The correct answer is choice C. Pancreas.Gestational diabetes is a type of diabetes that develops during pregnancy and affects how the cells use sugar (glucose).Glucose is the main source of energy for the body and it is regulated by a hormone called insulin, which is produced by the pancreas.

In gestational diabetes, the placenta (the organ that connects the baby to the mother) produces hormones that can make insulin less effective, leading to high blood sugar levels.This condition is called insulin resistance

Choice A is wrong because the lungs are not directly involved in glucose metabolism or insulin production.

Choice B is wrong because the kidneys are not the primary site of insulin production, although they can be affected by high blood sugar levels over time.

Choice D is wrong because the liver is not the main source of insulin, although it can help regulate blood sugar levels by storing and releasing glucose as needed.

Gestational diabetes usually does not cause any symptoms, but it can increase the risk of complications for both the mother and the baby, such as high blood pressure, pre-eclampsia, large birth weight, premature delivery, low blood sugar, and future diabetesTherefore, it is important to screen for gestational diabetes during pregnancy and manage it with a healthy diet, exercise, and medication if needed

The correct answer is choice D. Previous history of gestational diabetes.This is because having gestational diabetes in a previous pregnancy increases the risk of developing it again in a subsequent pregnancy.According to the CDC, about 50% of women with gestational diabetes go on to develop type 2 diabetes later in life.

Choice A is wrong because advanced maternal age is not a primary risk factor for gestational diabetes, although it may increase the risk slightly.

Choice B is wrong because family history of diabetes is not a primary risk factor for gestational diabetes, although it may indicate a genetic predisposition to insulin resistance.

Choice C is wrong because smoking during pregnancy is not a primary risk factor for gestational diabetes, although it may have other adverse effects on the mother and the baby.

Some of the other risk factors for gestational diabetes include obesity, hormonal changes, polycystic ovary syndrome, and pregnancy over 30 years of age.Gestational diabetes can cause complications such as high blood pressure, preeclampsia, large birth weight, premature delivery, respiratory distress syndrome, and low blood sugar in the baby.Gestational diabetes can be managed with a healthy diet, exercise, and medication if needed.

The correct answer is choice B. Second trimester.

Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth.It can happen at any stage of pregnancy, but is more common in the second or third trimester.This is because hormonal changes that occur during pregnancy can affect the body’s ability to produce enough insulin, a hormone that helps control blood sugar levels.

Choice A is wrong because gestational diabetes is less likely to develop during the first trimester, when the hormonal changes are not as significant.

Choice C is wrong because gestational diabetes is usually diagnosed and treated before the third trimester, to prevent complications for the mother and the baby.

Choice D is wrong because gestational diabetes is not a postpartum condition, although some women may have a higher risk of developing type 2 diabetes later in life if they had gestational diabetes.

Normal ranges for blood sugar levels during pregnancy are:

• Before meals: 60 to 95 mg/dL

• One hour after meals: 100 to 129 mg/dL

• Two hours after meals: 70 to 119 mg/dL

The correct answer is choice B. Preeclampsia.Gestational diabetes increases the risk of high blood pressure and preeclampsia, a serious complication of pregnancy that causes high blood pressure and other symptoms that can threaten both the mother’s and the baby’s life.

Choice A is wrong because preterm labor is not directly caused by gestational diabetes, although it may be done to prevent complications from preeclampsia or a large baby.

Choice C is wrong because ectopic pregnancy is not related to gestational diabetes.Ectopic pregnancy occurs when the fertilized egg implants outside the uterus, usually in the fallopian tube.

Choice D is wrong because placenta previa is not associated with gestational diabetes.Placenta previa occurs when the placenta covers part or all of the opening of the cervix.

The correct answer is

C. Type 2 diabetes.

Gestational diabetes (GDM) is a condition where the blood sugar levels are higher than normal during pregnancy.It usually goes away after giving birth, but it can increase the risk of developing type 2 diabetes later in life.

Type 2 diabetes is a chronic condition that affects how the body uses glucose (sugar) for energy.It can cause serious complications such as heart disease, kidney damage, nerve damage, eye problems and more.

A. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and other body functions.

It can cause symptoms such as fatigue, weight gain, depression, dry skin and hair loss.Hypothyroidism is not directly linked to gestational diabetes, but it can affect pregnancy outcomes and increase the risk of miscarriage, preterm birth and low birth weight.

B. Asthma is a condition where the airways become inflamed and narrow, making it hard to breathe.

It can cause symptoms such as wheezing, coughing, chest tightness and shortness of breath.Asthma is not directly linked to gestational diabetes, but it can affect pregnancy outcomes and increase the risk of preterm birth, low birth weight and preeclampsia.

D. Breast cancer is a type of cancer that starts in the breast tissue.

It can cause symptoms such as a lump in the breast, nipple discharge, skin changes and pain.Breast cancer is not directly linked to gestational diabetes, but it can be influenced by hormonal factors such as estrogen and progesterone levels, which may change during pregnancy and after menopause.

The correct answer is

A. Elevated fasting blood glucose levels.

Gestational diabetes (GDM) is a condition where the blood sugar levels are higher than normal during pregnancy.

It can affect the health of the mother and the baby if not well controlled.GDM usually goes away after delivery, but it can increase the risk of developing type 2 diabetes later in life.

A. Elevated fasting blood glucose levels.

This statement is true.

Fasting blood glucose levels are the levels of glucose in the blood after not eating or drinking anything except water for at least 8 hours.

Normal fasting blood glucose levels are between 70 and 100 mg/dL (3.9 and 5.6 mmol/L).

In GDM, the fasting blood glucose levels are higher than normal, usually above 95 mg/dL (5.3 mmol/L).This indicates that the body is not able to use insulin effectively to lower the blood sugar levels.

B. Decreased postprandial blood glucose levels.

This statement is false.

Postprandial blood glucose levels are the levels of glucose in the blood after eating a meal or a snack.

Normal postprandial blood glucose levels are below 140 mg/dL (7.8 mmol/L) within 2 hours of eating.

In GDM, the postprandial blood glucose levels are higher than normal, usually above 140 mg/dL (7.8 mmol/L) within 1 hour or above 120 mg/dL (6.7 mmol/L) within 2 hours of eating.This indicates that the body is not able to use insulin effectively to lower the blood sugar levels after a meal.

C. Elevated serum insulin levels.

This statement is false.

Serum insulin levels are the levels of insulin in the blood.

Insulin is a hormone that helps the cells to take up glucose from the blood for energy or storage.

Normal serum insulin levels vary depending on the time of day, the type of food eaten, and other factors.

In GDM, the serum insulin levels are not necessarily elevated, but they may be insufficient to overcome the insulin resistance caused by hormonal changes during pregnancy.Insulin resistance is a condition where the cells do not respond well to insulin and require more insulin to lower the blood sugar levels.

D. Decreased glycosylated hemoglobin levels.

This statement is false.

Glycosylated hemoglobin (HbA1c) is a measure of how much glucose is attached to hemoglobin, a protein in red blood cells that carries oxygen.

HbA1c reflects the average blood sugar levels over the past 2 to 3 months.

Normal HbA1c levels are below 5.7%.

In GDM, the HbA1c levels are not necessarily decreased, but they may be within or slightly above the normal range, depending on how well the blood sugar levels are controlled during pregnancy.HbA1c is not a reliable test for diagnosing GDM, as it may not reflect the recent changes in blood sugar levels caused by pregnancy.

The correct answer is

C. It transports glucose from the bloodstream into the cells for energy production.

Insulin is a hormone that regulates the metabolism of carbohydrates, fats, and proteins.It promotes the absorption of glucose from the blood into cells, where it can be used for energy or stored as glycogen or fat.It also inhibits glucose production and secretion by the liver and stimulates lipogenesis and protein synthesis.Insulin is essential for cell metabolism and low insulin levels can cause catabolism of body fat.

A. It converts glucose into glycogen for storage in the liver and muscles.

This statement is partially true, but not the main role of insulin.

Insulin does stimulate the formation of glycogen from glucose in the liver and muscles, but this is not its primary function.Glycogen is a form of stored glucose that can be mobilized when blood glucose levels are low.Insulin also inhibits the breakdown of glycogen (glycogenolysis) and the synthesis of glucose from amino acids and fatty acids (gluconeogenesis) in the liver.

B. It breaks down glucose into carbon dioxide and water for excretion in the urine and lungs.

This statement is false.

Insulin does not break down glucose, but rather facilitates its uptake by cells.

Glucose is broken down by a process called glycolysis, which produces pyruvate and ATP (energy).

Pyruvate can then enter the Krebs cycle and the electron transport chain to produce more ATP, carbon dioxide and water.Carbon dioxide is exhaled by the lungs and water is excreted by the kidneys.

Insulin has no direct role in these processes.

D. It stimulates glucose synthesis from amino acids and fatty acids in the liver.

This statement is false.

Insulin does not stimulate glucose synthesis, but rather inhibits it.

Glucose synthesis from non-carbohydrate sources, such as amino acids and fatty acids, is called gluconeogenesis.

This process occurs mainly in the liver and is stimulated by glucagon, a hormone that opposes insulin.Gluconeogenesis helps to maintain blood glucose levels when dietary intake or glycogen stores are low.Insulin suppresses gluconeogenesis by inhibiting the enzymes involved in this pathway.

The correct answer is

A. Polyuria, polydipsia, and polyphagia.

These are the classic signs and symptoms of diabetes, which occur due to high blood sugar levels.Gestational diabetes is a type of diabetes that develops during pregnancy and can affect the health of the mother and the baby.

B. Hypotension, bradycardia, and bradypnea.

Statement is wrong because these are signs of low blood pressure, low heart rate, and low breathing rate, which are not related to gestational diabetes.

C. Nausea, vomiting, and abdominal pain.

Statement is wrong because these are signs of ketoacidosis, a serious complication of diabetes that occurs when the body breaks down fat for energy and produces ketones.Ketoacidosis is rare in gestational diabetes and usually affects people with type 1 diabetes.

