A 26-week pregnant client has a Glucose challenge test (GCT) with 50 g of glucola, her results are 150mg/dl. What would be expected next step when caring for this client?

Increase in dietary protein

Schedule a repeat Glucose challenge test (GCT)

Restrict carbohydrate intake

Return for a fasting 3-hour glucose tolerance test (GTT)

Answer and Explanation

The Correct Answer is D

A. Increase in dietary protein is not the appropriate response based on the results of the glucose challenge test. Protein intake may be adjusted for other health reasons but is not typically a first-line intervention after an abnormal GCT result.

B. Schedule a repeat Glucose Challenge Test (GCT) is not typically the next step. If the initial GCT is abnormal (usually a result >130-140 mg/dL), a repeat test is not recommended. Instead, a 3-hour glucose tolerance test (GTT) is used to confirm or rule out gestational diabetes.

C. Restrict carbohydrate intake might be part of managing gestational diabetes if it is diagnosed, but it is not the immediate next step after an abnormal GCT result. The focus is on further testing with a 3-hour GTT to confirm gestational diabetes.

D. Return for a fasting 3-hour glucose tolerance test (GTT) is the correct next step. If a client’s GCT result is ≥130-140 mg/dL, a 3-hour GTT is typically scheduled. The 3-hour GTT is a more comprehensive test that involves fasting and measuring blood glucose levels after consuming a larger dose of glucose (100 g). This test is used to diagnose gestational diabetes.

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Correct Answer is A

Explanation

A. Newborns typically go through predictable behavioral states after birth. During the first period of reactivity, which lasts about 30–60 minutes after birth, the newborn is awake, alert, and active. This is followed by a period of sleep or decreased activity, which can last 2 to 4 hours. It is normal for the baby to be sleepy and difficult to awaken during this phase, especially around 2 hours of age.

B. Probable hypoglycemia could cause lethargy in a newborn, but it would typically be accompanied by other symptoms such as jitteriness, poor feeding, or abnormal vital signs. In a healthy 2-hour-old baby, sleepiness alone is not enough to suggest hypoglycemia.

C. Physiological abnormality is incorrect. There is no evidence of abnormality in a sleepy 2-hour-old newborn, as this is an expected part of the normal behavioral cycle after birth.

D. Inadequate oxygenation would likely present with signs such as cyanosis, abnormal respiratory rate, or poor perfusion, not just sleepiness.

A. Document the finding, as it is a normal finding at this time. B. Contact the primary care provider, as it indicates early DIC. C. Obtain a prescription for a CBC, as it suggests postpartum anemia. D. Contact the primary care provider, as it is a first sign of postpartum eclampsia.

Correct Answer is A

Explanation

A. A pulse rate of 66 beats per minute is within the normal range for a postpartum woman, particularly 12 hours after birth. It's common for the pulse rate to decrease after delivery, as the body stabilizes and returns to its pre-pregnancy state. This is not a cause for concern and can be considered a normal physiological response to the postpartum period.

B. Contact the primary care provider, as it indicates early DIC (disseminated intravascular coagulation). This is unlikely, as DIC typically presents with more severe symptoms, such as bleeding, bruising, and a drop in blood pressure, not a lower pulse rate. A normal or slightly decreased pulse is not indicative of DIC.

C. While it's important to monitor for signs of anemia in the postpartum period (such as fatigue, dizziness, or weakness), a pulse of 66 beats per minute is not a typical sign of anemia. Anemia would more likely be accompanied by other symptoms, such as pallor or weakness.

D. Postpartum eclampsia typically presents with high blood pressure, severe headache, visual disturbances, or seizures, not a low pulse rate. A pulse rate of 66 beats per minute is not a sign of eclampsia.

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A 26-week pregnant client has a Glucose challenge test (GCT) with 50 g of glucola, her results are 150mg/dl. What would be expected next step when caring for this client?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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