A nurse teaching a prenatal class is asked why infants of diabetic mothers are often larger than those born to women who do not have diabetes. On what information about pregnant women with diabetes should the nurse base the response?

Consuming more calories covers the insulin secreted by the fetus.

Fetal weight gain increases as a result of the common response of maternal overeating.

Extra circulating glucose causes the fetus to acquire fatty deposits.

Taking exogenous insulin stimulates fetal growth

Answer and Explanation

The Correct Answer is C

A. Consuming more calories covers the insulin secreted by the fetus. The fetus does not secrete insulin to regulate maternal glucose levels. Instead, the maternal pancreas produces insulin in response to blood sugar levels, but in diabetes, maternal insulin resistance leads to excess glucose being transferred to the fetus.

B. Fetal weight gain increases as a result of the common response of maternal overeating. While some women with diabetes may have increased caloric intake, this is not the primary reason for fetal macrosomia (large birth weight). The major factor is maternal hyperglycemia leading to excess fetal insulin production and fat deposition.

C. Extra circulating glucose causes the fetus to acquire fatty deposits. In diabetic pregnancies, excess maternal glucose crosses the placenta, leading to fetal hyperinsulinemia. The increased insulin promotes fat storage and excessive fetal growth, leading to macrosomia, which increases the risk of birth complications such as shoulder dystocia.

D. Taking exogenous insulin stimulates fetal growth. Insulin does not cross the placenta, so maternal insulin therapy does not directly affect fetal growth. Instead, fetal macrosomia results from prolonged exposure to maternal hyperglycemia, which causes the fetus to produce excessive insulin and store extra fat.

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Correct Answer is C

Explanation

A. Insert an internal fetal scalp electrode monitor. There is no indication for an internal fetal monitor, as the external monitoring shows a reassuring fetal heart rate pattern with moderate variability and no decelerations. Internal monitoring is typically used when external monitoring is inadequate or when fetal distress is suspected.

B. Contact the doctor at once and reposition the patient. There is no fetal distress or abnormal contraction pattern requiring immediate physician intervention. The fetal heart rate is within the normal range (110-160 bpm), and moderate variability indicates adequate oxygenation.

C. Document the finding in the patient's medical record. This is the correct action because the assessment findings indicate a well-oxygenated fetus and a normal labor progression. Contractions every 3-4 minutes lasting 60 seconds are within the expected range for oxytocin augmentation, and no abnormalities are present.

D. Discontinue the IV fluid containing Pitocin (oxytocin). There is no need to stop the oxytocin infusion, as the contraction pattern is appropriate, and there are no signs of uterine tachysystole or fetal distress.

A. Obtain equipment to start a 24-hour urine test on the patient. B. Obtain equipment for a manual pelvic exam. C. Prepare to draw blood for a hemoglobin and hematocrit. D. Obtain equipment for external electronic fetal heart rate monitoring. E. Prepare the patient for an ultrasound.

Correct Answer is ["C","D","E"]

Explanation

A. Obtain equipment to start a 24-hour urine test on the patient. A 24-hour urine test is not necessary for placenta previa. It is more commonly used for preeclampsia to assess proteinuria, which is unrelated to placenta previa.

B. Obtain equipment for a manual pelvic exam. A manual pelvic exam is contraindicated in placenta previa because it can cause further disruption of the placenta, leading to severe hemorrhage. Instead, diagnosis should be confirmed using ultrasound.

C. Prepare to draw blood for a hemoglobin and hematocrit. Hemoglobin and hematocrit levels must be monitored due to the risk of maternal hemorrhage in placenta previa. Significant blood loss can lead to anemia and may require blood transfusions.

D. Obtain equipment for external electronic fetal heart rate monitoring. Continuous fetal monitoring is essential in placenta previa to assess for signs of fetal distress. External monitoring is preferred to avoid vaginal examinations, which could worsen bleeding.

E. Prepare the patient for an ultrasound. Ultrasound is the diagnostic test of choice for placenta previa. It helps determine the exact location of the placenta and confirms whether it is covering the cervix. A transabdominal ultrasound is performed first, followed by a transvaginal ultrasound if necessary.

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A nurse teaching a prenatal class is asked why infants of diabetic mothers are often larger than those born to women who do not have diabetes. On what information about pregnant women with diabetes should the nurse base the response?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The nurse is preparing for the admission of a 30 weeks' gestation patient experiencing vaginal bleeding with a suspected diagnosis of placenta previa. In anticipating the patient's needs, which of the following would be most appropriate for the nurse to include? Select all that apply.

Correct Answer is ["C","D","E"]

Explanation

Professor Proctor: Always wants us to be safe while traveling anywhere- especially when coming to class. This is prioritized even over being on time.

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A nurse teaching a prenatal class is asked why infants of diabetic mothers are often larger than those born to women who do not have diabetes. On what information about pregnant women with diabetes should the nurse base the response?

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