D. Headache, blurred vision, and drowsiness.

Statement is wrong because these are signs of hyperglycemia (high blood sugar) or hypertensive disorders (high blood pressure), which can occur in gestational diabetes but are not specific to it.They can also be caused by other conditions such as dehydration, infection, or preeclampsia.

Normal ranges for blood sugar levels during pregnancy are:

• Before meals: 3.5 to 5.9 mmol/L (63 to 106 mg/dL)

• One hour after meals: 7.8 mmol/L (140 mg/dL) or less

• Two hours after meals: 6.4 mmol/L (115 mg/dL) or less

The correct answer is choice C. Choose foods that are high in fiber and low in fat.

This instruction will help the client control blood glucose levels and prevent constipation, which is common in pregnancy.

Foods high in fiber include fruits, vegetables, whole grains, beans, nuts, and seeds.

Foods low in fat include lean meats, poultry, fish, low-fat dairy products, and vegetable oils.

Choice A is wrong because eating three large meals per day with snacks in between can cause spikes and drops in blood glucose levels.

The client should eat smaller, more frequent meals throughout the day to maintain a steady blood glucose level.

Choice B is wrong because limiting carbohydrate intake to less than 40% of total calories can lead to ketosis, which is harmful for the fetus.

The client should consume about 45% to 65% of total calories from carbohydrates, preferably from complex sources such as whole grains, fruits, and vegetables.

Choice D is wrong because avoiding foods that contain artificial sweeteners is not necessary for gestational diabetes.

Artificial sweeteners do not affect blood glucose levels and can be used in moderation as part of a balanced diet.

However, the client should limit foods and beverages that are high in sugar and calories, such as soda, candy, cake, and ice cream.

The correct answer is choice D. Lispro insulin.

Lispro insulin is a rapid-acting insulin that can be injected 15 minutes before a meal to lower blood sugar.It is safe and effective for pregnant women with gestational diabetes.

Choice A is wrong because regular insulin is a short-acting insulin that needs to be injected 30 minutes before a meal.It may not provide enough control over blood sugar levels during pregnancy.

Choice B is wrong because NPH insulin is an intermediate-acting insulin that has a peak effect several hours after injection.It may cause low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia) if not timed correctly with meals and snacks.

Choice C is wrong because glargine insulin is a long-acting insulin that provides a steady level of insulin throughout the day.

It cannot be mixed with other types of insulin

The correct answer is choice B. One-hour blood glucose level of 185 mg/dL.

This indicates that the woman has impaired glucose tolerance, which is a risk factor for gestational diabetes.According to Mayo Clinic, a normal blood glucose level is lower than 140 mg/dL (7.8 mmol/L) after a glucose tolerance test.

A blood glucose level between 140 and 199 mg/dL (7.8 and 11 mmol/L) is considered impaired glucose tolerance,

Polycythemia is a condition where the baby has too many red blood cells, which can cause blood clots and other problems.It can occur in newborns whose mothers have gestational diabetes because of the high blood sugar levels in the mother’s blood.

Choice A is wrong because macrosomia is not a complication, but a risk factor for gestational diabetes.Macrosomia means having a large baby, which can cause difficulties during delivery and increase the need for a C-section.

Choice B is wrong because hypothermia is not a common complication of gestational diabetes.

Hypothermia means having a low body temperature, which can occur in newborns for various reasons, such as infection, prematurity, or exposure to cold.

Choice D is wrong because hyperglycemia is not a complication of gestational diabetes, but a cause of it.

Hyperglycemia means having high

A nurse is teaching a pregnant woman who has gestational diabetes about how to prevent type 2 diabetes in the future.

Which of the following statements by the woman indicates an understanding of the teaching?.

A. “I should have my blood glucose levels checked every year.”.

B. “I should avoid breastfeeding my baby.”.

C. “I should gain weight gradually after delivery.”.

D. “I should take oral antidiabetic drugs as prescribed.

Answer and explanation..

The correct answer is choice A.“I should have my blood glucose levels checked every year.” This statement indicates that the woman understands that she is at high risk of developing type 2 diabetes after having gestational diabetes and that regular screening can help detect it early and prevent complications.

Choice B is wrong because breastfeeding can actually lower the risk of type 2 diabetes in women who had gestational diabetes.Breastfeeding can also benefit the baby by reducing the risk of obesity and diabetes later in life.

Choice C is wrong because gaining weight gradually after delivery can increase the risk of type 2 diabetes in women who had gestational diabetes.

Losing excess weight and

The correct answer is

B. Preeclampsia.

Preeclampsia is a condition that causes high blood pressure and protein in the urine during pregnancy.It can lead to serious complications for the mother and the baby, such as seizures, organ damage, growth restriction, and placental abruption.

Advanced maternal age (35 years or older) is one of the risk factors for preeclampsia.Other risk factors include chronic hypertension, kidney disease, diabetes, obesity, multiple gestation, and history of preeclampsia.

A. Gestational diabetes.

Statement is wrong because gestational diabetes is a condition that causes high blood sugar levels during pregnancy.

It can affect the health of the mother and the baby, such as increasing the risk of macrosomia, cesarean delivery, hypoglycemia, and future diabetes.

However, advanced maternal age is not a major risk factor for gestational diabetes.

The main risk factors are obesity, family history of diabetes, previous gestational diabetes, and certain ethnicities.

C. Preterm labor.

Statement is wrong because preterm labor is when contractions start before 37 weeks of pregnancy and lead to cervical changes.

It can result in premature birth, which can cause health problems for the baby, such as breathing difficulties, bleeding in the brain, and infections.

Advanced maternal age is not a direct risk factor for preterm labor.

The main risk factors are multiple gestation, history of preterm birth, cervical insufficiency, infection, placental problems, and certain medical conditions.

D. Placenta previa.

Statement is wrong because placenta previa is when the placenta covers part or all of the cervix.

It can cause painless vaginal bleeding during pregnancy and delivery complications, such as hemorrhage and cesarean delivery.

Advanced maternal age is not a strong risk factor for placenta previa.

The main risk factors are previous cesarean delivery, multiple gestation, smoking, and previous uterine surgery.

The correct answer is choice D. Gestational diabetes.

Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy.

It can cause complications for both the mother and the baby, such as preeclampsia, macrosomia, and neonatal hypoglycemia.An elevated BMI increases the risk of developing gestational diabetes because excess body fat can impair insulin sensitivity and secretion.

Choice A is wrong because preterm labor is not directly related to BMI, but rather to other factors such as infections, cervical insufficiency, or multiple gestation.

Choice B is wrong because ectopic pregnancy is not associated with BMI, but rather with pelvic inflammatory disease, tubal surgery, or previous ectopic pregnancy.

Choice C is wrong because gestational hypertension is not caused by BMI alone, but rather by genetic factors, chronic hypertension, or renal disease.

Normal ranges for BMI are 18.5-24.9 kg/m2 for normal weight, 25.0-29.9 kg/m2 for overweight, and 30.0 kg/m2 or higher for obesity.

The correct answer is choiceD.

No history of endocrine disorders.This factor increases the client’s risk of developing gestational diabetes because endocrine disorders such as thyroid disease or polycystic ovary syndrome can affect insulin resistance and glucose metabolism.

Choice A is wrong because having a previous baby withlow birth weightis not a risk factor for gestational diabetes.In fact, having a previous baby withhigh birth weight(> 9 pounds) is a risk factor.

Choice B is wrong because being ofCaucasian originis not a risk factor for gestational diabetes.In fact, being ofnon-Caucasian originsuch as African American, Hispanic, Native American, Asian American, or Pacific Islander is a risk factor.

Choice C is wrong because havingno family history of diabetesis not a risk factor for gestational diabetes.In fact, having afamily history of diabetes(especially type 2 diabetes) in a first-degree relative (parent or sibling) is a risk factor.

Some other risk factors for gestational diabetes include being older than 25 years, being overweight or obese, having prediabetes or impaired glucose tolerance, having a history of gestational diabetes in a previous pregnancy, having hypertension or preeclampsia, or having polycystic ovary syndrome.

Normal ranges for fasting plasma glucose are 60 to 99 mg/dL for nonpregnant women and 70 to 95 mg/dL for pregnant women.Normal ranges for oral glucose tolerance test are less than 140 mg/dL at 1 hour and less than 120 mg/dL at 2 hours for nonpregnant women and less than 180 mg/dL at 1 hour and less than 155 mg/dL at 2 hours for pregnant women.

The correct answer is choice C. Gestational diabetes.Impaired glucose tolerance in pregnancy means that the blood sugar levels are elevated, but not high enough to be diagnosed with diabetes.However, this condition increases the risk of developing gestational diabetes, which is a type of diabetes that occurs only during pregnancy and affects both the mother and the baby.

Choice A is wrong because preterm labor is not directly caused by impaired glucose tolerance, although gestational diabetes may increase the risk of preterm labor.

Choice B is wrong because ectopic pregnancy is not related to impaired glucose tolerance or gestational diabetes.Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in the fallopian tube.

Choice D is wrong because gestational hypertension is not caused by impaired glucose tolerance, although gestational diabetes may increase the risk of gestational hypertension.Gestational hypertension is high blood pressure that develops after 20 weeks of pregnancy and goes away after delivery.

The correct answer is choice D. No history of endocrine disorder.This is because having a history of endocrine disorder, such as thyroid disease or polycystic ovary syndrome, can increase the risk of developing gestational diabetes.

Choice A is wrong because being of African-Caribbean origin is not a risk factor for gestational diabetes.The ethnic groups that have higher risk include Asian, Hispanic, Native American, and Pacific Islander.

Choice B is wrong because normal body mass index (BMI) is not a risk factor for gestational diabetes.On the contrary, having a high BMI (over 30) before pregnancy or gaining too much weight during pregnancy can increase the risk of gestational diabetes.

