Advanced Maternal Age Monitoring

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A pregnant woman weighs 90.9 kg. The nurse is educating the patient on complications that the patient may be at risk for during pregnancy. Which response by the patient indicates that she understands?

  • A. Due to my weight, there is a possibility that I may develop gestational diabetes.
  • B. I am not overweight, but I am still at risk for gestational diabetes.
  • C. My mother had preeclampsia during one of her pregnancies.
  • D. I will need to do a glucose tolerance test in my second trimester.
Correct Answer: A

Rationale: The correct answer is A because maternal obesity is a risk factor for gestational diabetes. The patient's weight of 90.9 kg puts her at an increased risk. Gestational diabetes is more likely to occur in overweight or obese pregnant women. The patient's understanding that her weight increases the possibility of developing gestational diabetes demonstrates comprehension of the risk factors.

Choice B is incorrect because weight alone is a significant risk factor for gestational diabetes, regardless of whether the patient is considered overweight or not.

Choice C is incorrect as a family history of preeclampsia is a risk factor for preeclampsia, not gestational diabetes.

Choice D is incorrect because while a glucose tolerance test may be part of prenatal care, it does not specifically address the patient's understanding of the risk factors associated with her weight and gestational diabetes.

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A pregnant patient at 32 weeks gestation is concerned about gestational diabetes. What is the nurse's priority intervention?

  • A. Encourage the patient to eat smaller, more frequent meals and monitor blood glucose levels.
  • B. Administer insulin as prescribed to control blood glucose levels.
  • C. Recommend a high-protein, low-carbohydrate diet to prevent blood sugar spikes.
  • D. Instruct the patient to limit fluid intake to reduce blood sugar fluctuations.
Correct Answer: A

Rationale: The correct answer is A because it addresses the immediate concern of managing blood glucose levels in a pregnant patient with gestational diabetes. Encouraging smaller, more frequent meals helps stabilize blood sugar levels and prevent spikes. Monitoring blood glucose levels is crucial for timely interventions. Administering insulin (B) may be necessary but not the priority. A high-protein, low-carb diet (C) is not typically recommended for gestational diabetes. Limiting fluid intake (D) is not appropriate as hydration is important during pregnancy. In summary, choice A is the priority as it directly addresses the patient's concern and promotes optimal blood sugar control during pregnancy.

The nurse is assessing a pregnant patient who is at 14 weeks gestation and reports light vaginal bleeding. What is the nurse's priority action?

  • A. Monitor the patient's blood pressure and check for protein in the urine.
  • B. Call the healthcare provider immediately to assess for miscarriage.
  • C. Encourage the patient to rest and wait for symptoms to resolve.
  • D. Perform a pelvic exam to check for cervical dilation.
Correct Answer: B

Rationale: The correct answer is B: Call the healthcare provider immediately to assess for miscarriage. The priority action in this scenario is to promptly notify the healthcare provider to assess for potential complications like miscarriage, which could be life-threatening to the patient or fetus. This step ensures timely intervention and appropriate management. Monitoring blood pressure and urine for protein (Choice A) is important but not the immediate priority. Encouraging rest and waiting for symptoms to resolve (Choice C) may delay necessary medical intervention. Performing a pelvic exam (Choice D) could potentially worsen the situation if miscarriage is occurring. Thus, calling the healthcare provider for assessment is the most appropriate and urgent action to take in this situation.

A nurse is monitoring a laboring person who is receiving oxytocin for labor induction. What is the priority assessment during oxytocin infusion?

  • A. monitor fetal heart rate
  • B. assess maternal vital signs
  • C. assess uterine tone
  • D. monitor for signs of uterine hyperstimulation
Correct Answer: C

Rationale: The correct answer is C: assess uterine tone. This is the priority assessment during oxytocin infusion because oxytocin can cause uterine hyperstimulation, leading to fetal distress. By assessing uterine tone regularly, the nurse can detect any signs of hyperstimulation early and take appropriate action to prevent complications. Monitoring fetal heart rate (A) is important but assessing uterine tone takes precedence as it directly impacts fetal well-being. Maternal vital signs (B) are important but are not as directly related to the safety of the fetus during oxytocin infusion. Monitoring for signs of uterine hyperstimulation (D) is essential, but assessing uterine tone is the proactive approach to detect hyperstimulation before it escalates.

A woman, 6 weeks pregnant, is having a vaginal examination. Which of the following would the practitioner expect to find?

  • A. Thin cervical muscle.
  • B. An enlarged ovary.
  • C. Thick cervical mucus.
  • D. Pale pink vaginal wall.
Correct Answer: B

Rationale: An enlarged ovary is a common finding in early pregnancy due to the corpus luteum. Thin cervical muscle, thick cervical mucus, and a pale pink vaginal wall are not typical findings at this stage.

When assessing the fruit intake of a pregnant client, the nurse notes that the client usually eats 1 piece of fruit per day and drinks a 12 oz glass of fruit juice per day. Which of the following is the most important communication for the nurse to make?

  • A. You are effectively meeting your daily fruit requirements.
  • B. Fruit juices are excellent sources of folic acid.
  • C. It would be even better if you were to consume more whole fruits and less fruit juice.
  • D. Your fruit intake far exceeds the recommended daily fruit intake.
Correct Answer: C

Rationale: Whole fruits provide fiber and additional nutrients compared to fruit juices, which may contain added sugars. Encouraging increased consumption of whole fruits aligns with healthy dietary guidelines for pregnancy.

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