Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for:
low birth weight.
preterm birth.
macrosomia.
congenital anomalies of the central nervous system.
The Correct Answer is C
Choice A reason: Low birth weight is not a common complication of GDM, as the fetus tends to grow larger than normal due to the excess glucose and insulin in the blood. Low birth weight is more likely to occur in infants of mothers with preexisting diabetes or other conditions that affect placental function.
Choice B reason: Preterm birth is a possible complication of GDM, as the increased fetal size and the risk of maternal hypertension or infection may induce labor before term. However, it is not the greatest risk for the fetus, as preterm infants can survive with proper care and treatment.
Choice C reason: Macrosomia is the greatest risk for the fetus of a mother with GDM, as it is defined as a birth weight of more than 4000 g or 8 lb 13 oz. Macrosomia can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, or cesarean birth. It can also increase the risk of neonatal hypoglycemia, jaundice, or respiratory distress.
Choice D reason: Congenital anomalies of the central nervous system are not a common complication of GDM, as they usually occur in the first trimester of pregnancy, before GDM is diagnosed or develops. Congenital anomalies are more likely to occur in infants of mothers with preexisting diabetes or other genetic or environmental factors.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is d. Amenorrhea.
Choice A: Chadwick’s sign is a non-specific, early sign of pregnancy that is typically characterized by a bluish discoloration of the cervix, vagina, and vulva. The Chadwick sign can typically be observed as early as six to eight weeks after conception, and commonly disappears shortly after birth. However, it’s not a definitive indication of pregnancy, and the absence of it on physical exam does not exclude a potential pregnancy.
Choice B: Hegar’s sign is a non-specific indication of pregnancy that is characterized by the compressibility and softening of the cervical isthmus (i.e., the portion of the cervix between the uterus and the vaginal portion of the cervix). It typically presents between the fourth and sixth week of pregnancy and may be present until the 12th week of pregnancy. However, the Hegar sign is not a definitive indication of pregnancy, and the absence of it does not exclude a potential pregnancy.
Choice C: A positive pregnancy test By 10 weeks, a home pregnancy test would almost certainly show a positive result if the woman is pregnant. This is because the hormone human chorionic gonadotropin (hCG), which is produced by the placenta after implantation of the embryo into the uterine wall, would be present in high enough levels to be detected by the test. However, a positive pregnancy test is not a presumptive sign of pregnancy, but rather a probable one.
Choice D: Amenorrhea, or the absence of menstrual periods, is often considered the most presumptive sign of pregnancy. This is because it’s one of the first noticeable signs of pregnancy for many women. By 10 weeks of gestation, the woman would likely have missed two menstrual periods if she usually has regular cycles. However, while amenorrhea is a common early sign of pregnancy, it can also be caused by various other conditions or factors such as stress, significant weight loss or gain, or certain medical conditions. Therefore, a missed period should be followed up with a pregnancy test to confirm pregnancy.
Correct Answer is D
Explanation
Choice A reason: Cheese is a good source of calcium, protein, and vitamin B12, but not folates. Folate is a water-soluble vitamin that is essential for the synthesis of DNA and the prevention of neural tube defects in the fetus.
Choice B reason: Potatoes are a good source of carbohydrates, potassium, and vitamin C, but not folates. Folate is found mainly in plant-based foods, especially dark green vegetables.
Choice C reason: Chicken is a good source of protein, iron, and zinc, but not folates. Folate is more abundant in legumes, nuts, and seeds than in animal products.
Choice D reason: Green leafy vegetables are a good source of folates, as well as vitamin A, vitamin K, and fiber. Folate is also known as folic acid when it is added to fortified foods or supplements. Pregnant women need at least 600 micrograms of folate per day.
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