Choice C is wrong because no family history of diabetes is not a risk factor for gestational diabetes.Having a family history of diabetes, especially in a first-degree relative (such as a parent or sibling), can increase the risk of gestational diabetes.

Normal ranges for blood glucose levels during pregnancy are:

• Fasting: less than 95 mg/dL

• One hour after meal: less than 140 mg/dL

• Two hours after meal: less than 120 mg/dL

The correct answer is choice A.Being 35 years old is a risk factor for gestational diabetes because the risk increases with age.

Choice B is wrong because having a BMI of 28 is not considered obese, which is a risk factor for gestational diabetes.Obesity is usually defined as having a BMI of 30 or higher.

Choice C is wrong because having a previous baby who weighed 3.5 kg (7.7 lb) at birth is not a risk factor for gestational diabetes.A risk factor is having a previous baby who weighed more than 4 kg (9 lb) at birth.

Choice D is wrong because having a history of PCOS (polycystic ovary syndrome) is not a risk factor for gestational diabetes.PCOS is a condition that affects the ovaries and hormones, but it does not directly cause gestational diabetes.

The correct answer is choice C. Type 2 diabetes.The nurse should explain that the woman has a higher risk of developing type 2 diabetes later in life because gestational diabetes is a condition where the body cannot use insulin properly during pregnancy.This can lead to high blood sugar levels and affect the health of both the mother and the baby.Gestational diabetes usually goes away after the baby is born, but it increases the chance of getting type 2 diabetes in the future.According to the CDC, up to 50% of women with gestational diabetes will develop type 2 diabetes within 5 to 10 years after delivery.

Choice A is wrong because hypertension is not directly related to gestational diabetes.However, high blood pressure can be a complication of pregnancy and can increase the risk of preeclampsia, a serious condition that can affect both the mother and the baby.

Choice B is wrong because osteoporosis is not directly related to gestational diabetes.

Osteoporosis is a condition where the bones become weak and brittle due to loss of bone density.It can be influenced by factors such as age, genetics, diet, lifestyle, and hormonal changes.

Choice D is wrong because thyroid disease is not directly related to gestational diabetes.

Thyroid disease is a condition where the thyroid gland produces too much or too little thyroid hormone, which regulates the metabolism and other body functions.It can be caused by autoimmune disorders, infections, tumors, medications, or iodine deficiency.

The correct answer is choice C. Perform a glucose tolerance test.

A fasting blood glucose level of 100 mg/dL is considered borderline for gestational diabetes and indicates the need for further testing.

A glucose tolerance test measures how the body responds to a glucose load and can diagnose gestational diabetes.

Choice A is wrong because a fasting blood glucose level of 100 mg/dL is not normal for a pregnant woman and does not rule out gestational diabetes.

Choice B is wrong because repeating the test in one week will not provide any additional information and may delay the diagnosis and treatment of gestational diabetes.

Choice D is wrong because insulin is not prescribed unless the woman has confirmed gestational diabetes and fails to control her blood glucose levels with diet and exercise.

The normal range for fasting blood glucose in pregnancy is 70 to 95 mg/dL.

The correct answer is choice A. Higher insulin resistance.According to a systematic review of gestational diabetes mellitus (GDM) in Africa, African-Caribbean women have higher insulin resistance than other ethnic groups, which increases their risk of developing GDM.

Insulin resistance is a condition where the body does not respond well to the hormone insulin, which regulates blood sugar levels.

Choice B is wrong because lower birth weight is not associated with GDM in African-Caribbean women.In fact, some studies have found that GDM increases the risk of macrosomia (large for gestational age infants) and higher mean birth weight.

Choice C is wrong because earlier onset of diabetes is not a characteristic of African-Caribbean women with GDM.

GDM is usually diagnosed in the second or third trimester of pregnancy, regardless of ethnicity.However, women with GDM have a higher risk of developing type 2 diabetes later in life.

Choice D is wrong because faster resolution of diabetes is not a characteristic of African-Caribbean women with GDM.Most women with GDM revert to normal glucose metabolism after delivery, but some may have persistent glucose intolerance or diabetes.The risk of developing type 2 diabetes after GDM is also higher for African-Caribbean women than other ethnic groups.

The correct answer is choice D. Teach the woman how to check her blood glucose levels at home.This is because gestational diabetes is a condition where the blood glucose levels are higher than normal during pregnancy, and it can affect the health of the mother and the baby.By checking her blood glucose levels at home, the woman can monitor her condition and adjust her treatment accordingly.

Choice A is wrong because increasing the intake of complex carbohydrates can raise the blood glucose levels and worsen gestational diabetes.Instead, the woman should follow a healthy eating plan that balances carbohydrates with protein and fat.

Choice B is wrong because blood pressure and urine protein levels are not directly related to gestational diabetes.They are more relevant for preeclampsia, a different complication of pregnancy that involves high blood pressure and kidney damage.

Choice C is wrong because limiting physical activity during pregnancy can increase the risk of gestational diabetes and other problems.Physical activity can help lower blood glucose levels, improve blood pressure and cholesterol levels, relieve stress, and prevent excessive weight gain.The woman should aim for 30 minutes of moderate activity at least 5 days a week, unless her doctor advises otherwise.

The correct answer is choice D. “I should have my baby weighed at every prenatal visit.” This statement indicates a need for further teaching because having the baby weighed at every prenatal visit is not a way to prevent or detect gestational diabetes.Gestational diabetes is a condition in which women develop high blood sugar during pregnancy due to hormonal changes and insufficient insulin production.It can cause complications for the mother and the baby, such as high blood pressure, heavy birth weight, premature delivery, low blood sugar and future diabetes.

Choice A is wrong because losing weight before getting pregnant if one has a high BMI is a good way to reduce the risk of gestational diabetes.Obesity is one of the biggest risk factors for developing gestational diabetes, as it affects the body’s ability to use insulin effectively.

Choice B is wrong because telling the doctor if one has a family history of diabetes is also a good way to reduce the risk of gestational diabetes.Having a parent or sibling with diabetes increases the likelihood of developing gestational diabetes, as it may indicate a genetic predisposition to insulin resistance.

Choice C is wrong because avoiding getting pregnant after 40 years old is another good way to reduce the risk of gestational diabetes.Maternal age is one of the most important independent risk factors for gestational diabetes, as older women tend to have more insulin resistance and less beta-cell function than younger women.

The correct answer is choice B. Preeclampsia.Gestational diabetes increases the risk of developing preeclampsia, a condition characterized by high blood pressure and protein in the urine that can lead to serious complications for the mother and the baby.

Choice A is wrong because anemia is not a common complication of gestational diabetes.

Anemia is a condition where the red blood cells are low or abnormal, causing fatigue, weakness and pale skin.

Choice C is wrong because placenta previa is not related to gestational diabetes.

Placenta previa is a condition where the placenta covers part or all of the opening of the cervix, causing bleeding and possible premature delivery.

Choice D is wrong because preterm labor is not directly caused by gestational diabetes.

Preterm labor is when contractions start before 37 weeks of pregnancy, which can result in a premature birth.However, gestational diabetes can increase the risk of other conditions that can lead to preterm labor, such as polyhydramnios (excess amniotic fluid) or macrosomia (large baby).

The correct answer is choice A. A 32-year-old woman who is obese and has PCOS.

This woman has two major risk factors for developing gestational diabetes: obesity and polycystic ovary syndrome (PCOS).Obesity increases insulin resistance and PCOS is associated with hormonal imbalances that affect glucose metabolism.

Choice B is wrong because being Asian and having a previous baby who weighed 4 kg (8.8 lb) at birth are not as strong risk factors as obesity and PCOS.However, they do increase the risk slightly.

Choice C is wrong because being Caucasian and having impaired glucose tolerance are also not as strong risk factors as obesity and PCOS.Impaired glucose tolerance means that the blood sugar level is higher than normal but not high enough to be diagnosed as diabetes.

Choice D is wrong because being Hispanic and having a parent with type 2 diabetes are also not as strong risk factors as obesity and PCOS.However, they do increase the risk slightly.

Normal ranges for blood glucose levels during pregnancy are:

• Fasting: less than 95 mg/dL

• One hour after meal: less than 140 mg/dL

• Two hours after meal: less than 120 mg/dL

The correct answer is choice A. Breastfeed your baby for at least six months.According to the CDC, breastfeeding can lower the risk of type 2 diabetes for both mothers and babies.

Breastfeeding can also help mothers lose weight after delivery and improve blood sugar control.

Choice B is wrong because oral antidiabetic drugs are not recommended for women with gestational diabetes.

Instead, they should monitor their blood glucose levels and follow a healthy eating plan and physical activity routine.If these measures are not enough, they may need insulin injections.

Choice C is wrong because having blood glucose levels checked every six months is not enough to prevent type 2 diabetes after delivery.Women with gestational diabetes should have their blood glucose tested 6 to 12 weeks after their baby is born and then every 1 to 3 years to make sure their levels are on target.

Choice D is wrong because following a low-protein, high-fat diet is not a good way to prevent type 2 diabetes after delivery.

A high-fat diet can increase the risk of obesity, heart disease, and insulin resistance.Women with gestational diabetes should follow a balanced diet that includes lean protein, healthy fats, whole grains, fruits, and vegetables.

The correct answer is choice B. The woman delivered a healthy baby who weighed 3 kg (6.6 lb) at birth.This indicates that the insulin therapy was effective in preventing macrosomia, which is a common complication of gestational diabetes mellitus (GDM).Macrosomia is defined as a birth weight above the 90th percentile for gestational age or above 4 kg (8.8 lb).Macrosomia increases the risk of birth trauma, shoulder dystocia, cesarean section, and neonatal hypoglycemia.

Choice A is wrong because normal blood pressure and urine protein levels throughout pregnancy are not specific indicators of insulin therapy effectiveness.They are more related to the prevention of pre-eclampsia, which is a separate complication of pregnancy that can affect women with or without GDM.

