A nurse is preparing to perform the glucose tolerance test for a pregnant client.
Which of the following statements by the client indicates a need for further clarification?
"I should not eat or drink anything after midnight.".
"I will need to have blood drawn at fasting and after drinking the sugary drink.".
"The sugary drink may taste sweet and cause some temporary discomfort.".
"I will be required to stay in the clinic for several hours during the test.".
The Correct Answer is D
The correct answer is choice D. “I will be required to stay in the clinic for several hours during the test.” This statement indicates a need for further clarification because the glucose tolerance test for a pregnant client usually takes 1 hour, not several hours. The client should be informed that she will need to have blood drawn at fasting and 1 hour after drinking the sugary drink.
Choice A is wrong because it is correct that the client should not eat or drink anything after midnight before the test.
Choice B is wrong because it is correct that the client will need to have blood drawn at fasting and after drinking the sugary drink.
Choice C is wrong because it is correct that the sugary drink may taste sweet and cause some temporary discomfort.
The normal range for blood glucose level after a 1-hour glucose tolerance test is less than 140 mg/dL. A blood glucose level of 130 to 140 mg/dL is considered a positive screening and requires a 3-hour glucose tolerance test to confirm gestational diabetes mellitus.
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Correct Answer is C
Explanation
The correct answer is choice C. Glucose tolerance test at 24 to 28 weeks of gestation.This is the recommended screening test for gestational diabetes mellitus (GDM) for women who have no risk factors.
The test involves measuring the blood glucose level one hour after ingesting a 50-gram glucose load.If the result is abnormal (greater than 140 mg/dL), a diagnostic three-hour oral glucose tolerance test (OGTT) is performed.
Choice A is wrong because fasting blood glucose test is not a screening test for GDM, but a diagnostic test that requires an overnight fast and measures the blood glucose level before eating.
It is usually done as part of the OGTT.
Choice B is wrong because random blood glucose test is not a reliable screening test for GDM, as it does not account for the timing and content of the last meal.
Choice D is wrong because hemoglobin A1c test is not a screening test for GDM, but a test that measures the average blood glucose level over the past two to three months.It is used to monitor the glycemic control of women with preexisting diabetes mellitus during pregnancy.
Correct Answer is B
Explanation
The correct answer is choice B. Impaired glucose tolerance.This means that the blood sugar levels are higher than normal, but not high enough to diagnose gestational diabetes.The normal ranges for the glucose tolerance test for gestational diabetes are:
• Fasting blood sugar level: less than 95 mg/dL (5.3 mmol/L)
• 1-hour level: less than 180 mg/dL (10 mmol/L)
• 2-hour level: less than 155 mg/dL (8.6 mmol/L)
The client’s fasting blood sugar level was within the normal range, but the 1-hour and 2-hour levels were above the normal range, indicating impaired glucose tolerance.
Choice A is wrong because normal glucose tolerance means that the blood sugar levels are within the normal range for all three measurements.
Choice C is wrong because gestational diabetes means that the blood sugar levels are above the diagnostic threshold for all three measurements:
• Fasting blood sugar level: 92 mg/dL (5.1 mmol/L) or higher
• 1-hour level: 180 mg/dL (10 mmol/L) or higher
• 2-hour level: 153 mg/dL (8.5 mmol/L) or higher
Choice D is wrong because pre-existing diabetes means that the blood sugar levels are above the diagnostic threshold for diabetes before pregnancy:
• Fasting blood sugar level: 126 mg/dL (7 mmol/L) or higher
• Random blood sugar level: 200 mg/dL (11.1 mmol/L) or higher
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