Nokea
The nurse is caring for a pregnant patient who is at 28 weeks gestation and has been diagnosed with gestational diabetes. Which of the following interventions should the nurse prioritize?
- A. Monitor the patient's blood glucose levels and administer insulin as needed.
- B. Educate the patient about safe exercise and nutrition practices to manage blood glucose.
- C. Recommend that the patient avoid all carbohydrates to control blood sugar.
- D. Schedule regular ultrasounds to assess fetal growth and development.
Correct Answer: B
Rationale: The correct answer is B because educating the patient about safe exercise and nutrition practices is crucial in managing gestational diabetes. Exercise and proper nutrition help control blood glucose levels and reduce the risk of complications for both the mother and the baby. Monitoring blood glucose levels and administering insulin (choice A) are important but not the priority at this stage. Avoiding all carbohydrates (choice C) is not recommended as balanced carbohydrate intake is essential. Regular ultrasounds (choice D) are important but do not directly address managing gestational diabetes.
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What is the total number of chromosomes contained in a mature sperm or ovum?
- A. 22
- B. 23
- C. 44
- D. 46
Correct Answer: B
Rationale: Gametes (sex chromosomes) contain 23 chromosomes.
Which clinical conditions are associated with increased levels of alpha-fetoprotein (AFP)? (Select all that apply.)
- A. Down syndrome
- B. Molar pregnancy
- C. Twin gestation
- D. Incorrect gestational age assessment of a normal fetus—estimation is earlier in the pregnancy
Correct Answer: C
Rationale: Elevated AFP levels are seen in multiple gestations, miscalculated gestational age, and threatened abortion.
A pregnant patient is at 30 weeks gestation and is concerned about gestational diabetes. Which of the following is a key sign that the nurse should monitor for?
- A. Frequent urination and excessive thirst
- B. Nausea and vomiting after meals
- C. Increased appetite and weight gain
- D. Fatigue and dizziness during physical activity
Correct Answer: A
Rationale: The correct answer is A: Frequent urination and excessive thirst. In gestational diabetes, the body may not be able to produce enough insulin, leading to high blood sugar levels. The excess sugar in the blood can cause increased thirst and frequent urination as the body tries to eliminate the sugar through urine. This is a key sign that the nurse should monitor for in a pregnant patient at 30 weeks gestation. Nausea and vomiting after meals (B) are more commonly associated with morning sickness in early pregnancy. Increased appetite and weight gain (C) can occur during pregnancy but are not specific signs of gestational diabetes. Fatigue and dizziness during physical activity (D) can be common in pregnancy due to hormonal changes and increased demands on the body but are not specific to gestational diabetes.
A patient in labor is diagnosed with an occiput posterior (OP) fetal position. What is the most appropriate intervention to facilitate delivery?
- A. Encourage the patient to push vigorously with each contraction
- B. Position the patient on her hands and knees
- C. Perform a cesarean section
- D. Perform a cesarean section
Correct Answer: B
Rationale: The correct answer is B: Position the patient on her hands and knees. This position, known as the all-fours position, can help rotate the baby from an occiput posterior position to a more favorable position for delivery. Gravity assists in the rotation of the baby, making delivery easier. Encouraging the patient to push vigorously (option A) may not be effective in this situation as the baby may be facing the wrong way. Performing a cesarean section (option C and D) should be considered only if other interventions fail or if there are complications that necessitate surgical delivery.
A patient who is 40 weeks pregnant presents to the labor and delivery unit with decreased fetal movement. What is the first step in management?
- A. Perform a nonstress test (NST)
- B. Administer a corticosteroid injection
- C. Monitor fetal heart rate
- D. Monitor the fetal heart rate
Correct Answer: A
Rationale: The correct answer is A: Perform a nonstress test (NST). This is the first step in assessing fetal well-being when a patient presents with decreased fetal movement at 40 weeks gestation. The NST evaluates fetal heart rate in response to fetal movement, providing immediate information on fetal well-being. Administering a corticosteroid injection (B) would not be indicated at this point as it is not the first-line management for decreased fetal movement. Monitoring fetal heart rate (C and D) is important, but the NST provides more comprehensive information on fetal well-being.