A client with diet controlled gestational diabetes mellitus arrives for a routine appointment at the prenatal clinic. The client's glycosylated hemoglobin (HbA1C) is 5%. Which action should the nurse take?
Reference Range: Glycosylated hemoglobin (HbA1C) [4% to 5.9% ]

Continue with the current diabetic plan of care.

Refer the client to the diabetic educator.

Administer prescribed subcutaneous insulin.

Obtain a 24 hour urine collection for total protein.

Answer and Explanation

The Correct Answer is A

Rationale:

A. Continue with the current diabetic plan of care: A glycosylated hemoglobin (HbA1C) of 5% is within the normal reference range for pregnant clients and indicates good blood glucose control. Maintaining the current diet-controlled management plan is appropriate, with ongoing monitoring to ensure continued stability.

B. Refer the client to the diabetic educator: Referral to a diabetic educator is important for clients struggling with glucose control or requiring insulin management. Since this client’s HbA1C is within the target range and diet-controlled management is effective, referral is not immediately necessary.

C. Administer prescribed subcutaneous insulin: Insulin administration is indicated when diet and lifestyle measures fail to maintain adequate blood glucose control. The client’s HbA1C of 5% demonstrates effective glucose management without the need for pharmacologic intervention.

D. Obtain a 24 hour urine collection for total protein: A 24-hour urine collection is used to assess for proteinuria, which is a marker of preeclampsia, not a routine follow-up for gestational diabetes with well-controlled blood glucose.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

Rationale:

A. Interest in enrolling in breastfeeding classes: While breastfeeding education is helpful, it does not directly address the immediate concern of poor weight gain in the infant.

B. Herbal supplements the mother is taking: Herbal supplements may affect milk production or infant tolerance in some cases, but they are less likely to be the primary factor when the infant is feeding frequently and producing an adequate number of wet diapers.

C. Types of foods the mother is eating: Maternal diet generally does not significantly impact breast milk quantity or quality in healthy, well-nourished women. While important for overall health, it is not the most critical factor to assess here.

D. Length of time the infant nurses at each breast: Assessing how long the infant feeds at each breast provides crucial information about milk transfer and effectiveness of breastfeeding. Despite frequent nursing and normal diaper output, inadequate time at the breast may explain why the infant has not regained birth weight.

A. Peritonitis. B. Hydrocephalus has increased. C. Malfunction of the valves. D. Child has grown since placement.

Correct Answer is C

Explanation

Rationale:

A. Peritonitis: Peritonitis can occur as a complication of a ventriculoperitoneal (VP) shunt, particularly if infection spreads from the peritoneal cavity. While serious, infection is less common than mechanical failure and is not the leading cause of shunt revision.

B. Hydrocephalus has increased: Recurrence or progression of hydrocephalus may indicate shunt failure, but it is usually a consequence of valve malfunction or obstruction rather than a separate cause requiring revision on its own.

C. Malfunction of the valves: Valve malfunction is the most frequent reason for VP shunt revision. Obstruction, blockage, or mechanical failure of the shunt valves can prevent proper cerebrospinal fluid drainage, necessitating surgical correction to restore normal intracranial pressure.

D. Child has grown since placement: Growth can alter the length or positioning of the shunt tubing, but most shunts are designed with extra length to accommodate growth. Growth alone rarely necessitates revision compared to valve or mechanical failure.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client with diet controlled gestational diabetes mellitus arrives for a routine appointment at the prenatal clinic. The client's glycosylated hemoglobin (HbA1C) is 5%. Which action should the nurse take? Reference Range: Glycosylated hemoglobin (HbA1C) [4% to 5.9% ]

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

The nurse knows that a shunt procedure is the therapy of choice in almost all cases of hydrocephalus. Which is the most common reason for revision of a child's ventriculoperitoneal shunt?

Correct Answer is C

Explanation

Patient Data Exhibits The nurse is performing an assessment on the toddler. For each assessment finding, click to indicate whether the findings from the assessment should be a concern or not a concern to the nurse. Each row must have only one response option selected.

A primigravida client at 32-weeks gestation presents to the clinic with a report of a pounding headache. The client demonstrates hyperreflexia. The nurse should recognize the client's symptoms may be caused by which condition?

A client presents to labor and delivery at 36-weeks gestation reporting bright red vaginal bleeding without contractions. Which result should the nurse review first in the client's medical record?

The nurse is caring for a client following an emergency cesarean delivery under general anesthesia. Which assessment finding. occurring in the first 8 hours after delivery, is most critical and requires immediate intervention?

Patient Data Exhibits The nurse is planning care for the client. Drag from Word Choices to complete the sentence. The nurse is planning interventions to reduce the client's risk of dropdown, dropdown and dropdown.

A clinic nurse is assessing infants and toddlers for fine and gross motor development. Which child should the nurse refer to a healthcare provider (HCP) for further evaluation?

In assessing a 1-day-old male newborn, the nurse observes that the scrotal sac is large, swollen, smooth, and taut. Which assessment technique should the nurse perform to determine if the newborn has a hydrocele?

The nurse is caring for a preschooler with spina bifida admitted with a febrile urinary tract infection. Which action should the nurse prioritize to minimize complications of vesicoureteral reflux?

A client with diet controlled gestational diabetes mellitus arrives for a routine appointment at the prenatal clinic. The client's glycosylated hemoglobin (HbA1C) is 5%. Which action should the nurse take?
Reference Range: Glycosylated hemoglobin (HbA1C) [4% to 5.9% ]