Choice C is wrong because having no episodes of hypoglycemia or hyperglycemia during pregnancy is not sufficient to indicate insulin therapy

The correct answer is choice D. Thrush.

Thrush is a fungal infection that can affect the mouth, skin, or genitals.

It is more common in people with diabetes, especially if their blood sugar levels are not well controlled.High blood sugar levels can weaken the immune system and make it harder to fight off infections.

Choice A is wrong because pneumonia is a bacterial or viral infection of the lungs.It is not directly related to gestational diabetes, although having diabetes may increase the risk of respiratory infections in general.

Choice B is wrong because meningitis is an inflammation of the membranes that cover the brain and spinal cord.

It can be caused by bacteria, viruses, fungi, or other organisms.Gestational diabetes does not increase the risk of meningitis.

Choice C is wrong because cholecystitis is an inflammation of the gallbladder.

It can be caused by gallstones, infections, or other factors.Gestational diabetes does not increase the risk of cholecystitis.

Normal ranges for blood sugar levels during pregnancy are:

• Before meals: 3.5 to 5.9 mmol/L

• One hour after meals: 7.8 mmol/L or lower

• Two hours after meals: 6.4 mmol/L or lower

The correct answer is choice C. Blurred vision.

Blurred vision is a sign of hyperglycemia, which means high blood sugar.Hyperglycemia can occur in pregnant women who have gestational diabetes, a condition that develops during pregnancy and usually disappears after giving birth.Hyperglycemia can cause problems for the mother and the baby if not treated properly.

Choice A is wrong because hypotension means low blood pressure, which is not a sign of hyperglycemia.Hypotension can have other causes, such as dehydration, bleeding, or infection.

Choice B is wrong because bradycardia means slow heart rate, which is not a sign of hyperglycemia.Bradycardia can have other causes, such as heart disease, medication, or hypothyroidism.

Choice D is wrong because pallor means pale skin, which is not a sign of hyperglycemia.Pallor can have other causes, such as anemia, shock, or low blood flow.

Some other signs of hyperglycemia include increased thirst, frequent urination, excessive sweating, fatigue, and genital itching or thrush.Normal blood sugar ranges for pregnant women are 60 to 99 mg/dL before meals and less than 120 mg/dL one hour after meals.

The correct answer is choice B. Hypoglycemia.Excessive sweating is a common symptom of low blood sugar (glucose) levels, which can occur in gestational diabetes if the woman takes too much insulin or does not eat enough carbohydrates.Hypoglycemia can also cause other symptoms such as shakiness, dizziness, hunger, headache, and confusion.

Choice A is wrong because dehydration does not cause excessive sweating, but rather the opposite.Dehydration can occur if the woman has high blood sugar levels, which can cause increased thirst and urination.

Choice C is wrong because ketoacidosis is a serious complication of diabetes that occurs when the body breaks down fat for energy due to lack of insulin.Ketoacidosis can cause symptoms such as nausea, vomiting, abdominal pain, fruity breath odor, and rapid breathing.

Excessive sweating is not a typical sign of ketoacidosis.

Choice D is wrong because anemia is a condition in which the blood does not have enough red blood cells or hemoglobin to carry oxygen to the tissues.Anemia can cause symptoms such as fatigue, weakness, pale skin, shortness of breath, and chest pain.

Excessive sweating is not a common symptom of anemia.

Normal ranges for blood glucose levels during pregnancy are:

• Fasting: 60 to 95 mg/dL

• One hour after a meal: 100 to 129 mg/dL

• Two hours after a meal: 70 to 119 mg/dL

The correct answer is choice D. Notify the provider.

A blood glucose level of 200 mg/dL (11.1 mmol/L) after a meal is too high for a pregnant woman with gestational diabetes and indicates poor glycemic control.

The provider should be informed of this result and may adjust the woman’s treatment plan accordingly.

Choice A is wrong because insulin is not always prescribed for gestational diabetes.

Some women can manage their blood sugar levels with diet and exercise alone.

Insulin should only be administered as prescribed by the provider and not based on a single test result.

Choice B is wrong because drinking water will not lower the blood glucose level significantly.

Water can help prevent dehydration and constipation, which are common problems in pregnancy, but it does not affect insulin sensitivity or glucose metabolism.

Choice C is wrong because repeating the test in 15 minutes will not change the outcome.

A blood glucose level of 200 mg/dL (11.1 mmol/L) after a meal is clearly abnormal and needs immediate attention.

Delaying the notification of the provider may increase the risk of complications for the woman and her baby.

According to Diabetic.org, the normal blood glucose levels for gestational diabetes are:

• Fasting: less than 95 mg/dL (5.3 mmol/L)

• One hour after a meal: less than 140 mg/dL (7.8 mmol/L)

• Two hours after a meal: less than 120 mg/dL (6.7 mmol/L)

These levels may vary slightly depending on the clinic or lab, but

The correct answer is choice A. Eat smaller meals more frequently throughout the day.

This can help prevent symptoms of hyperglycemia (high blood sugar) by keeping the blood sugar level more stable and avoiding spikes and dips.Eating smaller meals can also help prevent overeating and weight gain, which can worsen insulin resistance and gestational diabetes.

Choice B is wrong because foods that are high in fiber and low in fat can actually help control blood sugar levels by slowing down the digestion and absorption of carbohydrates.Fiber can also help lower cholesterol levels and prevent constipation.

Choice C is wrong because simple carbohydrates and sugars can raise blood sugar levels quickly and cause hyperglycemia.Women with gestational diabetes should limit their intake of these foods and choose complex carbohydrates that are rich in fiber, such as whole grains, fruits, and vegetables.

Choice D is wrong because skipping breakfast can lead to low blood sugar levels in the morning and high blood sugar levels later in the day.

It can also increase hunger and cravings, which can result in overeating at lunch and dinner.Women with gestational diabetes should eat a balanced breakfast that includes protein, carbohydrates, and healthy fats.

The correct answer is choice C. Elevated urine specific gravity.

This is because hyperglycemia causes osmotic diuresis, which increases the concentration of solutes in the urine.

Urine specific gravity is a measure of the density of urine compared to water and reflects the amount of solutes in the urine.A normal range for urine specific gravity is 1.005 to 1.030.

Choice A is wrong because elevated serum ketones are a sign of ketoacidosis, which is a complication of diabetes mellitus type 1, not gestational diabetes.Ketoacidosis occurs when the body breaks down fat for energy due to insufficient insulin and produces ketones, which are acidic byproducts that can lower the blood pH.

Choice B is wrong because decreased serum osmolality indicates dilution of the blood, which can be caused by excessive fluid intake, diuretic use, or syndrome of inappropriate antidiuretic hormone (SIADH).

Serum osmolality is a measure of the concentration of solutes in the blood and reflects the balance between water and electrolytes.A normal range for serum osmolality is 275 to 295 mOsm/kg.

Choice D is wrong because decreased blood pH indicates acidosis, which can be caused by ketoacidosis, lactic acidosis, renal failure, or respiratory failure.

Blood pH is a measure of the acidity or alkalinity of the blood and reflects the balance between carbon dioxide and bicarbonate.A normal range for blood pH is 7.35 to 7.45.

The correct answer is choice A. Sublingual.

The nurse should use the sublingual route to administer the glucose, which means placing the glucose under the tongue of the woman.This route allows for faster absorption of glucose into the bloodstream than the oral route, which involves swallowing the glucose.This is especially important for a pregnant woman with gestational diabetes and hyperglycemia, who needs to lower her blood sugar levels quickly to avoid complications for herself and her baby.

Choice B. Buccal is wrong because it means placing the glucose inside the cheek against the buccal mucosa.This route has been shown to result in a lower plasma glucose concentration than the oral route, which is not desirable for a woman with hyperglycemia.

Choice C. Oropharyngeal is wrong because it means placing the glucose in the back of the mouth near the throat.This route is not recommended for glucose administration because it can cause choking or aspiration.

Choice D. Nasogastric is wrong because it means inserting a tube through the nose into the stomach and delivering the glucose through the tube.This route is invasive and unnecessary for glucose administration, unless the woman is unable to take glucose by mouth.

Normal ranges for blood glucose levels during pregnancy are 3.5 to 5.9 mmol/l before meals and less than 7.8 mmol/l one hour after meals.

The correct answer is choice A. Fetal distress.According to the search results, maternal hyperglycemia during labor is highly associated with macrosomia in neonates, which can lead to fetal distress due to shoulder dystocia, birth trauma, or hypoxia.

Fetal distress can be detected by abnormal fetal heart rate patterns or meconium-stained amniotic fluid.

Choice B. Uterine atony is wrong because it is not a direct complication of hyperglycemia during labor.

Uterine atony is a failure of the uterus to contract after delivery, which can cause postpartum hemorrhage.

It can be caused by multiple factors such as prolonged labor, overdistension of the uterus, infection, or medications.

Choice C. Maternal hypothermia is wrong because it is not a common complication of hyperglycemia during labor.

Maternal hypothermia can occur due to exposure to cold environment, anesthesia, or infection.

It can affect the maternal and fetal metabolism and oxygenation.

Choice D. Placental abruption is wrong because it is not a direct complication of hyperglycemia during labor.

Placental abruption is a premature separation of the placenta from the uterine wall, which can cause fetal and maternal hemorrhage, hypoxia, and shock.

It can be caused by trauma, hypertension, smoking, or cocaine use.

The correct answer is choice A.“I should check my blood glucose levels four times a day.” This statement indicates that the woman understands the importance of monitoring her blood sugar levels regularly to manage gestational diabetes and prevent complications for herself and her baby.

Choice B is wrong because drinking juice or soda can increase blood sugar levels and worsen hyperglycemia.Instead, the woman should drink water or sugar-free beverages if she feels thirsty.

