

Fasting blood glucose test is not a screening test for GDM, but a diagnostic test that requires an overnight fast and measures the blood glucose level before eating.

It is usually done as part of the OGTT.

Choice B:

Random blood glucose test is not a reliable screening test for GDM, as it does not account for the timing and content of the last meal.

Choice C:

This is the recommended screening test for gestational diabetes mellitus (GDM) for women who have no risk factors.

The test involves measuring the blood glucose level one hour after ingesting a 50-gram glucose load.If the result is abnormal (greater than 140 mg/dL), a diagnostic three-hour oral glucose tolerance test (OGTT) is performed

Choice D:

Hemoglobin A1c test is not a screening test for GDM, but a test that measures the average blood glucose level over the past two to three months.It is used to monitor the glycemic control of women with preexisting diabetes mellitus during pregnancy.

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Total Questions : 6

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Screening and Diagnosis

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