A nurse is reinforcing teaching with a client who has gestational diabetes mellitus.
Which of the following statements by the client indicates an understanding of the teaching?

“My baby will be monitored for hypoglycemia after birth.”

“I will check my blood glucose once every 8 hours.”

“My baby is at risk for being underweight at birth.”

“I should ensure that only 5 percent of my daily calories come from protein sources.”

Answer and Explanation

The Correct Answer is A

This statement indicates an understanding of the teaching because babies born to mothers with gestational diabetes mellitus (GDM) are at risk for low blood sugar (hypoglycemia) after birth due to high insulin levels.

Choice B is wrong because a client who has GDM should check their blood glucose more frequently than once every 8 hours. The American Diabetes Association recommends checking blood glucose levels before meals and one hour after the start of each meal.

Choice C is wrong because a baby born to a mother with GDM is at risk for being overweight (macrosomia) at birth, not underweight. This can lead to complications such as shoulder dystocia, birth trauma, and cesarean delivery.

Choice D is wrong because a client who has GDM should ensure that about 15 to 20 percent of their daily calories come from protein sources, not 5 percent. Protein helps regulate blood glucose levels and supports fetal growth.

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Correct Answer is C

Explanation

This is a manifestation of a fat embolism, which is a condition where particles of fat get into the bloodstream and block blood flow. A fat embolism can occur after trauma or surgery to the legs, when fat from the bone marrow escapes into the bloodstream.

Choice A is wrong because a report of pain as 6 on a scale of 0 to 10 is not specific to a fat embolism.

Pain is a common symptom of many conditions and injuries.

Choice B is wrong because pulses 2+ distal to the client’s fracture are normal and indicate adequate blood flow to the extremity.

Choice D is wrong because bruising around the fracture site is an expected finding after a compound fracture and does not indicate a fat embolism.

Normal ranges for blood pressure are 90/60 mmHg to 120/80 mmHg and for heart rate are 60 to 100 beats per minute.

Petechiae are small red or purple spots on the skin caused by bleeding under the skin.

They can range in size from pinpoint to several millimeters. Fat embolism syndrome (FES) is a serious complication of a fat embolism that affects the lungs, skin or brain and can be fatal. FES usually occurs 12 to 72 hours after trauma.

A. An HbA1c value greater than 8% indicates diabetic control of blood sugar. B. The HbA1c value is altered by eating habits the day before the test. C. The HbA1c value determines long-term blood glucose control for the past 120 days. D. An HbA1c test is performed once per year.

Correct Answer is C

Explanation

The HbA1c value determines long-term blood glucose control for the past 120 days. This is because the HbA1c test measures what percentage of hemoglobin proteins in your blood are coated with sugar (glycated). Hemoglobin proteins in red blood cells live for around 120 days, so the test reflects your average blood sugar level for the past two to three months.

Choice A is wrong because an HbA1c value greater than 8% indicates poor diabetic control of blood sugar. The HbA1c target for most people with type 1 diabetes is 48 mmol/mol (or 6.5%) or lower.

Choice B is wrong because the HbA1c value is not altered by eating habits the day before the test. The test does not require fasting and can be done at any time of the day.

Choice D is wrong because an HbA1c test should be performed more than once per year.

The frequency of the test depends on the type of diabetes, your treatment plan and your blood sugar level. For example, you may need the test twice a year if you have good blood sugar control, or four times a year if you take insulin or have trouble keeping your blood sugar level within your target range.

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A nurse is reinforcing teaching with a client who has gestational diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

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A nurse is reinforcing teaching with a client who has gestational diabetes mellitus.
Which of the following statements by the client indicates an understanding of the teaching?