A patient is being discharged from the hospital after the evacuation of a molar pregnancy. The nurse recognizes that additional discharge teaching is required when the patient makes which statement?

"I don't need to see the doctor for another year when I will come back for follow-up

I will use contraception for the next year

I need to be monitored for choriocarcinoma during the next year

I am so sad that I lost this baby

Answer and Explanation

The Correct Answer is A

A. "I don't need to see the doctor for another year when I will come back for follow-up." This statement is incorrect because close follow-up is essential after a molar pregnancy to monitor for gestational trophoblastic disease (GTD) or choriocarcinoma. Regular hCG level monitoring is required weekly until levels are undetectable, then monthly for at least 6–12 months. Delaying follow-up for a year could lead to missed complications.

B. "I will use contraception for the next year." This statement is correct. Pregnancy should be avoided for at least one year after a molar pregnancy to ensure accurate monitoring of hCG levels. A rising hCG level could indicate malignant transformation rather than a new pregnancy.

C. "I need to be monitored for choriocarcinoma during the next year." This statement is correct. Choriocarcinoma is a potential complication of molar pregnancy, and early detection through serial hCG monitoring is crucial. Any persistent or rising hCG levels may indicate malignancy requiring chemotherapy.

D. "I am so sad that I lost this baby." This statement is understandable. A molar pregnancy is an emotionally distressing event, and feelings of grief and loss are valid. Emotional support, counseling, or support groups may be beneficial for the patient’s mental well-being.

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Correct Answer is A

Explanation

A. There is progressive resistance to the effects of insulin. During pregnancy, placental hormones (such as human placental lactogen, estrogen, and progesterone) cause increasing insulin resistance. This ensures that glucose remains available for fetal growth. However, in gestational diabetes, the pancreas cannot compensate with increased insulin production, leading to hyperglycemia.

B. Pregnancy fosters the development of carbohydrate cravings. While some pregnant individuals experience cravings, this is not a defining cause of gestational diabetes. The condition results from hormonal changes leading to insulin resistance, not dietary habits alone.

C. Hypoinsulinemia develops early in the first trimester. Gestational diabetes is not caused by a deficiency of insulin (hypoinsulinemia) but by insulin resistance. In fact, insulin production often increases, but it is insufficient to overcome the resistance caused by placental hormones.

D. Glucose levels decrease to accommodate fetal growth. In a normal pregnancy, glucose levels remain stable, and the fetus actively takes glucose from maternal circulation. However, in gestational diabetes, maternal glucose levels rise due to insulin resistance, increasing the risk of fetal overgrowth (macrosomia).

A. True B. False

Correct Answer is B

Explanation

While many women are able to get pregnant again after an ectopic pregnancy, it is not guaranteed. The ability to conceive again depends on various factors, such as:

The extent of damage to the fallopian tube.
Whether one or both tubes are still functional.
The treatment used (e.g., methotrexate vs. surgery).
Any underlying fertility issues.

It is important to be honest but reassuring, explaining that many women do go on to have healthy pregnancies, but future fertility can be affected and should be discussed with a healthcare provider. Saying she "absolutely will" get pregnant again is inaccurate and potentially misleading.

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A patient is being discharged from the hospital after the evacuation of a molar pregnancy. The nurse recognizes that additional discharge teaching is required when the patient makes which statement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse would include which of the following statements when describing the pathophysiology of gestational diabetes?

Correct Answer is A

Explanation

A woman is admitted due to a suspected ectopic pregnancy. While explaining treatment the patient asks if she will be able to get pregnant again. You answer that she absolutely will get pregnant again. Is this the correct thing to say?

Correct Answer is B

Explanation

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