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

Explanation

A. By subtracting 3 months from the first day of the client's last menstrual cycle and then adding 7 days and 1 year: This is Naegele's rule for estimating the due date: subtract 3 months from the first day of the last menstrual period (LMP), add 7 days, and then add 1 year.

B. By adding 3 months to the first day of the client's last menstrual cycle and then subtracting 7 days and 1 year: This reverses the correct order. You subtract 3 months, not add.

C. By subtracting 7 days from the first day of the client's last menstrual cycle and then adding 3 months and 1 year: This calculation incorrectly subtracts days instead of adding days.

D. By adding 7 days to the first day of the client's last menstrual cycle and then subtracting 3 months and 1 year: The rule adds days and subtracts months, but adding a year here is not correct. You add 1 year at the end.

A. "This test determines if kernicterus will occur in the newborn." B. "This test detects Rh-positive antibodies in the mother's blood." C. This test detects Rh-negative antibodies in a newborn who is Rh-positive." D. "This test determines the presence of maternal antibodies in the newborn's blood."

Correct Answer is B

Explanation

A. "This test determines if kernicterus will occur in the newborn." Kernicterus is caused by severe jaundice and bilirubin toxicity but is not directly predicted by the indirect Coombs test.

B. "This test detects Rh-positive antibodies in the mother's blood." The indirect Coombs test is used to detect Rh antibodies in the mother’s blood, which could indicate a risk of hemolytic disease of the newborn if the fetus is Rh-positive.

C. "This test detects Rh-negative antibodies in a newborn who is Rh-positive." This describes the direct Coombs test, which checks for antibodies attached to the newborn’s red blood cells.

D. "This test determines the presence of maternal antibodies in the newborn's blood." The indirect Coombs test is used to detect antibodies in the maternal blood, not in the newborn's blood.

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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

How is the estimated due date in pregnancy calculated?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a newly licensed nurse about the purpose of an indirect Coombs test. Which of the following statements should the nurse include in the teaching?

Correct Answer is B

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