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 D

Explanation

A. Progesterone plays a significant role in maintaining pregnancy and preparing the breasts for lactation, but it is not responsible for the milk let-down reflex.
B. Estrogen helps with breast development and ductal growth during pregnancy, but it does not trigger the milk let-down reflex.
C. Prolactin is responsible for milk production (lactogenesis) but not for the actual release of milk from the breast.
D. Oxytocin is the hormone responsible for the milk let-down reflex, which causes milk to be released from the milk glands into the nipple when the baby suckles. It also promotes uterine contractions after childbirth.

A. Polyhydramnios B. Placenta previa C. Placental abruption D. Ruptured ectopic pregnancy

Correct Answer is B

Explanation

A. Polyhydramnios refers to an excessive amount of amniotic fluid and typically presents with maternal discomfort, dyspnea, and possibly preterm labor, but not with vaginal bleeding as a primary symptom.

B. Placenta previa is the most likely diagnosis based on the assessment findings. It typically presents with painless, bright red vaginal bleeding in the second or third trimester, a soft, nontender uterus, no contractions, and a normal fetal heart rate. The bleeding may start spontaneously and often recurs. This fits the client's clinical picture precisely.

C. Placental abruption usually involves painful vaginal bleeding, a firm or tender uterus, and may be associated with uterine contractions or abnormal fetal heart rate patterns. The absence of pain and uterine tenderness in this case makes placental abruption less likely.

D. Ruptured ectopic pregnancy would not be expected at 33 weeks’ gestation. Ectopic pregnancies typically present in the first trimester and are accompanied by severe abdominal pain, vaginal bleeding, and signs of hypovolemic shock if ruptured.

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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

A nurse is teaching a new mother about breastfeeding. The nurse determines that the teaching was successful when the woman identifies which hormone as responsible for milk let-down?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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