Choice C is wrong because vaginal discharge or itching are not symptoms of hyperglycemia, but of a possible yeast infection, which can be more common in women with diabetes.The woman should report any signs of infection to her doctor, but this is not related to managing hyperglycemia.

Choice D is wrong because stopping insulin or oral medication after delivery can cause blood sugar levels to rise and increase the risk of developing type 2 diabetes in the future.The woman should follow her doctor’s advice on when and how to stop taking medication for gestational diabetes.

The correct answer is choice B. Drink water only for 8 hours before the test.This is because the test measures how your body responds to sugar (glucose) and drinking water will not affect your blood sugar levels.The test involves drinking a sugary drink and having your blood drawn before and after to check how your body handles the glucose.

Choice A is wrong because eating a high-carbohydrate meal the night before will raise your blood sugar levels and may interfere with the test results.

Choice C is wrong because caffeine and smoking can also affect your blood sugar levels and should be avoided before the test.

Choice D is wrong because some medications can affect your blood sugar levels and should be discussed with your doctor before the test.

The normal range for blood sugar levels during the glucose tolerance test is below 140 mg/dL (7.8 mmol/L) at one hour after drinking the sugary drink.If your level is higher than that, you may have gestational diabetes and need further testing.Gestational diabetes is a condition that develops during pregnancy and can cause problems for you and your baby if not well managed.

The correct answer is choice C. 185 mg/dL.According to the Mayo Clinic, a blood sugar level of 190 mg/dL or higher indicates gestational diabetes.A blood sugar level below 140 mg/dL is usually considered normal.

Therefore, a blood sugar level of 185 mg/dL is above the normal range and below the diagnostic threshold for gestational diabetes.

Choice A is wrong because 160 mg/dL is within the normal range for the glucose tolerance test.

Choice B is wrong because 175 mg/dL is also within the normal range for the glucose tolerance test.

Choice D is wrong because 200 mg/dL is above the diagnostic threshold for gestational diabetes.

The correct answer is choice D. Macrosomia.Macrosomia is a condition where the baby grows larger than normal due to excess sugar from the mother’s blood.This can lead to complications such as injuries during delivery, low blood sugar and mineral levels, jaundice, pre-term birth, and breathing problems for the baby.It can also increase the risk of obesity and diabetes later in life for the baby.

Choice A is wrong because intrauterine growth restriction (IUGR) is a condition where the baby grows smaller than normal due to poor nutrition or oxygen supply from the placenta.

Gestational diabetes does not cause IUGR, but other factors such as high blood pressure, smoking, infections, or chromosomal abnormalities can.

Choice B is wrong because respiratory distress syndrome (RDS) is a condition where the baby has difficulty breathing due to immature lungs that lack surfactant, a substance that helps keep the air sacs open.

Gestational diabetes does not directly cause RDS, but it can increase the risk of pre-term birth, which is a major risk factor for RDS.

Choice C is wrong because congenital anomalies are structural or functional defects that are present at birth due to genetic or environmental factors.

Gestational diabetes does not cause congenital anomalies, but it can increase the risk of them if it is present before or during early pregnancy, when the baby’s organs are forming.

The correct answer is choice B. Type 2 diabetes.This test is done to check if the woman has developed type 2 diabetes after having gestational diabetes during pregnancy.Gestational diabetes is a condition in which women develop high blood sugar during pregnancy.It usually goes away after delivery, but it increases the risk of developing type 2 diabetes later in life.Type 2 diabetes is a chronic condition that affects how the body uses glucose, a type of sugar that is the main source of energy for the cells.

Choice A is wrong because type 1 diabetes is an autoimmune condition that usually develops in childhood or young adulthood and requires insulin injections for life.

It is not caused by gestational diabetes.

Choice C is wrong because prediabetes is a condition in which blood sugar levels are higher than normal but not high enough to be diagnosed as diabetes.

It is a risk factor for developing type 2 diabetes, but it is not the same as having diabetes.

Choice D is wrong because metabolic syndrome is a cluster of conditions that increase the risk of heart disease, stroke and type 2 diabetes.These conditions include high blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels.

Metabolic syndrome can be diagnosed by measuring these factors, not by a glucose tolerance test.

The correct answer is choice D. 2400 calories.

A pregnant woman with gestational diabetes and a BMI of 30 needs to consume enough calories to support her pregnancy and maintain a healthy weight.The calorie level recommended for gestational diabetes varies widely depending on the individual’s needs, activity level, and weight gain goals.However, a general guideline is to consume 30 kcal/kg of ideal body weight (pre-pregnant weight) in the first trimester, 36 kcal/kg in the second trimester, and 38 kcal/kg in the third trimester.

Assuming that the woman’s ideal body weight is 65 kg (based on a BMI of 25), her calorie intake would be:

• First trimester: 30 x 65 = 1950 calories

• Second trimester: 36 x 65 = 2340 calories

• Third trimester: 38 x 65 = 2470 calories

Therefore, the closest answer is 2400 calories per day during the third trimester of pregnancy.

A. 1800 calories.

Statement is wrong because this is too low for a pregnant woman with gestational diabetes and a BMI of 30.Eating too few calories can lead to ketosis, which is harmful for the baby.

It can also cause low blood sugar, hunger, fatigue, and poor nutrition.

B. 2000 calories.

Statement is wrong because this is also too low for a pregnant woman with gestational diabetes and a BMI of 30.

It may not provide enough energy and nutrients for the mother and the baby.

C. 2200 calories.

Statement is wrong because this is still below the recommended range for a pregnant woman with gestational diabetes and a BMI of 30.

It may not meet the increased needs of the third trimester of pregnancy.

The correct answer is choice A. The nurse should monitor the woman’s blood glucose levels every hour during labor.This is because the goal of intrapartum insulin therapy is maternal and fetal euglycemia with a maternal glucose less than 90 mg/dL.Hourly blood glucose monitoring can help adjust the insulin infusion rate and prevent hypoglycemia or hyperglycemia.

Choice B is wrong because every two hours is not frequent enough to maintain optimal glucose control during labor.

Choice C is wrong because every four hours is too long to wait between blood glucose checks and could lead to complications.

Choice D is wrong because every six hours is even longer and more risky than choice C. Normal ranges for blood glucose levels during labor are between 4.0 and 6.0-7.0 mmol/L (72-108 mg/dL).Women with gestational diabetes who require less than 1.0 units/kg/d of insulin may not need intravenous insulin, but they still need to be monitored regularly.

The correct answer is choice A. The nurse should check the newborn’s blood glucose level within one hour after birth.This is because infants born to mothers with gestational diabetes are at risk of developing hypoglycemia due to increased insulin secretion in response to maternal-fetal hyperglycemia.Hypoglycemia can cause neurological damage and other complications in newborns, so early detection and treatment are essential.

Choice B is wrong because two hours after birth may be too late to prevent or treat hypoglycemia in some infants.

Choice C is wrong because three hours after birth is even later and may increase the risk of adverse outcomes.

Choice D is wrong because four hours after birth is the latest time to check the blood glucose level and may miss some cases of hypoglycemia that occur earlier.

The correct answer is choice C. The woman had no episodes of hypoglycemia or hyperglycemia during pregnancy.This indicates that the interventions were successful in maintaining normal blood glucose levels and preventing complications for the mother and the baby.

Choice A is wrong because the woman gained less than 10 kg (22 lb) during pregnancy.

This is below the recommended weight gain range for women with gestational diabetes, which depends on their pre-pregnancy body mass index (BMI).According to a study based on over 12 thousand participants, the ideal weight gain range for women with gestational diabetes was 10–15.9 kg for underweight, 8–11.9 kg for normal weight, 6–7.9 kg for overweight, and -5–3.9 kg for obesity.

Choice B is wrong because the woman delivered a baby who weighed 3 kg (6.6 lb) at birth.

This is within the normal range for birth weight, but it does not necessarily reflect the effectiveness of the interventions for gestational diabetes.A baby born to a mother with gestational diabetes may be at risk of being large for gestational age (LGA), which is defined as a birth weight above the 90th percentile for gestational age.LGA babies may have complications such as shoulder dystocia, hypoglycemia, and respiratory distress syndrome.

Choice D is wrong because the woman’s blood glucose levels returned to normal within six weeks after delivery.

This is a desirable outcome, but it does not indicate that the interventions were successful during pregnancy.

Gestational diabetes usually

The correct answer is choice C.Being older than 25 years at the time of pregnancy is a risk factor for developing gestational diabetes.Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don’t already have diabetes.It occurs when the body can’t make enough insulin during pregnancy.

Choice A is wrong because being underweight before pregnancy is not a risk factor for gestational diabetes.In fact, obesity is one of the biggest risk factors for this condition.

Choice B is wrong because having a history of infertility or miscarriage is not a risk factor for gestational diabetes.However, having a family history of diabetes is a risk factor.

Choice D is wrong because having a family history of autoimmune disease is not a risk factor for gestational diabetes.

Autoimmune diseases are conditions where the immune system attacks the body’s own tissues, such as type 1 diabetes or rheumatoid arthritis.Gestational diabetes is not an autoimmune disease, but rather a disorder of insulin resistance.

Normal ranges for blood glucose levels during pregnancy are:

• Fasting: less

The correct answer is choice B. Preeclampsia.

Preeclampsia is a complication of pregnancy that is characterized by high blood pressure, proteinuria, and edema.It can result from uncontrolled blood sugar levels, as well as other risk factors such as obesity, hypertension, and previous large for gestational age (LGA) infant.

Preeclampsia can lead to serious complications for both the mother and the baby, such as eclampsia, HELLP syndrome, placental abruption, and intrauterine growth restriction.

Choice A. Placenta previa is wrong because it is a condition where the placenta covers the cervix partially or completely.It is not caused by uncontrolled blood sugar levels, but by factors such as previous cesarean section, multiple gestation, advanced maternal age, and smoking.

