A nurse is providing care for a pregnant patient.

The patient’s medical history includes Gravida 4 Para 3, 32 weeks of gestation, and a BMI of 32. The patient has a history of two newborns weighing over 4.5 kg (10 lb) and a family history of type one diabetes mellitus (maternal). The fetal heart tones are 140/min via doppler.

Which of the following provider prescriptions should the nurse plan to implement? Select the three actions the nurse should plan to take.

Conduct a non-stress test twice per week.

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

Instruct the patient to check a random blood glucose level once daily.

Anticipate a prescription for metformin.

Answer and Explanation

Correct Answer : A,B,D

Choice A rationale

A nonstress test (NST) is a test during pregnancy that measures the baby’s heart rate and response to movement. It is designed to ensure the baby is doing well and getting enough oxygen. Your provider might order it during the third trimester if you’re experiencing certain complications.

Choice B rationale

During pregnancy, women need nutrient-rich sources of carbohydrate, in the right amounts. Restriction of simple carbohydrates has been shown to reduce postprandial hyperglycemia, fetal glucose exposure, and fetal overgrowth. Therefore, encouraging the patient to limit carbohydrate intake to 40% of their daily calories could be beneficial.

Choice C rationale

Checking a random blood glucose level once daily is not typically recommended during pregnancy. Instead, blood glucose levels are usually checked at specific times, such as fasting (before breakfast), before other meals, and 1 hour after meals. This helps to provide more accurate information about how the body is managing blood glucose levels throughout the day.

Choice D rationale

Metformin is generally considered safe for use during pregnancy. It can also be used to treat women with gestational diabetes mellitus (diabetes that develops during pregnancy)7. Given the patient’s history and risk factors, it would be reasonable to anticipate a prescription for metformin.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A rationale

Betamethasone does not increase the fetal heart rate. It is a corticosteroid given to pregnant women who are at risk of preterm delivery to enhance fetal lung maturity and prevent respiratory distress syndrome.

Choice B rationale

Betamethasone is not used to stop preterm labor contractions. Other medications, such as tocolytics, are used for this purpose.

Choice C rationale

This is the correct answer. Betamethasone is given to promote fetal lung maturity. It is usually given in two doses, 24 hours apart, and takes effect within 24 hours of administration.

Choice D rationale

Betamethasone does not halt cervical dilation. It is given to enhance fetal lung maturity, not to stop labor.

A. Chadwick’s sign. B. Chvostek’s sign. C. Goodell’s sign. D. Cullen’s sign.

Correct Answer is D

Explanation

Choice A rationale

Chadwick’s sign is a bluish discoloration of the cervix, vagina, and labia resulting from increased blood flow. This sign is commonly seen in early pregnancy, but it does not indicate the presence of blood in the peritoneum.

Choice B rationale

Chvostek’s sign is a clinical sign of existing nerve hyperexcitability seen in hypocalcemia. It refers to an abnormal reaction to the stimulation of the facial nerve. This sign is not related to a ruptured ectopic pregnancy.

Choice C rationale

Goodell’s sign is a significant softening of the vaginal portion of the cervix from increased vascularization. This vascular softening is seen in early pregnancy. It does not indicate the presence of blood in the peritoneum.

Choice D rationale

Cullen’s sign is the appearance of bruising in the skin around the umbilicus. It occurs when there is blood in the peritoneum, or intra-abdominal bleeding. In the case of a suspected ruptured ectopic pregnancy, Cullen’s sign would indicate the presence of blood in the peritoneum.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who is at 30 weeks of gestation and is in preterm labor. The client has a new prescription for betamethasone and asks the nurse about the purpose of this medication. Which of the following explanations should the nurse provide?

Correct Answer is C

Explanation

Choice B rationale

Choice C rationale

Choice D rationale

Correct Answer is D

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

A nurse is caring for a client during the first trimester of pregnancy. After reviewing the client’s blood work, the nurse notices she does not have immunity to rubella. When should the nurse understand is the recommended time for rubella immunization?

A nurse is attending to a client who is receiving opioid epidural analgesia during labor. Which of the following observations should the nurse prioritize?

A nurse is caring for a client who is 2 days postpartum, is breastfeeding, and reports nipple soreness. Which of the following measures should the nurse suggest to reduce discomfort during breastfeeding? (Select all that apply.)

A nurse is preparing to assess a newborn who is postmature. Which of the following findings should the nurse expect?

A nurse is caring for a newborn immediately after birth. Once a patent airway has been ensured, what should be the nurse’s priority action?

A nurse is caring for a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagina. Which of the following actions should the nurse perform first?

A nurse is caring for a client who is in active labor and notes late decelerations in the FHR. Which of the following actions should the nurse take first?