A nurse in a prenatal clinic is teaching a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching?
"I know I am at increased risk to develop type 2 diabetes."
"I will take my glyburide daily with breakfast."
"I will reduce my exercise schedule to 3 days a week."
"I should limit my carbohydrates to 50% of caloric intake."
The Correct Answer is C
Choice A reason: "I know I am at increased risk to develop type 2 diabetes." is a correct statement, because it indicates that the client understands the long-term implications of gestational diabetes. The client should be aware that gestational diabetes increases the risk of developing type 2 diabetes later in life, and that she should have regular screening and follow-up.
Choice B reason: "I will take my glyburide daily with breakfast." is a correct statement, because it indicates that the client understands the medication regimen for gestational diabetes. The client should take glyburide, a sulfonylurea that lowers blood glucose levels, as prescribed by the provider, and monitor her blood glucose levels before and after meals.
Choice C reason: "I will reduce my exercise schedule to 3 days a week." is an incorrect statement, because it indicates that the client does not understand the importance of physical activity for gestational diabetes. The client should exercise at least 30 minutes a day, 5 days a week, unless contraindicated by the provider. Exercise can help improve insulin sensitivity, lower blood glucose levels, and prevent excessive weight gain.
Choice D reason: "I should limit my carbohydrates to 50% of caloric intake." is a correct statement, because it indicates that the client understands the dietary guidelines for gestational diabetes. The client should consume a balanced diet that provides adequate but not excessive amounts of carbohydrates, protein, and fat, and that is consistent in carbohydrate intake throughout the day.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Prostaglandin E2 is not an appropriate medication for the client, because it is a uterotonic agent that stimulates uterine contractions and cervical ripening. Prostaglandin E2 is used to induce labor, not to stop it.
Choice B reason: Methylergonovine is not an appropriate medication for the client, because it is a uterotonic agent that causes sustained uterine contractions and vasoconstriction. Methylergonovine is used to prevent or treat postpartum hemorrhage, not to stop preterm labor.
Choice C reason: Terbutaline is an appropriate medication for the client, because it is a tocolytic agent that relaxes the uterine smooth muscle and inhibits contractions. Terbutaline is used to delay preterm labor and prolong pregnancy.
Choice D reason: Oxytocin is not an appropriate medication for the client, because it is a uterotonic agent that stimulates uterine contractions and milk ejection. Oxytocin is used to augment labor, not to stop it.
Correct Answer is C
Explanation
Choice A reason: Monitoring the newborn's blood pressure is not the most appropriate action, as it is not directly related to the signs of diaphoresis, jitteriness, and lethargy. These signs are more indicative of hypoglycemia, which is a low blood sugar level that can affect newborns, especially those who are premature, small for gestational age, or have diabetic mothers.
Choice B reason: Initiating phototherapy is not the most appropriate action, as it is used to treat hyperbilirubinemia, which is a high level of bilirubin in the blood that can cause jaundice, a yellowish discoloration of the skin and eyes. Hyperbilirubinemia does not cause diaphoresis, jitteriness, or lethargy.
Choice C reason: Obtaining blood glucose by heel stick is the most appropriate action, as it can confirm the diagnosis of hypoglycemia, which is the most likely cause of the signs of diaphoresis, jitteriness, and lethargy. The nurse should perform a heel stick using a sterile lancet and a glucose meter, and obtain a blood sample from the lateral aspect of the heel. The nurse should also provide warmth, stimulation, and feeding to the newborn, and report the blood glucose level to the provider.
Choice D reason: Placing the newborn in a radiant warmer is not the most appropriate action, as it can cause dehydration, fluid loss, and further hypoglycemia. The nurse should use a radiant warmer only if the newborn is hypothermic, which is a low body temperature that can also affect newborns. The nurse should monitor the newborn's temperature and skin color, and adjust the warmer accordingly.
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