A nurse is reinforcing teaching with a client who is at 15 weeks of gestation and is about to undergo an amniocentesis. The nurse should reinforce that this test can identify which of the following traits or problems? (Select all that apply.)

Cephalopelvic disproportion

Neural tube defects

Rh incompatibility

Fetal gender

Chromosome defects

Answer and Explanation

Correct Answer : B,C,D,E

Choice A rationale: Cephalopelvic disproportion is a condition where the baby's head is too large or the mother's pelvis is too small for a vaginal delivery. Amniocentesis does not provide information about this condition.
Choice B rationale: Amniocentesis can be used to detect neural tube defects such as spina bifida and anencephaly.
Choice C rationale: Rh incompatibility occurs when the mother is Rh-negative, and the fetus is Rh-positive. This can lead to hemolytic disease of the newborn (HDN) if untreated. While Rh incompatibility can be detected through blood tests (maternal blood), amniocentesis is typically not used to diagnose this condition.
Choice D rationale: Amniocentesis can be used to determine the fetal gender by analyzing the DNA in the amniotic fluid. This is not the primary purpose of amniocentesis, but it can certainly identify the gender, especially in cases where this information is needed for medical reasons, such as gender-linked genetic disorders.
Choice E rationale: Amniocentesis is commonly used to screen for chromosomal abnormalities such as Down syndrome (trisomy 21) and other genetic conditions.

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Correct Answer is A

Explanation

Choice A rationale:

Newborns of diabetic mothers are at risk of developing hypoglycemia (low blood sugar) after birth, especially if they are large for gestational age like the newborn in this scenario.
Choice B rationale:

Hypercalcemia (high blood calcium levels) is not a typical concern in newborns of diabetic mothers, and it is not directly related to the baby's size.
Choice C rationale:

Decreased REC (Respiratory Exchange Capacity) is not a common issue in this scenario, and it is not related to the baby's size or the mother's diabetes.

A. Schedule a 3-hour oral glucose tolerance test. B. Obtain an HbA1C C. Tell the client to increase carbohydrates to 65% of daily nutritional intake. D. Reinforce instruction about insulin administration.

Correct Answer is D

Explanation

Choice A rationale:
A 3-hour oral glucose tolerance test is typically done during the initial diagnosis of gestational diabetes, not for ongoing monitoring. Since the client is already diagnosed, this action is not necessary at this stage.
Choice B rationale:
Obtaining an HbA1C is not necessary in this situation. HbA1C provides information about average blood glucose levels over the past 2-3 months and is not specific to postprandial glucose levels.
Choice C rationale:
Telling the client to increase carbohydrates to 65% of daily nutritional intake would not be appropriate since the client already has elevated blood glucose levels. Reducing carbohydrate intake and focusing on a balanced diet are more appropriate for managing gestational diabetes.
Choice D rationale:
Given that the client's blood glucose levels after meals are consistently above the target range (generally <140 mg/dL for 1-hour post-meal), it indicates a need for better glycemic control, which may require insulin therapy.

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A nurse is reinforcing teaching with a client who is at 15 weeks of gestation and is about to undergo an amniocentesis. The nurse should reinforce that this test can identify which of the following traits or problems? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a newborn who weighs 5,160 g (11 lb, 6 oz) and whose mother has diabetes mellitus. For which of the following data should the nurse monitor?

Correct Answer is A

Explanation

A nurse is reviewing laboratory results from a client who is at 28 weeks of gestation and has gestational diabetes. The nurse notes that blood glucose levels taken 1 hour following a meal range from 145 mg/dL to 162 mg/dL over the past week. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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