The nurse would include which of the following statements when describing the pathophysiology of gestational diabetes?
There is progressive resistance to the effects of insulin
Pregnancy fosters the development of carbohydrate cravings.
Hypoinsulinemia develops early in the first trimester
Glucose levels decrease to accommodate fetal growth.
The Correct Answer is A
A. There is progressive resistance to the effects of insulin. During pregnancy, placental hormones (such as human placental lactogen, estrogen, and progesterone) cause increasing insulin resistance. This ensures that glucose remains available for fetal growth. However, in gestational diabetes, the pancreas cannot compensate with increased insulin production, leading to hyperglycemia.
B. Pregnancy fosters the development of carbohydrate cravings. While some pregnant individuals experience cravings, this is not a defining cause of gestational diabetes. The condition results from hormonal changes leading to insulin resistance, not dietary habits alone.
C. Hypoinsulinemia develops early in the first trimester. Gestational diabetes is not caused by a deficiency of insulin (hypoinsulinemia) but by insulin resistance. In fact, insulin production often increases, but it is insufficient to overcome the resistance caused by placental hormones.
D. Glucose levels decrease to accommodate fetal growth. In a normal pregnancy, glucose levels remain stable, and the fetus actively takes glucose from maternal circulation. However, in gestational diabetes, maternal glucose levels rise due to insulin resistance, increasing the risk of fetal overgrowth (macrosomia).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Fetal heart rate of 118 beats/min. A fetal heart rate of 118 bpm is within the normal range of 110-160 bpm and does not necessarily indicate fetal distress. While continuous monitoring is important in post-term pregnancies, this finding alone does not require urgent assessment.
B. One fetal movement noted in a two-hour assessment by the mother. Decreased fetal movement is a concerning sign that requires further assessment. At 42 weeks gestation, the aging placenta may lead to reduced oxygen and nutrient supply, increasing the risk of fetal compromise. Normally, at least 10 movements should be felt within two hours. A significant decrease in movement could indicate fetal distress or hypoxia, requiring immediate evaluation with a non-stress test (NST) or biophysical profile (BPP).
C. Cervix dilated 2 cm and 50% effaced. A partially dilated and effaced cervix is expected in a post-term pregnancy and does not indicate fetal distress. It suggests that labor may be approaching but does not require additional urgent assessment.
D. Score of 8 on the biophysical profile. A biophysical profile (BPP) score of 8 out of 10 is reassuring and indicates normal fetal well-being. If the score were 4 or lower, it would require immediate intervention, but a score of 8 suggests adequate oxygenation and fetal health.
Correct Answer is D
Explanation
A. Correct coagulation failure by giving platelets. Anaphylactoid syndrome of pregnancy (amniotic fluid embolism) can cause disseminated intravascular coagulation (DIC), but correcting coagulation abnormalities is not the immediate priority. The first intervention should focus on oxygenation and stabilizing the cardiovascular system.
B. Provide emotional support to the woman and her family. While emotional support is important, this is not the priority in a life-threatening emergency. The focus should be on immediate resuscitation efforts to prevent maternal and fetal death.
C. Maintain cardiac output and assess intake & output. Maintaining cardiac output is critical, but this is secondary to oxygenation. The initial response should be administering high-flow oxygen to improve maternal and fetal oxygenation before managing hemodynamic stability.
D. Administer oxygen by tight face mask 8-10L/min. Amniotic fluid embolism causes sudden respiratory distress, hypoxia, and cardiovascular collapse. Immediate high-flow oxygen delivery is the first and most critical intervention to improve oxygenation, support cardiac function, and prevent further complications.
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