Gestational diabetes Exam Questions & Answers
A 32 year old multigravida at 28 weeks comes in to the clinic. She has given birth three times,
once at 35 weeks (twins), once at 38 weeks (singleton), and once at 41 weeks (singleton). All
children are alive and well. She had one spontaneous abort...
Gestational diabetes Exam Questions & Answers
A 32 year old multigravida at 28 weeks comes in to the clinic. She has given birth three times,
once at 35 weeks (twins), once at 38 weeks (singleton), and once at 41 weeks (singleton). All
children are alive and well. She had one spontaneous abortion at 10 weeks. How should the
nurse record her obstetrical history using GTPAL designation?
a. 3-2-0-1-3
b. 4-1-1-1-2
c. 5-2-1-1-4
d. 4-2-1-0-2 Correct answer-c (G is for gravidity, the number of times she was pregnant,
including the current pregnancy. T is for term, meaning babies born at 37 weeks or older. P
refers to any births between 20 and 37 weeks, both term and preterm describe live births. A is
abortion for any fetal loss whether spontaneous or elective, up to 20 weeks gestation. L is for
living, referring to all living children.)
A 32 year old multigravida at 28 weeks comes into the clinic. The nurse notes her fasting 1 hour
glucose screening level is 164 mg/dL. Which information does the nurse recognize in the client's
history to support a diagnosis of gestational diabetes?
a. maternal great-aunt has non-insulent Type-2 diabetes
b. Child weighed 9 lbs (4.08 kg) at 41 weeks gestation
c. Trace of protein noted in the urine
d. client is 64 in tall and weighs 134 prior to pregnancy Correct answer-b (family history is
not a risk factor unless it is first-degree. Birth weight over 9 lbs, maternal age over 25, history of
unexplained stillborn, family history of type 1, strong family history of type 2, and history of
gdm in previous pregnancy are all risk factors. D is within the normal BMI range.)
, Gestational diabetes Exam Questions & Answers
A 32 year old multigravida at 28 weeks comes into the clinic. The nurse notes her fasting 1 hour
glucose screening level is 164 mg/dL. She is scheduled for a 3 hour oral glucose tolerance test.
Which special instructions in addition to fasting 8 hour before the appointment should the
nurse give?
a. only coffee or tea is allowed once the fasting level has been drawn
b. follow an unrestricted diet and exercise pattern for 3 days before the test
c. write down questions and call the lab the day before the test
d. smoking in moderation is allowed up to the time the test begins Correct answer-b
(caffeine in any form should be avoided because it increases glucose levels. smoking should be
avoided at least 12 hours before the test. Smoking shouldnt be done during pregnancy at all)
A 32 year old multigravida at 28 weeks comes into the clinic. Her screenings for GDM are
positive. The patient asks why she wasnt tested until 28 weeks. The nurse's response should be
based on the understanding of which normal physiologic change of pregnancy?
a. maternal insulin crosses the placenta to regulate fetal glucose levels throughout the
pregnancy
b. in the first trimester, estrogen and progesterone cause an increase in fasting glucose levels
c. hormonal changes in the second and third trimester increase the maternal insulin resistance
d. fetal insulin increases each trimester, forcing the mother's body to produce more glucose
Correct answer-c (maternal insulin does not cross the placenta. increased estrogen and
progesterone stimulate the pancreas to increase insulin production, decreasing glucose levels.
, Gestational diabetes Exam Questions & Answers
Increasing hormones in the second and third trimester act as insulin antagonists. Most pregnant
bodies are able to handle this, but some are not as tolerant. Fetal insulin starts around 10 weeks
gestation and is adequate for the glucose the baby gets from the mother.)
A 32 year old multigravida at 28 weeks comes into the clinic. Her screenings for GDM are
positive. The patient asks how she will know if she has high blood sugar. Which response should
the nurse give? (select all)
a. hyperglycemia often presents as increased thirst and urination
b. hyperglycemia causes a headache and flushed, dry skin
c. hyperglycemia causes cool and clammy skin
d. hyperglycemia causes an increased sensation of being hungry Correct answer-a, b, and
d (hypoglycemia causes cool and clammy skin)
A 32 year old multigravida at 28 weeks comes into the clinic. Her screenings for GDM are
positive. She asks about content and timing of her meals How should the nurse advice? (select
all)
a. eliminate the bedtime snack if heartburn develops
b. choose complex carbs that are high in fiber
c. increase the protein if anemia develops
d .avoid foods high in refined sugars
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