In terms of the incidence and classification of diabetes, maternity nurses should know that:
Type 1 diabetes is most common
Type 2 diabetes often goes undiagnosed
Type 1 diabetes may become type 2 during pregnancy
Gestational diabetes mellitus (GDM) means that the woman will be receiving insulin treatment until 6 weeks after birth
The Correct Answer is B
Choice A rationale
Type 1 diabetes is not the most common type of diabetes. Type 1 diabetes is a condition where the pancreas produces little or no insulin, which is a hormone that regulates the blood glucose level. Type 1 diabetes usually develops in childhood or adolescence and requires lifelong insulin therapy. Type 1 diabetes accounts for about 5% to 10% of all cases of diabetes.
Choice B rationale
Type 2 diabetes often goes undiagnosed. Type 2 diabetes is a condition where the body becomes resistant to the action of insulin or the pancreas produces insufficient insulin. Type 2 diabetes usually develops in adulthood and is associated with obesity, physical inactivity, and family history. Type 2 diabetes can be managed with diet, exercise, oral medications, or insulin. Type 2 diabetes accounts for about 90% to 95% of all cases of diabetes. However, many people with type 2 diabetes do not have any symptoms or are unaware of their condition, which can lead to delayed diagnosis and complications.
Choice C rationale
Type 1 diabetes cannot become type 2 during pregnancy. Type 1 and type 2 diabetes are different conditions with different causes and treatments. Type 1 diabetes is an autoimmune disorder that destroys the insulin-producing cells in the pancreas, while type 2 diabetes is a metabolic disorder that impairs the insulin sensitivity or secretion. Type 1 diabetes cannot be reversed or prevented, while type 2 diabetes can be prevented or delayed with lifestyle changes.
Choice D rationale
Gestational diabetes mellitus (GDM) does not mean that the woman will be receiving insulin treatment until 6 weeks after birth. GDM is a condition where the blood glucose level becomes elevated during pregnancy, usually after 24 weeks of gestation. GDM can cause complications for the mother and the fetus, such as preeclampsia, macrosomia, and neonatal hypoglycemia. GDM can be managed with diet, exercise, oral medications, or insulin. GDM usually resolves after delivery, but the woman should be tested for diabetes 6 to 12 weeks postpartum, as she has a higher risk of developing type 2 diabetes later in life.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Maternal serum alpha-fetoprotein (MSAFP) is a protein produced by the fetal liver and yolk sac. It crosses the placenta and enters the maternal blood. High levels of MSAFP may indicate neural tube defects such as spina bifida or anencephaly in the fetus. Low levels of MSAFP may indicate chromosomal abnormalities such as Down syndrome or trisomy 18 in the fetus.
Choice B rationale
Fetal lung maturity is not assessed by MSAFP. Fetal lung maturity is assessed by measuring the lecithin/sphingomyelin (L/S) ratio or the phosphatidylglycerol (PG) level in the amniotic fluid. These tests are usually done in the third trimester of pregnancy.
Choice C rationale
Rh incompatibility is not identified by MSAFP. Rh incompatibility is a condition where the mother has Rh-negative blood and the fetus has Rh-positive blood. This can cause hemolytic disease of the newborn (HDN) if the mother develops antibodies against the fetal red blood cells. Rh incompatibility is identified by testing the mother's blood type and antibody screen, and the father's blood type if available.
Choice D rationale
MSAFP does not assess various markers of fetal well-being. MSAFP is only one of the markers that can be used in the maternal serum screening test, which is also known as the quad screen or the triple screen. The other markers are human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A. These markers can help detect the risk of certain birth defects or genetic disorders in the fetus, but they are not definitive tests. Fetal well-being can be assessed by other tests such as fetal movement count, nonstress test, biophysical profile, or Doppler ultrasound.
Correct Answer is D
Explanation
Choice A rationale
This is incorrect because respirations 16/min are within the normal range and do not indicate magnesium toxicity. The nurse should monitor the client's respiratory rate and report any signs of respiratory depression, such as less than 12/min.
Choice B rationale
This is incorrect because fetal heart rate 158/min is within the normal range and does not indicate fetal distress. The nurse should monitor the fetal heart rate and report any signs of bradycardia, tachycardia, or decreased variability.
Choice C rationale
This is incorrect because headache for 30 min is a common symptom of pre-eclampsia and does not indicate magnesium toxicity. The nurse should administer analgesics as prescribed and report any signs of increased intracranial pressure, such as blurred vision, confusion, or seizures.
Choice D rationale
This is correct because urinary output 40 mL in 2 hr is below the expected amount and indicates renal impairment. The nurse should report this finding to the provider and monitor the client's fluid intake and output, serum creatinine, and blood urea nitrogen levels. The nurse should also assess the client for signs of fluid overload, such as edema, crackles, or dyspnea.
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