Choice C. Chorioamnionitis is wrong because it is an infection of the amniotic fluid and membranes that surround the fetus.

It is not caused by uncontrolled blood sugar levels, but by bacteria that ascend from the vagina or cervix into the uterus.It can cause fever, uterine tenderness, foul-smelling amniotic fluid, and fetal tachycardia.

Choice D. Abruptio placentae is wrong because it is a condition where the placenta separates from the uterine wall before delivery.It is not caused by uncontrolled blood sugar levels, but by factors such as trauma, hypertension, smoking, cocaine use, and previous history of abruption.

The correct answer is choice D. Birth weight.

The nurse should measure the birth weight of the newborn to determine if the newborn has macrosomia.Macrosomia is a condition in which a baby has a weight of more than 8 pounds, 13 ounces at birth.It is commonly caused by medical conditions, such as obesity or diabetes, of the mother during pregnancy.

Choice A is wrong because head circumference is not a reliable indicator of macrosomia.Some babies may have a large head circumference due to genetic factors or hydrocephalus, but not necessarily due to macrosomia.

Choice B is wrong because chest circumference is not a reliable indicator of macrosomia.Some babies may have a large chest circumference due to genetic factors or congenital heart defects, but not necessarily due to macrosomia.

Choice C is wrong because abdominal circumference is not a reliable indicator of macrosomia.Some babies may have a large abdominal circumference due to genetic factors or abdominal wall defects, but not necessarily due to macrosomia.

The correct answer is choice A. Monitor her blood glucose levels regularly and keep them within the target range.This is because gestational diabetes can cause high blood sugar that can affect the pregnancy and the baby’s health.High blood sugar can increase the risk of premature birth and other complications.

By monitoring and controlling blood glucose levels, the woman can reduce these risks and have a healthier pregnancy.

Choice B is wrong because drinking plenty of fluids and avoiding caffeine and alcohol are general recommendations for pregnant women, but they do not specifically prevent preterm birth due to gestational diabetes.

Choice C is wrong because progesterone supplements are used to prevent preterm birth in women who have a history of spontaneous preterm birth or a short cervix, but they are not indicated for women with gestational diabetes.

Choice D is wrong because pelvic floor exercises and avoiding lifting heavy objects are also general recommendations for pregnant women, but they do not directly prevent preterm birth due to gestational diabetes.Pelvic floor exercises can help with urinary incontinence and pelvic organ prolapse, while avoiding lifting heavy objects can prevent back pain and injury.

The correct answer is choice D. Seizures.This intervention is necessary to prevent seizures because hypoglycemia can cause brain injury and neurologic impairment in newborns.Seizures are one of the most common signs of hypoglycemia in newborns.

Choice A is wrong because respiratory distress syndrome is caused by a lack of surfactant in the lungs, not by hypoglycemia.

Choice B is wrong because necrotizing enterocolitis is an inflammatory condition of the intestines that affects premature or sick infants, not by hypoglycemia.

Choice C is wrong because intraventricular hemorrhage is a bleeding into the brain ventricles that occurs mainly in very low birth weight infants, not by hypoglycemia.

The correct answer is choice C. Type 2 diabetes.Women with gestational diabetes have a very high risk of developing type 2 diabetes later in life.Gestational diabetes is a condition where the body cannot use insulin properly during pregnancy, leading to high blood sugar levels.

This can affect the health of both the mother and the baby.

Choice A is wrong because hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate metabolism and growth.

Gestational diabetes does not increase the risk of hypothyroidism.

Choice B is wrong because osteoporosis is a condition where the bones become weak and brittle, increasing the risk of fractures.

Gestational diabetes does not increase the risk of osteoporosis.

Choice D is wrong because cardiovascular disease is a term that refers to various conditions that affect the heart and blood vessels, such as heart attack and stroke.Gestational diabetes may increase the risk of cardiovascular disease, but not as much as type 2 diabetes.

The correct answer is choice C.Being older than 25 years at the time of pregnancy is a risk factor for developing gestational diabetes.Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don’t already have diabetes.It occurs when the body can’t make enough insulin during pregnancy.

Choice A is wrong because being underweight before pregnancy is not a risk factor for gestational diabetes.In fact, obesity is one of the biggest risk factors for gestational diabetes.

Choice B is wrong because having a history of infertility or miscarriage is not a risk factor for gestational diabetes.However, having a family history of diabetes is a risk factor for gestational diabetes.

Choice D is wrong because having a family history of autoimmune diseases is not a risk factor for gestational diabetes.

Autoimmune diseases are conditions where the immune system attacks the body’s own tissues, such as type 1 diabetes or rheumatoid arthritis.Gestational diabetes is not an autoimmune disease, but rather a disorder of insulin resistance and secretion.

The correct answer is choice A. The nurse should monitor the woman’s blood glucose levels every hour during labor.This is because labor is a stressful event that can increase the blood glucose levels and the risk of complications for both the mother and the baby.The goal is to maintain the maternal glucose between 4.0 and 6.0-7.0 mmol/L during labor.

Choice B is wrong because every two hours is too infrequent to detect and correct any fluctuations in blood glucose levels during labor.

Choice C is wrong because every four hours is even more infrequent and could lead to poor glucose control and adverse outcomes.

Choice D is wrong because every six hours is the least frequent and the most dangerous option for monitoring blood glucose levels during labor.

Normal ranges for blood glucose levels are 3.9 to 5.5 mmol/L for fasting or preprandial values, and less than 7.8 mmol/L for postprandial values.

The correct answer is choice A. One hour.The nurse should check the newborn’s blood glucose level within one hour after birth because infants born to mothers with gestational diabetes are at risk of hypoglycemia due to hyperinsulinemia.Hypoglycemia can cause neurologic damage or death if left untreated.

Choice B is wrong because two hours is too long to wait for checking the blood glucose level of a newborn at risk of hypoglycemia.

Choice C is wrong because three hours is too long to wait for checking the blood glucose level of a newborn at risk of hypoglycemia.

Choice D is wrong because four hours is too long to wait for checking the blood glucose level of a newborn at risk of hypoglycemia.

Normal blood glucose levels for newborns are between 47 and 70 mg/dL.Mild hypoglycemia is defined as less than 47 mg/dL and severe hypoglycemia is defined as less than 36 mg/dL.

The correct answer is choice C. The woman had no episodes of hypoglycemia or hyperglycemia during pregnancy.This indicates that the interventions were successful in maintaining normal blood glucose levels and preventing complications for the mother and the baby.

Choice A is wrong because the woman gained less than 10 kg (22 lb) during pregnancy.This is not a reliable outcome of gestational diabetes interventions, as weight gain depends on many factors such as pre-pregnancy weight, body mass index, diet, and physical activity.

Choice B is wrong because the woman delivered a baby who weighed 3 kg (6.6 lb) at birth.This is not a specific outcome of gestational diabetes interventions, as birth weight can be influenced by other factors such as genetics, gestational age, maternal nutrition, and fetal growth.

Choice D is wrong because the woman’s blood glucose levels returned to normal within six weeks after delivery.This is not a direct outcome of gestational diabetes interventions during pregnancy, as blood glucose levels usually return to normal after delivery regardless of the interventions.However, women with gestational diabetes have a higher risk of developing type 2 diabetes later in life and should be screened regularly.

The correct answer is choice C. The woman should report any vaginal discharge or itching to her doctor, as these could be signs of a yeast infection, which is more common in women with diabetes.Yeast infections can cause irritation and discomfort, and may increase the risk of preterm labor or urinary tract infections

Choice A is wrong because checking blood glucose levels four times a day is recommended during pregnancy, not after delivery.After delivery, the woman may need to check her blood glucose levels less often, depending on her doctor’s advice

Choice B is wrong because drinking juice or soda can raise blood glucose levels and worsen hyperglycemia.The woman should drink water or sugar-free beverages if she feels thirsty

Choice D is wrong because stopping insulin or oral medication after delivery can lead to uncontrolled blood glucose levels and complications.

The woman should follow her doctor’s instructions on how to adjust her medication after delivery.Some women may need to continue taking insulin or oral medication for a while, while others may be able to stop or switch to a different type of medication

The nurse should tell the woman to wash her hands with soap and water before testing, prick the side of her fingertip with a lancet, and apply gentle pressure to the puncture site until a drop of blood forms.These steps are necessary to ensure a clean and adequate blood sample for the glucose meter.

Choice A is wrong because washing hands with soap and water is not enough.The woman should also dry her hands thoroughly to avoid diluting the blood sample.

Choice B is wrong because pricking the side of the fingertip with a lancet is not enough.The woman should also avoid squeezing the finger too hard, as this can affect the accuracy of the result.

Choice C is wrong because applying gentle pressure to the puncture site until a drop of blood forms is not enough.The woman should also wipe away the first drop of blood with a clean tissue and use the second drop for testing.

Normal ranges for blood glucose levels during pregnancy are 60 to 105 mg/dL before meals and less than 120 mg/dL one hour after meals.

The woman should report any abnormal readings to her health care provider.

Lispro insulin is a rapid-acting insulin that starts to work within 15 minutes and lasts for 2 to 4 hours.It is used to provide blood glucose control before meals for people with diabetes.A pregnant woman with gestational diabetes who is experiencing symptoms of hyperglycemia needs rapid-acting blood glucose control to prevent complications for herself and her baby.

Choice A is wrong because regular insulin is a short-acting insulin that starts to work within 30 minutes and lasts for 5 to 8 hours.It is not as fast as lispro insulin and may not provide adequate blood glucose control for a pregnant woman with hyperglycemia.

Choice B is wrong because NPH insulin is an intermediate-acting insulin that starts to work within 2 to 4 hours and lasts for 10 to 18 hours.It is used to provide background insulin throughout the day and night, but it is not suitable for rapid-acting blood glucose control.

