A nurse is caring for a client who is pregnant.
Exhibits

Select the 3 actions that the nurse should plan to take

Encourage the client to limit carbohydrate intake to 40% of their daily calories.

Instruct the client to check a random blood glucose level once daily

Anticipate a prescription for metformin.

Conduct a non-stress test twice per week.

Answer and Explanation

Correct Answer : A,C,D

A. Encourage the client to limit carbohydrate intake to 40% of their daily calories. For clients with gestational diabetes, dietary modifications are a critical intervention. Limiting carbohydrate intake to 40% of daily calories can help regulate blood glucose levels.

B. Instruct the client to check a random blood glucose level once daily. The client should check fasting and postprandial blood glucose levels regularly (usually multiple times per day) to manage glucose control more effectively.

C. Anticipate a prescription for metformin. Given the elevated fasting blood glucose levels and high HbA1C (12%), this client may require pharmacological management to control blood sugar levels. Metformin is a common oral hypoglycemic agent used during pregnancy when diet and lifestyle changes are insufficient.

D. Conduct a non-stress test twice per week. Clients with uncontrolled gestational diabetes or poorly controlled blood sugar levels are at increased risk of fetal complications such as macrosomia, stillbirth, and preterm labor. A non-stress test (NST) twice a week helps monitor fetal well-being and detect early signs of distress.

E. Tell the client to refrain from exercise until after delivery. Exercise is generally recommended for clients with gestational diabetes unless contraindicated. Regular physical activity can help lower blood glucose levels and improve insulin sensitivity.

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

Explanation

A. Chromosome defects: Amniocentesis can detect chromosomal abnormalities, such as Down syndrome (trisomy 21).

B. Fetal gender: Amniocentesis can identify the gender of the fetus by analyzing the fetal cells obtained from the amniotic fluid.

C. Neural tube defects: Amniocentesis can detect neural tube defects such as spina bifida by measuring the levels of alpha-fetoprotein (AFP) in the amniotic fluid.

D. Cephalopelvic disproportion: Cephalopelvic disproportion (CPD) is a mechanical issue that occurs during labor, where the fetal head is too large to fit through the mother's pelvis. It cannot be diagnosed with an amniocentesis.

E. Rh incompatibility: Rh incompatibility is diagnosed through blood tests, not amniocentesis. However, amniocentesis can be used in cases of severe Rh incompatibility to assess the fetus’s condition.

A. February 11 B. April 27 C. February 27 D. April 11

Correct Answer is A

Explanation

A. February 11:

The first day of the client’s last menstrual period is May 4.

Subtract 3 months: May → April → March → February.
Add 7 days: 4 + 7 = 11.
The EDD is February 11.

B. April 27: This date is beyond 40 weeks of pregnancy. Using Naegele's rule correctly should result in a February due date, not an April date.

C. February 27: While February is the correct month, this date does not align with Naegele’s Rule because the addition of 7 days to May 4 results in February 11, not February 27.

D. April 11: April 11 places the due date in the wrong month. This choice may result from adding 7 days without adjusting the months correctly when subtracting 3 months.

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A nurse is caring for a client who is pregnant. Exhibits Select the 3 actions that the nurse should plan to take

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who is at 15 weeks of gestation and is about to undergo an amniocentesis. The nurse should reinforce that this test can identify which of the following traits or problems? (Select all that apply.)

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

Explanation

A nurse in a prenatal clinic is determining a client’s estimated date of delivery using Naegels rule. The first day of her last menstrual period was May 4. Which of the following dates should the nurse tell the client is her estimated date of delivery?

Correct Answer is A

Explanation

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A nurse is caring for a client who is pregnant.
Exhibits

Select the 3 actions that the nurse should plan to take