A woman who is 26 weeks pregnant has just found out that she has gestational diabetes. Which of the following therapies will most likely be ordered first for this patient?

Oral hypoglycemic medications

Diet control and exercise

Inhaled insulin

Regular insulin injections

Answer and Explanation

The Correct Answer is B

A. Oral hypoglycemic medications. While some oral hypoglycemic agents, such as metformin or glyburide, are used in gestational diabetes, the first-line treatment is always dietary modification and exercise. Medications are only introduced if blood glucose levels remain uncontrolled with lifestyle changes.

B. Diet control and exercise. The initial treatment for gestational diabetes focuses on controlling blood glucose through dietary adjustments, portion control, and regular physical activity. If lifestyle modifications fail to maintain glucose levels within the target range, insulin or oral medications may be introduced.

C. Inhaled insulin. Inhaled insulin is not commonly used in pregnancy because its safety and efficacy for gestational diabetes have not been well established. Insulin therapy, if needed, is typically administered via subcutaneous injection rather than inhalation.

D. Regular insulin injections. Insulin therapy is considered if diet and exercise alone fail to control blood glucose levels. However, it is not the first-line treatment, as many women can successfully manage gestational diabetes without requiring insulin therapy.

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Correct Answer is B

Explanation

A. Eclampsia. Eclampsia is characterized by seizures in a patient with preeclampsia, but it does not cause dark red vaginal bleeding, a tense abdomen, or increased contraction frequency. While eclampsia is a serious complication, the symptoms described are more indicative of placental abruption.

B. Abruptio placentae. Abruptio placentae (placental abruption) occurs when the placenta prematurely separates from the uterine wall, causing painful, dark red vaginal bleeding, frequent contractions, and a tense, rigid uterus (uterine hypertonicity). This is a medical emergency because it can lead to severe fetal distress, maternal hemorrhage, and disseminated intravascular coagulation (DIC).

C. Rupture of the uterus. Uterine rupture presents with sudden, severe abdominal pain, loss of fetal station, and fetal distress, often with maternal hemodynamic instability. While it is an emergency, it is more commonly associated with a history of prior uterine surgery (such as a cesarean section), which is not mentioned in this case.

D. Placenta previa. Placenta previa presents with painless, bright red vaginal bleeding, not dark red bleeding with severe pain and uterine hypertonicity. Placenta previa is caused by an abnormally implanted placenta over the cervix, but it does not typically cause a firm, tense uterus or excessive contractions.

A. An ectopic pregnancy does not need major treatment and can be delivered vaginally." B. "An ectopic pregnancy involves a fertilized ovum outside the uterus that cannot be transferred to the uterus." C. "An ectopic pregnancy involves a cancerous fertilized ovum in either fallopian tube." D. "An ectopic pregnancy involves a fertilized ovum in the vagina

Correct Answer is B

Explanation

A. "An ectopic pregnancy does not need major treatment and can be delivered vaginally." This statement is incorrect. An ectopic pregnancy involves the fertilized ovum implanting outside the uterus, most commonly in a fallopian tube, which poses serious risks to the mother. The pregnancy cannot be carried to term, and it requires prompt medical intervention, such as medication or surgery, to prevent life-threatening complications.
B. "An ectopic pregnancy involves a fertilized ovum outside the uterus that cannot be transferred to the uterus." This is an accurate explanation of an ectopic pregnancy. The fertilized egg implants outside the uterus, most commonly in the fallopian tubes, and cannot develop into a viable pregnancy. The condition requires immediate treatment to prevent tube rupture and internal bleeding.
C. "An ectopic pregnancy involves a cancerous fertilized ovum in either fallopian tube." This is incorrect. An ectopic pregnancy is not cancerous. It refers to a pregnancy where the fertilized ovum implants in an abnormal location outside the uterus, most commonly the fallopian tubes, not involving cancerous growth.
D. "An ectopic pregnancy involves a fertilized ovum in the vagina." This statement is incorrect. An ectopic pregnancy occurs when the fertilized ovum implants outside the uterus, but it does not implant in the vagina. The condition most commonly involves the fallopian tubes but can also occur in other locations such as the cervix, ovary, or abdominal cavity.

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A woman who is 26 weeks pregnant has just found out that she has gestational diabetes. Which of the following therapies will most likely be ordered first for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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