Choice C is wrong because glargine insulin is a long-acting insulin that starts to work within 1 to 2 hours and lasts for 24 hours.It is used to provide steady insulin levels between meals and overnight, but it is not appropriate for rapid-acting blood glucose control.

The correct answer is choice B. Biophysical profile.

A biophysical profile is a test that combines a nonstress test with an ultrasound to assess the well-being of the fetus.

It measures five parameters: fetal heart rate, fetal breathing movements, fetal body movements, fetal tone, and amniotic fluid volume.A biophysical profile is indicated for pregnant women with gestational diabetes who are taking oral antidiabetic drugs because these medications can cross the placenta and affect the fetal blood glucose levels.

Choice A is wrong because a nonstress test is a test that measures the fetal heart rate response to fetal movements.It is a screening test for fetal well-being, but it does not provide information about the fetal blood glucose levels or the amniotic fluid volume.

Choice C is wrong because an amniocentesis is a test that involves inserting a needle into the uterus to obtain a sample of amniotic fluid for genetic or biochemical analysis.It is not routinely performed for pregnant women with gestational diabetes unless there is a suspicion of a chromosomal abnormality or a fetal infection.

Choice D is wrong because chorionic villus sampling is a test that involves obtaining a sample of placental tissue for genetic or biochemical analysis.

It is usually performed between 10 and 13 weeks of gestation for women who are at high risk of having a baby with a chromosomal abnormality or a genetic disorder.It is not indicated for pregnant women with gestational diabetes who are taking oral antidiabetic drugs.

The correct answer is choice A. The nurse should monitor the woman’s blood glucose levels every hour during labor.This is because the maternal glucose level should be maintained between 4.0 and 6.0-7.0 mmol/L during labor to prevent neonatal hypoglycemia.

Choice B is wrong because monitoring every two hours may not be frequent enough to detect and correct any fluctuations in blood glucose levels.

Choice C is wrong because monitoring every four hours is too infrequent and may increase the risk of complications for the mother and the baby.

Choice D is wrong because monitoring every six hours is even more infrequent and may lead to poor outcomes.

Normal ranges for blood glucose levels during pregnancy are:

• Fasting or preprandial: < 95 mg/dL

• Postprandial (1 hour): < 140 mg/dL

• Postprandial (2 hours): < 120 mg/dL

The correct answer is choice A. One hour.The nurse should check the newborn’s blood glucose level within one hour after birth because infants born to mothers with gestational diabetes are at risk of hypoglycemia due to increased insulin secretion in response to maternal-fetal hyperglycemia.Hypoglycemia can cause symptoms such as jitteriness, lethargy, poor feeding, cyanosis and apnea.

Checking the blood glucose level within one hour can help identify and treat hypoglycemia promptly.

Choice B. Two hours is wrong because it may delay the detection and treatment of hypoglycemia, which can have adverse effects on the newborn’s brain development.

Choice C. Three hours is wrong for the same reason as choice B. Choice D. Four hours is wrong for the same reason as choice B and C. Normal ranges for blood glucose levels in newborns vary depending on the method of measurement, but generally they are above 47 mg/dL.Some sources suggest a lower cutoff of 40 mg/dL.

The correct answer is choice C. The woman had no episodes of hypoglycemia or hyperglycemia during pregnancy.

This outcome indicates that the interventions were successful in maintaining a normal blood glucose level for the woman and preventing complications for her and her baby.

Choice A is wrong because the recommended weight gain for a pregnant woman with gestational diabetes is 11.5 to 16 kg (25 to 35 lb).

Gaining less than 10 kg (22 lb) may indicate inadequate nutrition or poor glycemic control.

Choice B is wrong because the ideal birth weight for a baby of a woman with gestational diabetes is between 2.5 and 4 kg (5.5 and 8.8 lb).

A baby who weighs 3 kg (6.6 lb) at birth is within the normal range, but it does not necessarily reflect the effectiveness of the interventions.

Choice D is wrong because the woman’s blood glucose levels may or may not return to normal within six weeks after delivery.

Gestational diabetes usually resolves after giving birth, but some women may develop type 2 diabetes later in life.

Therefore, a postpartum glucose test is recommended to check the woman’s status.

Normal ranges for blood glucose levels during pregnancy are:

• Fasting: less than 95 mg/dL

• One hour after meals: less than 140 mg/dL

• Two hours after meals: less than 120 mg/dL

The correct answer is choice A. “I should check my blood glucose levels four times a day.” This statement indicates that the woman understands the importance of monitoring her blood glucose levels after delivery to detect any changes or abnormalities.Most women with gestational diabetes will not have severe hyperglycemia after delivery, but they should be followed for at least 6–12 weeks to determine their glucose status.

Normal blood glucose levels are between 70 and 130 mg/dL before meals and less than 180 mg/dL two hours after meals.

Choice B is wrong because “I should drink juice or soda if I feel thirsty.” This statement indicates that the woman does not understand how to manage symptoms of hyperglycemia after delivery.

Drinking juice or soda can raise blood glucose levels and worsen hyperglycemia.

The woman should drink water or sugar-free beverages if she feels thirsty.

Choice C is wrong because “I should report any vaginal discharge or itching to my doctor.” This statement indicates that the woman does not understand how to recognize symptoms of hyperglycemia after delivery.

Vaginal discharge or itching can be signs of a yeast infection, which can occur more frequently in women with diabetes, but they are not specific to hyperglycemia.

Symptoms of hyperglycemia include increased thirst, frequent urination, blurred vision, fatigue, and headache.

Choice D is wrong because “I should stop taking my insulin or oral medication after delivery.” This statement indicates that the woman does not understand how to manage her blood glucose levels after delivery.Although most women with gestational diabetes will have normal blood glucose levels after delivery, some may have persisting hyperglycemia that requires medical management.The woman should consult with her doctor before stopping any medication and follow the guidelines of the American Diabetes Association and other relevant organizations.

The correct answer is choice C.Being older than 25 years at the time of pregnancy is a risk factor for developing gestational diabetes.Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don’t already have diabetes.It occurs when the body can’t make enough insulin during pregnancy.

Choice A is wrong because being underweight before pregnancy is not a risk factor for gestational diabetes.In fact, obesity is one of the biggest risk factors for this condition.

Choice B is wrong because having a history of infertility or miscarriage is not a risk factor for gestational diabetes.However, having a family history of diabetes is a risk factor.

Choice D is wrong because having a family history of autoimmune disease is not a risk factor for gestational diabetes.Autoimmune diseases are conditions where the immune system attacks the body’s own tissues, such as type 1 diabetes or rheumatoid arthritis.Gestational diabetes is not an autoimmune disease, but rather a disorder of insulin resistance and secretion.

The correct answer is choice C. Complex carbohydrates.

Complex carbohydrates are composed of long chains of glucose molecules that take longer to digest and provide a steady source of energy for the body.

They also help regulate blood glucose levels by preventing rapid spikes and drops.Complex carbohydrates are found in foods such as whole grains, beans, fruits, and vegetables.

Choice A is wrong because simple carbohydrates are composed of one or two sugar units that are quickly absorbed and metabolized by the body.

They can cause rapid fluctuations in blood glucose levels and should be limited by people who have gestational diabetes.Simple carbohydrates are found in foods such as candy, soda, honey, and white bread.

Choice B is wrong because refined carbohydrates are processed foods that have had most of their fiber and nutrients removed.

They are also quickly digested and can cause blood glucose levels to rise rapidly.Refined carbohydrates are found in foods such as white rice, pasta, pastries, and cereals.

Choice D is wrong because sugar alcohols are a type of sweetener that have fewer calories

The correct answer is choice D. Exercise can help the woman by enhancing her insulin sensitivity and glucose utilization.This means that the woman’s body can use the insulin and glucose more efficiently, which can help lower her blood glucose levels and prevent complications for herself and her baby.

Choice A is wrong because increasing her appetite and caloric intake can worsen her blood glucose control and lead to excessive weight gain, which can increase the risk of gestational diabetes complications such as preeclampsia, macrosomia, and cesarean delivery.

Choice B is wrong because lowering her blood pressure and heart rate are not the main benefits of exercise for a woman with gestational diabetes.

While exercise can have some positive effects on blood pressure and heart rate, these are not the primary goals of exercise therapy for gestational diabetes.The main goal is to improve blood glucose control and prevent fetal complications.

Choice C is wrong because reducing her risk of preterm labor and delivery is not a direct benefit of exercise for a woman with gestational diabetes.Exercise may have some indirect effects on reducing preterm labor and delivery by improving maternal health and well-being, but there is no clear evidence that exercise alone can prevent preterm labor and delivery in women with gestational diabetes.

The correct answer is choice D. All of the above.

The nurse should tell the woman to wash her hands with soap and water before testing, prick the side of her fingertip with a lancet, and apply gentle pressure to the puncture site until a drop of blood forms.These steps are necessary to ensure accurate and safe blood glucose monitoring at home.

Choice A is wrong because washing hands with soap and water is not enough.The woman should also dry her hands thoroughly before testing.

Choice B is wrong because pricking the side of the fingertip is not enough.The woman should also rotate the puncture sites to avoid soreness and infection.

Choice C is wrong because applying gentle pressure to the puncture site is not enough.The woman should also dispose of the lancet and the test strip properly and record the blood glucose result.

Normal blood glucose ranges for pregnant women with gestational diabetes are 95 mg/dL or less before meals, 140 mg/dL or less 1 hour after meals, and 120 mg/dL or less 2 hours after meals.

The correct answer is choice D. Lispro insulin.

Lispro insulin is a type of rapid-acting insulin that can provide blood glucose control within 15 minutes of injection.It is suitable for pregnant women with gestational diabetes who need to lower their blood sugar quickly after meals.

Choice A is wrong because regular insulin is a type of short-acting insulin that takes about 30 minutes to start working and lasts for 3 to 6 hours.It is not as fast as lispro insulin and may cause low blood sugar if taken too early before meals.

