A pregnant client at 28 weeks has been diagnosed with gestational diabetes. Which statement by the client indicates a need for further teaching?

"I may need insulin if diet alone doesn't control my levels."

"I will monitor my blood sugar as instructed."

"My baby could grow larger than normal if my blood sugar stays high."

"Since this only happens during pregnancy, I don't need follow-up after delivery."

Answer and Explanation

The Correct Answer is D

A. This statement is accurate. Some clients with gestational diabetes may require insulin therapy if dietary modifications and lifestyle changes do not adequately control blood glucose levels. This demonstrates understanding of treatment options.

B. Monitoring blood sugar as instructed is correct and essential. Self-monitoring of blood glucose helps manage gestational diabetes effectively and reduces maternal and fetal complications.

C. This statement is also correct. Poorly controlled gestational diabetes can result in macrosomia (larger than normal fetal size), which increases the risk of birth trauma and complications during delivery.

D. This statement is incorrect and indicates a need for further teaching. While gestational diabetes typically resolves after delivery, clients are at increased risk of developing type 2 diabetes later in life. Follow-up postpartum screening, usually 6–12 weeks after delivery, is essential to monitor glucose levels and provide early intervention if needed. Ignoring follow-up care could delay detection of persistent hyperglycemia or future diabetes risk.

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Correct Answer is C

Explanation

A. Ultrasound can help identify certain fetal anomalies, including neural tube defects such as spina bifida, but this is not the primary purpose of performing an ultrasound immediately prior to an amniocentesis. Its main role at this stage is procedural guidance, not screening.

B. Estimating fetal age using ultrasound is most accurate in the first trimester. By 36 weeks, gestational age is generally already known, and ultrasound at this point is not primarily used for dating.

C. Ultrasound prior to amniocentesis is used to determine the precise location of the placenta, fetus, and amniotic fluid pockets. This ensures that the provider can safely insert the needle into the amniotic sac without injuring the fetus or placenta, minimizing procedural risks such as fetal trauma, placental puncture, or leakage of amniotic fluid. This is the most critical and appropriate explanation for the client at 36 weeks.

D. While ultrasound can detect multiple fetuses, this information is typically established earlier in pregnancy. By 36 weeks, the presence of more than one fetus is already known, so this is not the primary reason for pre-amniocentesis ultrasound.

A. The affected arm should not be elevated. B. The affected arm should be used for intravenous (IV) therapy. C. Venipuncture for blood work should be performed on the affected arm. D. The blood pressure (BP) cuff should not be applied to the affected arm.

Correct Answer is D

Explanation

A. The affected arm should be elevated on a pillow postoperatively to promote venous and lymphatic drainage, reduce swelling, and prevent lymphedema. Elevation is a critical part of early recovery, and avoiding it would increase the risk of fluid accumulation and discomfort.

B. The affected arm should not be used for IV therapy because lymphatic drainage may have been compromised during the mastectomy. Introducing an IV or performing invasive procedures on this arm increases the risk of infection, impaired healing, and lymphedema, a potentially long-term complication.

C. Venipuncture or blood draws should also avoid the affected arm. Puncturing veins in this limb can lead to fluid accumulation, swelling, infection, and delayed healing. Bloodwork and injections should be performed on the unaffected arm or an alternate site to reduce these risks.

D. The blood pressure cuff should not be applied to the affected arm because repeated compression can impede lymphatic flow and increase the risk of lymphedema. The cuff should always be used on the unaffected arm, and if necessary, alternative methods for monitoring blood pressure (such as a thigh cuff) can be employed. This intervention is a standard precaution immediately after mastectomy and is emphasized during patient education to prevent long-term complications.

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A pregnant client at 28 weeks has been diagnosed with gestational diabetes. Which statement by the client indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure. Which of the following is an appropriate response by the nurse?

Correct Answer is C

Explanation

When educating a group of postoperative clients who underwent a mastectomy, which immediate postoperative intervention is important for the nurse to consider when caring for these women?

Correct Answer is D

Explanation

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