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A client with pregestational type 1 diabetes mellitus is being taught by a nurse about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should aim to maintain my fasting blood glucose between 100 and 120.
- B. I should engage in moderate exercise for 30 minutes if my blood glucose is 250 or higher.
- C. I will continue taking my insulin if I experience nausea and vomiting.
- D. I will avoid exercise if my blood glucose exceeds 250.
Correct Answer: C
Rationale: The correct answer is C because continuing to take insulin during nausea and vomiting is crucial for maintaining blood glucose control in clients with diabetes. Nausea and vomiting can lead to decreased food intake, risking hypoglycemia if insulin is not adjusted.
Choice A is incorrect because fasting blood glucose levels should ideally be maintained between 60-90 mg/dL in pregnant clients with diabetes for optimal outcomes, not 100-120 mg/dL.
Choice B is incorrect because engaging in moderate exercise when blood glucose is high (250 or higher) can exacerbate hyperglycemia rather than help in lowering blood glucose levels.
Choice D is incorrect because avoiding exercise when blood glucose exceeds 250 is not recommended. Exercise can help lower blood glucose levels and improve insulin sensitivity.
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A healthcare provider is assisting with the care for a client who reports manifestations of preterm labor. Which of the following findings are risk factors for this condition? (Select all that apply)
- A. Urinary tract infection
- B. Multifetal pregnancy
- C. Oligohydramnios
- D. All of the Above
Correct Answer: D
Rationale: The correct answer is D because all of the choices are risk factors for preterm labor.
A: Urinary tract infection can lead to inflammation and contractions.
B: Multifetal pregnancy puts more stress on the uterus, increasing the risk.
C: Oligohydramnios is associated with a higher risk of preterm labor due to decreased amniotic fluid levels.
In summary, all the choices contribute to the increased likelihood of preterm labor.
A healthcare provider is discussing the differences between true labor and false labor with a group of expectant parents. Which of the following characteristics should the healthcare provider include when discussing true labor?
- A. Contractions become stronger with walking.
- B. Discomfort can be relieved with a back massage.
- C. Contractions become irregular with a change in activity.
- D. Discomfort is felt above the umbilicus.
Correct Answer: A
Rationale: The correct answer is A: Contractions become stronger with walking. This is because true labor is characterized by contractions that consistently increase in intensity and frequency, which is often enhanced by physical activity like walking. Contractions in false labor do not typically intensify with movement. Discomfort in true labor is usually not easily relieved by a back massage (B) and contractions in true labor remain regular even with changes in activity (C). Discomfort in true labor is typically felt in the lower abdomen and back, not above the umbilicus (D).
A client is reinforcing discharge teaching with a client who has premature rupture of membranes at 26 weeks of gestation. Which of the following instructions should the client include?
- A. Use a condom with sexual intercourse
- B. Avoid bubble bath solution when taking a tub bath
- C. Wipe from front to back when performing perineal hygiene
- D. Keep a daily record of fetal kick counts
Correct Answer: D
Rationale: The correct answer is D: Keep a daily record of fetal kick counts. This is important for monitoring fetal well-being, especially in cases of premature rupture of membranes. By counting fetal kicks daily, the client can assess fetal movements and report any changes promptly to healthcare providers. This helps in early detection of fetal distress or problems.
A: Using a condom with sexual intercourse is not relevant to the situation of premature rupture of membranes.
B: Avoiding bubble bath solution is important for preventing vaginal infections but not directly related to monitoring fetal well-being.
C: Wiping from front to back during perineal hygiene is a general hygiene practice and not specific to the situation of premature rupture of membranes.
A nurse in a clinic receives a phone call from a client who would like information about pregnancy testing. Which of the following information should the nurse provide to the client?
- A. You should wait 4 weeks after conception to be tested for pregnancy.
- B. You should be off any medications for 24 hours prior to the pregnancy test.
- C. You should not eat or drink for at least 8 hours prior to the pregnancy test.
- D. You should use your first morning urination specimen for a home pregnancy test.
Correct Answer: D
Rationale: The correct answer is D. Using the first morning urine specimen for a home pregnancy test is recommended because it is more concentrated, increasing the accuracy of the test. This is due to the higher levels of the pregnancy hormone hCG present in the urine after a night of not urinating.
Choice A is incorrect because pregnancy testing can usually be done as early as 1-2 weeks after conception, not necessarily 4 weeks.
Choice B is incorrect as being on medications does not typically affect the accuracy of a pregnancy test.
Choice C is incorrect as there is no need for fasting before a pregnancy test; it does not impact the test results.
A client in active labor is irritable, reports the urge to have a bowel movement, vomits, and states, 'I've had enough. I can't do this anymore.' Which of the following stages of labor is the client experiencing?
- A. Second stage
- B. Fourth stage
- C. Transition phase
- D. Latent phase
Correct Answer: C
Rationale: The client is experiencing the transition phase of labor. This stage occurs between the first and second stages, characterized by intense contractions, rapid cervical dilation, and strong emotions like irritability and feeling overwhelmed. The urge to have a bowel movement and vomiting are common signs indicating the baby is descending. The statement 'I can't do this anymore' is typical of transition as it signifies the peak of discomfort before the urge to push in the second stage. Other options are incorrect as the symptoms described align with the transition phase.