A nurse is evaluating the outcomes of care for a pregnant woman who has gestational diabetes and received insulin therapy during pregnancy.

Which of the following findings indicates that the insulin therapy was effective?

The woman had normal blood pressure and urine protein levels throughout pregnancy

The woman delivered a healthy baby who weighed 3 kg (6.6 lb) at birth.

The woman had no episodes of hypoglycemia or hyperglycemia during pregnancy

The woman's blood glucose levels returned to normal within six weeks after delivery.

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. The woman delivered a healthy baby who weighed 3 kg (6.6 lb) at birth. This indicates that the insulin therapy was effective in preventing macrosomia, which is a common complication of gestational diabetes mellitus (GDM) . Macrosomia is defined as a birth weight above the 90th percentile for gestational age or above 4 kg (8.8 lb) . Macrosomia increases the risk of birth trauma, shoulder dystocia, cesarean section, and neonatal hypoglycemia .

Choice A is wrong because normal blood pressure and urine protein levels throughout pregnancy are not specific indicators of insulin therapy effectiveness. They are more related to the prevention of pre-eclampsia, which is a separate complication of pregnancy that can affect women with or without GDM .

Choice C is wrong because having no episodes of hypoglycemia or hyperglycemia during pregnancy is not sufficient to indicate insulin therapy

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Correct Answer is D

Explanation

The nurse should tell the woman to wash her hands with soap and water before testing, prick the side of her fingertip with a lancet, and apply gentle pressure to the puncture site until a drop of blood forms.These steps are necessary to ensure a clean and adequate blood sample for the glucose meter.

Choice A is wrong because washing hands with soap and water is not enough.The woman should also dry her hands thoroughly to avoid diluting the blood sample.

Choice B is wrong because pricking the side of the fingertip with a lancet is not enough.The woman should also avoid squeezing the finger too hard, as this can affect the accuracy of the result.

Choice C is wrong because applying gentle pressure to the puncture site until a drop of blood forms is not enough.The woman should also wipe away the first drop of blood with a clean tissue and use the second drop for testing.

Normal ranges for blood glucose levels during pregnancy are 60 to 105 mg/dL before meals and less than 120 mg/dL one hour after meals.

The woman should report any abnormal readings to her health care provider.

A. Elevated fasting blood glucose levels B. Decreased postprandial blood glucose levels C. Elevated serum insulin levels. D. Decreased glycosylated hemoglobin levels

Correct Answer is A

Explanation

The correct answer is

A. Elevated fasting blood glucose levels.

Gestational diabetes (GDM) is a condition where the blood sugar levels are higher than normal during pregnancy.

It can affect the health of the mother and the baby if not well controlled.GDM usually goes away after delivery, but it can increase the risk of developing type 2 diabetes later in life.

A. Elevated fasting blood glucose levels.

This statement is true.

Fasting blood glucose levels are the levels of glucose in the blood after not eating or drinking anything except water for at least 8 hours.

Normal fasting blood glucose levels are between 70 and 100 mg/dL (3.9 and 5.6 mmol/L).

In GDM, the fasting blood glucose levels are higher than normal, usually above 95 mg/dL (5.3 mmol/L).This indicates that the body is not able to use insulin effectively to lower the blood sugar levels.

B. Decreased postprandial blood glucose levels.

This statement is false.

Postprandial blood glucose levels are the levels of glucose in the blood after eating a meal or a snack.

Normal postprandial blood glucose levels are below 140 mg/dL (7.8 mmol/L) within 2 hours of eating.

In GDM, the postprandial blood glucose levels are higher than normal, usually above 140 mg/dL (7.8 mmol/L) within 1 hour or above 120 mg/dL (6.7 mmol/L) within 2 hours of eating.This indicates that the body is not able to use insulin effectively to lower the blood sugar levels after a meal.

C. Elevated serum insulin levels.

This statement is false.

Serum insulin levels are the levels of insulin in the blood.

Insulin is a hormone that helps the cells to take up glucose from the blood for energy or storage.

Normal serum insulin levels vary depending on the time of day, the type of food eaten, and other factors.

In GDM, the serum insulin levels are not necessarily elevated, but they may be insufficient to overcome the insulin resistance caused by hormonal changes during pregnancy.Insulin resistance is a condition where the cells do not respond well to insulin and require more insulin to lower the blood sugar levels.

D. Decreased glycosylated hemoglobin levels.

This statement is false.

Glycosylated hemoglobin (HbA1c) is a measure of how much glucose is attached to hemoglobin, a protein in red blood cells that carries oxygen.

HbA1c reflects the average blood sugar levels over the past 2 to 3 months.

Normal HbA1c levels are below 5.7%.

In GDM, the HbA1c levels are not necessarily decreased, but they may be within or slightly above the normal range, depending on how well the blood sugar levels are controlled during pregnancy.HbA1c is not a reliable test for diagnosing GDM, as it may not reflect the recent changes in blood sugar levels caused by pregnancy.

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A nurse is evaluating the outcomes of care for a pregnant woman who has gestational diabetes and received insulin therapy during pregnancy. Which of the following findings indicates that the insulin therapy was effective?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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A nurse is evaluating the outcomes of care for a pregnant woman who has gestational diabetes and received insulin therapy during pregnancy.

Which of the following findings indicates that the insulin therapy was effective?