A pregnant client has just completed the glucose tolerance test for gestational diabetes.

The nurse reviews the client's blood sugar level results.

The fasting blood sugar level was 95 mg/dL, the 1-hour level was 175 mg/dL, and the 2-hour level was 145 mg/dL.

Based on these results, the nurse would interpret them as indicating:.

Normal glucose tolerance

Impaired glucose tolerance

Gestational diabetes

Pre-existing diabetes

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Impaired glucose tolerance. This means that the blood sugar levels are higher than normal, but not high enough to diagnose gestational diabetes. The normal ranges for the glucose tolerance test for gestational diabetes are:

• Fasting blood sugar level: less than 95 mg/dL (5.3 mmol/L)

• 1-hour level: less than 180 mg/dL (10 mmol/L)

• 2-hour level: less than 155 mg/dL (8.6 mmol/L)

The client’s fasting blood sugar level was within the normal range, but the 1-hour and 2-hour levels were above the normal range, indicating impaired glucose tolerance.

Choice A is wrong because normal glucose tolerance means that the blood sugar levels are within the normal range for all three measurements.

Choice C is wrong because gestational diabetes means that the blood sugar levels are above the diagnostic threshold for all three measurements:

• Fasting blood sugar level: 92 mg/dL (5.1 mmol/L) or higher

• 1-hour level: 180 mg/dL (10 mmol/L) or higher

• 2-hour level: 153 mg/dL (8.5 mmol/L) or higher

Choice D is wrong because pre-existing diabetes means that the blood sugar levels are above the diagnostic threshold for diabetes before pregnancy:

• Fasting blood sugar level: 126 mg/dL (7 mmol/L) or higher

• Random blood sugar level: 200 mg/dL (11.1 mmol/L) or higher

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Correct Answer is B

Explanation

The correct answer is choice B.“I can drink water during the test to stay hydrated.” This statement indicates an understanding of the procedure because water does not affect the blood glucose level and can help prevent dehydration during the test.

Choice A is wrong because “I should avoid any high-sugar foods for a week before the test.” This statement is incorrect because the client only needs to avoid eating or drinking anything except water for at least eight hours before the test.

Avoiding high-sugar foods for a week before the test is unnecessary and may alter the results.

Choice C is wrong because “I need to fast for 12 hours before the test.” This statement is incorrect because the client only needs to fast for eight hours before the test.

Fasting for longer than eight hours may cause hypoglycemia (low blood sugar) or ketosis (high levels of ketones in the blood).

Choice D is wrong because “I should avoid physical activity on the day of the test.” This statement is incorrect because moderate physical activity does not affect the blood glucose level and may help reduce stress during the test.

However, strenuous exercise should be avoided as it may lower the blood glucose level too much.

Normal ranges for blood glucose levels during the glucose tolerance test are:

• Fasting: less than 5.3 mmol/L (95 mg/dL)

• One hour: less than 10.0 mmol/L (180 mg/dL)

• Two hours: less than 8.6 mmol/L (155 mg/dL)

A. Fasting blood glucose test at 16 weeks of gestation B. Random blood glucose test at 20 weeks of gestation C. Glucose tolerance test at 24 to 28 weeks of gestation D. Hemoglobin A1c test at 32 weeks of gestation

Correct Answer is C

Explanation

The correct answer is choice C. Glucose tolerance test at 24 to 28 weeks of gestation.This is the recommended screening test for gestational diabetes mellitus (GDM) for women who have no risk factors.

The test involves measuring the blood glucose level one hour after ingesting a 50-gram glucose load.If the result is abnormal (greater than 140 mg/dL), a diagnostic three-hour oral glucose tolerance test (OGTT) is performed.

Choice A is wrong because fasting blood glucose test is not a screening test for GDM, but a diagnostic test that requires an overnight fast and measures the blood glucose level before eating.

It is usually done as part of the OGTT.

Choice B is wrong because random blood glucose test is not a reliable screening test for GDM, as it does not account for the timing and content of the last meal.

Choice D is wrong because hemoglobin A1c test is not a screening test for GDM, but a test that measures the average blood glucose level over the past two to three months.It is used to monitor the glycemic control of women with preexisting diabetes mellitus during pregnancy.

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Naxlex Comprehensive Predictor Exams

A client is scheduled to undergo the glucose tolerance test for gestational diabetes screening. The nurse provides instructions to the client. Which statement by the client indicates an understanding of the procedure?

Correct Answer is B

Explanation

A nurse is reviewing the antenatal care plan for a pregnant woman who has no risk factors for gestational diabetes. The nurse should expect the woman to have which of the following tests to screen for gestational diabetes?

Correct Answer is C

Explanation

A nurse is preparing to perform the glucose tolerance test for a pregnant client. Which of the following statements by the client indicates a need for further clarification?