A nurse at a provider’s office is caring for a 24-year-old female client.

Exhibits

Complete the following sentence by using the lists of options.
The nurse should prepare to reinforce teaching with the client about a

dropdown

with a prescription of

dropdown

.

Choice A rationale:

At approximately 20 weeks of gestation, the fundus is typically located at the level of the umbilicus. By 32 weeks, the uterus has grown significantly beyond this point. Therefore, a fundal height at the umbilicus would be inconsistent with 32 weeks gestation and may suggest intrauterine growth restriction or incorrect dating if observed.

Choice B rationale:

At 32 weeks of gestation, the fundus is expected to be located about halfway between the umbilicus and the xiphoid process. Fundal height in centimeters generally correlates with gestational age between 20 and 36 weeks. Thus, a measurement of approximately 32 cm from the symphysis pubis to the top of the fundus is expected, placing it midway between these anatomical landmarks.

Choice C rationale:

The fundus typically reaches the xiphoid process around 36 to 40 weeks of gestation. At 32 weeks, it has not yet ascended to this level. A fundal height at the xiphoid process at 32 weeks may suggest polyhydramnios, macrosomia, or multiple gestation, and would require further evaluation.

Choice D rationale:

At 16 weeks of gestation, the fundus is generally located halfway between the symphysis pubis and the umbilicus. By 32 weeks, the uterus has expanded well beyond this point. A fundal height at this level would be abnormally low for 32 weeks and could indicate fetal growth restriction or oligohydramnios.

Choice A rationale: Transient hypoglycemia is a common physiologic occurrence in term newborns during the first few hours after birth due to the abrupt cessation of maternal glucose supply. The newborn must transition to endogenous glucose production through glycogenolysis and gluconeogenesis. This transitional dip typically resolves with feeding and thermoregulation, making this statement scientifically accurate and reflective of normal neonatal adaptation.

Choice B rationale: Skin-to-skin contact enhances thermoregulation by reducing heat loss through conduction and evaporation. Maintaining a stable body temperature reduces metabolic demands and conserves glucose stores. Additionally, skin-to-skin contact promotes early breastfeeding, which provides exogenous glucose. These combined effects help stabilize neonatal blood glucose levels, making this an evidence-based intervention for hypoglycemia prevention and management.

Choice C rationale: Clamping the umbilical cord terminates the placental transfer of maternal glucose, which is the fetus’s primary energy source in utero. After birth, the newborn must rely on hepatic glycogen stores and initiate gluconeogenesis to maintain glucose homeostasis. This sudden metabolic shift can lead to transient hypoglycemia, especially in infants with increased glucose demands or limited glycogen reserves.

Choice D rationale: Persistent hypoglycemia, particularly glucose levels consistently below 50 mg/dL despite adequate feeding, may necessitate intravenous glucose administration to prevent neurologic injury. IV dextrose provides immediate correction of hypoglycemia when oral intake is insufficient or symptoms are severe. This intervention is especially critical in symptomatic infants or those at high risk, such as macrosomic newborns or infants of diabetic mothers.

Choice E rationale: The lower limit of normal blood glucose in neonates is generally considered to be 40 mg/dL in the first 4 hours and 45 mg/dL after that. However, stating that 40 to 45 mg/dL is the normal lower limit for up to 72 hours is imprecise. Glucose thresholds vary slightly by institution and age in hours, and levels should ideally rise above 50 mg/dL with feeding. Therefore, this statement lacks full accuracy.

Choice F rationale: Frequent breastfeeding provides a consistent source of glucose and stimulates endogenous insulin regulation. Early and effective feeding is the primary intervention for asymptomatic hypoglycemia in term infants. Breast milk contains lactose, which is metabolized into glucose and galactose, supporting energy needs. Therefore, this statement correctly reflects the role of frequent feeding in stabilizing neonatal glucose levels.