A nurse is caring for a client who is at 23 weeks of gestation and has been unable to control her gestational diabetes mellitus with oral hypoglycemic therapy, diet and exercise. The nurse should anticipate a prescription from the provider for which of the following medications for the client?

Letrozole

Lactulose

Insulin

Metoprolol

Answer and Explanation

The Correct Answer is C

A. Letrozole: Letrozole is an aromatase inhibitor used for ovulation induction in clients with infertility. It is not used to manage gestational diabetes and would have no role in glucose regulation during pregnancy.

B. Lactulose: Lactulose is a laxative commonly used to treat constipation or hepatic encephalopathy. It has no glucose-lowering effects and is not appropriate for managing gestational diabetes mellitus.

C. Insulin: Insulin is the treatment of choice for gestational diabetes when diet, exercise, and oral agents fail to control blood glucose. It does not cross the placenta and allows precise glucose management, making it safe and effective during pregnancy.

D. Metoprolol: Metoprolol is a beta-blocker used to treat hypertension or certain cardiac conditions. It is not indicated for gestational diabetes and may affect glucose metabolism, especially at higher doses.

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Correct Answer is C

Explanation

A. "Perhaps you should see a counselor to discuss these feelings further.": Referring the client to counseling at this stage may be premature and imply that her feelings are abnormal. Early pregnancy ambivalence is a common emotional response and does not necessarily indicate a psychological problem.

B. "Have you spoken to your mother about these feelings?": While family support can be helpful, this response redirects the conversation instead of acknowledging the client’s emotional experience. It may also assume a supportive maternal relationship that might not exist.

C. "Ambivalent feelings are quite common for women early in pregnancy.": This response normalizes the client's emotional state and provides reassurance. It supports open communication and reflects an understanding of the common psychological adjustments experienced in early pregnancy.

D. "Don't worry. You will be fine once the baby is born.": This dismisses the client’s concerns and minimizes her current emotional experience. It can prevent further discussion and make the client feel misunderstood or unsupported.

A. Keep calcium gluconate readily available. B. Check urinary output every 2 hr. C. Check deep tendon reflexes every 1 hr. D. Provide intermittent fetal monitoring. E. Report respiratory rate of less than 12 breaths/min to the provider.

Correct Answer is ["A","C","E"]

Explanation

A. Keep calcium gluconate readily available: Magnesium sulfate can cause toxicity, including respiratory depression and cardiac arrest. Calcium gluconate is the antidote and must be available at the bedside in case of adverse effects. This is a critical safety measure during therapy.

B.Urinary output should be monitored hourly, not every 2 hours, because magnesium is excreted by the kidneys. Reduced urine output can quickly lead to magnesium accumulation and toxicity, so frequent monitoring is essential.

C. Check deep tendon reflexes every 1 hr: Loss of deep tendon reflexes is an early sign of magnesium toxicity. Hourly assessments help detect neuromuscular depression and guide dosage adjustments. Reflex monitoring is essential during magnesium infusion.

D. Provide intermittent fetal monitoring: This is inappropriate in the context of severe hypertension and magnesium sulfate administration. Continuous fetal monitoring is required to assess fetal well-being and detect signs of distress, especially in a high-risk situation.

E. Report respiratory rate of less than 12 breaths/min to the provider: Respiratory depression is a major sign of magnesium toxicity. A respiratory rate below 12 indicates central nervous system depression and requires immediate attention. Prompt reporting allows timely intervention to prevent complications.

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A nurse is caring for a client who is at 23 weeks of gestation and has been unable to control her gestational diabetes mellitus with oral hypoglycemic therapy, diet and exercise. The nurse should anticipate a prescription from the provider for which of the following medications for the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A nurse at an antepartum clinic is admitting a client who is at 30 weeks of gestation. Exhibits Which of the following actions should the nurse take after administering the prescribed medications? Select all that apply.

Correct Answer is ["A","C","E"]

Explanation

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