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
Choice A reason: A daily consumption of alcohol does not necessarily indicate a risk for alcoholism, although it is not recommended for pregnant women. Alcoholism is a chronic disease that involves physical and psychological dependence on alcohol, and it requires more than one criterion to be diagnosed.
Choice B reason: She will not be at risk for abusing other substances as well, unless she has a history or predisposition for substance abuse. Alcohol use during pregnancy does not cause other substance abuse problems, although it may co-occur with them.
Choice C reason: The fetus is not at risk for multiple organ anomalies, unless the mother consumes large amounts of alcohol during the first trimester of pregnancy. This can cause fetal alcohol syndrome (FAS), which is characterized by facial dysmorphia, growth retardation, and intellectual disability. However, FAS is rare and not related to moderate alcohol intake during the second trimester.
Choice D reason: The fetus is placed at risk for altered brain growth, as alcohol can cross the placenta and affect the developing nervous system of the fetus. Alcohol exposure during the second trimester can impair the formation and migration of neurons, leading to reduced brain size and function. This can result in learning difficulties, behavioral problems, and cognitive impairments in the child.
Correct Answer is C
Explanation
Choice A reason: Penicillin is not a correct option, as it is not effective against chlamydia. Penicillin is an antibiotic that works by inhibiting the cell wall synthesis of bacteria. However, chlamydia is an intracellular bacterium that does not have a cell wall and is resistant to penicillin.
Choice B reason: Acyclovir is not a correct option, as it is not effective against chlamydia. Acyclovir is an antiviral drug that works by inhibiting the DNA synthesis of viruses. However, chlamydia is a bacterium, not a virus, and is not affected by acyclovir².
Choice C reason: Doxycycline is the correct option, as it is one of the recommended medications for the treatment of chlamydia. Doxycycline is a tetracycline antibiotic that works by inhibiting the protein synthesis of bacteria. It can penetrate the cells and kill chlamydia by interfering with its growth and reproduction. The CDC recommends a 7-day course of doxycycline (100 mg orally twice a day) for the treatment of uncomplicated chlamydia infection.
Choice D reason: Podofilox is not a correct option, as it is not effective against chlamydia. Podofilox is a topical medication that works by destroying the tissue of genital warts caused by human papillomavirus (HPV). However, chlamydia is a different infection that does not cause genital warts and is not treated by podofilox.
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