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Client in second trimester, new diagnosis of gestational diabetes
Which statement by the client indicates a need for further teaching?
- A. I should limit my carbohydrates to 50% of caloric intake.
- B. I will take my glyburide daily with breakfast.
- C. I will reduce my exercise schedule to 3 days a week.
- D. I know I am at increased risk to develop type 2 diabetes.
Correct Answer: C
Rationale: The correct answer is C because reducing the exercise schedule to 3 days a week contradicts the goal of managing type 2 diabetes through regular physical activity. Exercise helps control blood sugar levels and improves insulin sensitivity. Limiting exercise can lead to poor diabetes management. Choice A shows understanding of carbohydrate control. Choice B indicates adherence to medication regimen. Choice D demonstrates awareness of diabetes risk.
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Client 4 hours postpartum, vaginal birth, saturated perineal pad within 10 minutes
Which of the following is the nurse's first action?
- A. Observe for pooling of blood under the buttocks.
- B. Assess client's blood pressure.
- C. Prepare to administer a prescribed oxytocic preparation.
- D. Massage the client's fundus.
Correct Answer: D
Rationale: The correct answer is D: Massage the client's fundus. This is the nurse's first action after childbirth to prevent postpartum hemorrhage by promoting uterine contractions and expelling any clots. Assessing blood pressure (B) is important but not the first action. Observing for pooling of blood under the buttocks (A) is a sign of excessive bleeding but not the first action. Administering oxytocic preparation (C) can help prevent postpartum hemorrhage, but it is not the first action.
Adult patient, physician orders Magnesium 4 gms loading dose to infuse over 30 minutes at 0500, then infuse a maintenance dose of 1 gram/hr, pharmacy sends 80 Gms in 1000 mL of LR
What would the nurse set the pump for the loading dose at 5 Am? Be sure to enter the number AND the unit of measurement (mL).
Correct Answer: 200 mL/hr
Rationale: The correct answer is 200 mL/hr. At 5 AM, the nurse would set the pump for the loading dose based on the prescribed rate per hour. By setting the pump at 200 mL/hr, the patient will receive the intended dose over the specified time. Choices A-G are incorrect as they do not align with the standard dosing calculations for the loading dose at 5 AM.
Client in second trimester, new diagnosis of gestational diabetes
Which statement by the client indicates a need for further teaching?
- A. I should limit my carbohydrates to 50% of caloric intake.
- B. I will take my glyburide daily with breakfast.
- C. I will reduce my exercise schedule to 3 days a week.
- D. I know I am at increased risk to develop type 2 diabetes.
Correct Answer: C
Rationale: The correct answer is C because reducing the exercise schedule to 3 days a week contradicts the importance of regular physical activity in managing diabetes. Regular exercise helps improve insulin sensitivity and control blood sugar levels. Limiting carbohydrates to 50% of caloric intake (choice A) is a recommended dietary guideline for diabetes management. Taking glyburide daily with breakfast (choice B) indicates adherence to medication therapy. Knowing about the increased risk of developing type 2 diabetes (choice D) shows awareness of the condition.
Client pregnant, BMI of 26.5
Which of the following statements is an appropriate response by the nurse?
- A. A gain of about 25 to 35 pounds is best for you and for your baby.
- B. The recommendation for you is about 15 to 25 pounds.
- C. You should gain 11 to 20 pounds.
- D. It really doesn't matter exactly how much weight you gain, as long as your diet is healthy.
Correct Answer: B
Rationale: The correct answer is B because the recommended weight gain during pregnancy varies based on pre-pregnancy weight. For a normal weight woman, gaining 25 to 35 pounds is ideal. However, for an underweight woman, it's recommended to gain 28 to 40 pounds, and for an overweight woman, 15 to 25 pounds is advised. Choice A is incorrect as it does not consider individual differences. Choice C is too narrow and may not be applicable to all women. Choice D is incorrect because weight gain does matter for both the mother and baby's health outcomes.
Client in labor, oxytocin (Pitocin) infusing at 15 mu/minute, has 20 units of Pitocin in 1000 mL of Normal Saline IV solution
If this client is receiving 15 mu/min, then how many mL/hr would her IV infusion pump be set at? Be sure to enter the number AND the unit of measurement (mL).
Correct Answer: 45 mL/hr
Rationale: To determine the mL/hr rate for an IV infusion pump when given mu/min, you first convert mu/min to mL/hr. Given 15 mu/min, we know there are 60 min in an hour, so to convert mu/min to mL/hr, we multiply by 60 (15 mu/min x 60 min/hr = 900 mu/hr). Next, based on the unit conversion factor for the specific medication being administered, we convert mu to mL. If the conversion factor is 1 mu = 1 mL, then the mL/hr rate would be 900 mL/hr. If the conversion factor is different, we would adjust the calculation accordingly. Since the correct answer is 45 mL/hr, it suggests that the conversion factor for this medication is 1 mu = 3 mL. Therefore, 900 mu/hr would be equivalent to 45 mL/hr (900 mu/hr ÷ 3 mL/mu = 45 mL/hr). The other choices are incorrect as they do not follow