Choice B is wrong because NPH insulin is a type of intermediate-acting insulin that takes about 2 to 4 hours to start working and lasts for 12 to 18 hours.It is not suitable for rapid-acting blood glucose control and may cause low blood sugar if taken too often or at the wrong time.

Choice C is wrong because glargine insulin is a type of long-acting insulin that takes about 1 to 2 hours to start working and lasts for 24 hours.It is not suitable for rapid-acting blood glucose control and may cause low blood sugar if taken with other types of insulin.

Gestational diabetes is a condition in which a hormone made by the placenta prevents the body from using insulin effectively.

Glucose builds up in the blood instead of being absorbed by the cells.It can cause complications for the mother and the baby, such as high blood pressure, large birth weight, premature delivery, low blood sugar, and future diabetes.Gestational diabetes can be managed with a healthy diet, exercise, and medication if needed.

Insulin is a hormone that helps regulate blood glucose levels.There are different types of insulin that vary in how quickly they start working, how long they last, and how they are taken.

The correct answer is choice A. Nonstress test.A nonstress test is a screening tool that uses fetal heart rate patterns and accelerations as an indicator of fetal well-being.It is commonly performed for pregnant women who have gestational diabetes and are taking oral antidiabetic drugs to monitor the effects of the medication on the baby.

Choice B. Biophysical profile is wrong because it is an ultrasound assessment of the fetal status with an NST.It utilizes ultrasound with EFM to assess five variables: fetal breathing movements, fetal movement, fetal tone, amniotic fluid volume, and fetal heart rate.

Choice C.Amniocentesis is wrong because it is a diagnostic procedure where a needle is inserted through the abdominal wall into the uterine cavity to obtain amniotic fluid and commonly performed for genetic testing, neural tube defects, fetal lung maturity, and hemolytic disease in the fetus or intrauterine infection.

Choice D. Chorionic villus sampling (CVS) is wrong because it is a diagnostic procedure where a needle is inserted through the abdominal wall into the uterine cavity to obtain chorionic villi (placental tissue) and commonly performed for chromosomal, metabolic and DNA testing.It does not test for neural tube defects.

The correct answer is choice A. The nurse should monitor the woman’s blood glucose levels every hour during labor.This is because maternal blood glucose levels around the time of delivery are directly related to the risk of neonatal hypoglycemia.Therefore, achieving maternal euglycemia in women with gestational diabetes mellitus is critical to decreasing the risk of neonatal complications.

Choice B is wrong because every two hours is not frequent enough to ensure optimal glucose control during labor.

Choice C is wrong because every four hours is even less frequent and may miss significant fluctuations in blood glucose levels.

Choice D is wrong because every six hours is too infrequent and may put the mother and the baby at risk of adverse outcomes.

The maternal glucose should be maintained between 4.0 and 6.0-7.0 mmol/L during labor.Most women with gestational diabetes, especially if they require less than 1.0 units/kg/d of insulin, can simply be monitored without intravenous insulin.However, women who are taking medication for gestational diabetes require more frequent glucose monitoring, typically with hourly evaluations.

The correct answer is choice A. The nurse should check the newborn’s blood glucose level within one hour after birth.This is because newborns of mothers with gestational diabetes are at risk of developing hypoglycemia due to hyperinsulinemia.Hypoglycemia can cause neurological damage or death if not treated promptly.

Choice B is wrong because two hours may be too late to detect and treat hypoglycemia in a newborn at risk.

Choice C is wrong because three hours is definitely too late to check the blood glucose level of a newborn at risk of hypoglycemia.

Choice D is wrong because four hours is way too late to check the blood glucose level of a newborn at risk of hypoglycemia.

The normal blood glucose level for a newborn is between 70 and 150 mg/dL.However, some infants may have transient low blood glucose levels as low as 25 mg/dL within the first two hours of life, which is physiologic and self-limited.Infants with risk factors for hypoglycemia, such as maternal diabetes, should be screened at 2 hours of age and then before each feeding for the first and second days of life.A blood glucose level of less than 45 mg/dL in an asymptomatic infant or less than 36 mg/dL in a symptomatic infant is considered hypoglycemic and requires treatment.

The correct answer is choice B. The woman delivered a baby who weighed 3 kg (6.6 lb) at birth.

This indicates that the interventions were successful because the baby’s weight is within the normal range and not affected by gestational diabetes mellitus (GDM).According to one study, an ideal gestational weight gain (GWG) range for women with GDM is 8-11.9 kg for normal weight, 6-7.9 kg for overweight, and -5-3.9 kg for obesity.

Choice A is wrong because the woman gained less than 10 kg (22 lb) during pregnancy.This may be too low for a normal weight woman and may increase the risk of small for gestational age (SGA) or preterm birth.

Choice C is wrong because the woman had no episodes of hypoglycemia or hyperglycemia during pregnancy.

This may be a result of good blood glucose control, but it does not reflect the outcome of the interventions on the baby’s health.

Choice D is wrong because the woman’s blood glucose levels returned to normal within six weeks after delivery.This may happen in most women with GDM, but it does not indicate the effectiveness of the interventions during pregnancy.

The correct answer is choice A. The woman should check her blood glucose levels four times a day to monitor and manage her condition.This will help her avoid complications such as ketoacidosis, hypoglycemia, or fetal macrosomia.

Choice B is wrong because drinking juice or soda can increase blood glucose levels and worsen hyperglycemia.The woman should drink water or sugar-free beverages if she feels thirsty.

Choice C is wrong because vaginal discharge or itching may indicate a yeast infection, which is more common in women with diabetes, but not a sign of hyperglycemia.The woman should report any signs of infection to her doctor, but also check her blood glucose levels regularly.

Choice D is wrong because stopping insulin or oral medication after delivery can cause blood glucose levels to rise and lead to diabetic ketoacidosis, a life-threatening condition.The woman should consult with her doctor before making any changes to her medication regimen.

Normal ranges for blood glucose levels during pregnancy are:

• Before meals: 60-99 mg/dL

• One hour after meals: 100-129 mg/dL

• Two hours after meals: <120 mg/dL

The correct answer is choice A. Regular appointments allow for insulin therapy initiation if needed.This is because gestational diabetes is a condition in which women develop high blood sugar during pregnancy, which can cause complications for both the mother and the baby.Insulin is a hormone that helps lower blood sugar levels, and some women with gestational diabetes may need to take insulin injections to control their blood sugar.

Choice B is wrong because prenatal appointments do not help in diagnosing gestational diabetes.Gestational diabetes is usually diagnosed by a blood test that measures the glucose levels before and after meals.This test is typically done between 24 and 28 weeks of pregnancy.

Choice C is wrong because attending appointments does not ensure access to emotional support.Emotional support is important for pregnant women, especially those with gestational diabetes, but it can be provided by other sources such as family, friends, counselors or support groups.

Choice D is wrong because regular appointments do not allow for adjustment of insulin dosage.Insulin dosage is determined by the blood sugar levels of the woman, which she can monitor at home using a glucose meter.The doctor or midwife may adjust the insulin dosage based on the results of the blood tests and the feedback from the woman.

The correct answer is choice B. Walking, swimming, or prenatal yoga are moderate-intensity exercises that can improve insulin sensitivity.

This means that the body can use insulin more effectively to lower blood glucose levels.Exercise also has other benefits for pregnant women with gestational diabetes, such as reducing the risk of hypertension, preeclampsia, and macrosomia.

Choice A is wrong because engaging in high-intensity exercises such as weightlifting is not recommended for pregnant women with gestational diabetes.High-intensity exercises can increase blood pressure and stress hormones, which can raise blood glucose levels and cause complications.

Choice C is wrong because avoiding physical activity altogether is not recommended for pregnant women with gestational diabetes.Physical activity can help control blood glucose levels and prevent excessive weight gain, which can lead to adverse outcomes for both the mother and the baby.

Choice D is wrong because only strenuous exercises such as running are not effective in managing blood sugar levels.Strenuous exercises can also increase blood pressure and stress hormones, which can have negative effects on blood glucose levels and fetal well-being.Moderate-intensity exercises are preferred over strenuous exercises for pregnant women with gestational diabetes.

Normal ranges for blood glucose levels during pregnancy are 60 to 100 mg/dL before meals and bedtime snacks, and less than 140 mg/dL one hour after meals.

The correct answer is choice C. “I will monitor my portion sizes and calculate the number of carbohydrates I consume.” This statement indicates that the client understands the concept of carbohydrate counting, which is a method of planning meals based on the amount and type of carbohydrates in foods.

Carbohydrate counting helps to control blood glucose levels by matching insulin or medication doses to carbohydrate intake.

Choice A is wrong because protein intake does not directly affect blood glucose levels, although it is important to consume adequate protein for overall health and fetal development.

Choice B is wrong because fruits and vegetables are good sources of carbohydrates, vitamins, minerals, and fiber, and should not be avoided.

However, they should be counted as part of the total carbohydrate intake.

Choice D is wrong because consuming unlimited amounts of carbohydrates, even from whole grains, can cause hyperglycemia and complications for the mother and the fetus.

Whole grains are preferable to refined grains because they have more fiber and nutrients, but they still need to be measured and counted as carbohydrates.

The correct answer is choice C. The nurse should instruct the client to rotate injection sites to ensure consistent insulin absorption.Rotating injection sites helps prevent lipodystrophy, which is a condition that affects the subcutaneous fat tissue and can impair insulin absorption.

Choice A is wrong because injecting insulin directly into the umbilical area is not recommended for pregnant clients, as it may cause irritation or infection of the umbilical cord.

Choice B is wrong because needles should be disposed of in a puncture-resistant container, not in a regular trash bin, to prevent needlestick injuries.

Choice D is wrong because insulin vials should be stored in the refrigerator, not in the freezer, to maintain potency.Freezing can damage the insulin molecules and reduce their effectiveness.

The correct answer is choice C. Grilled salmon and quinoa.

This food choice provides a good balance of protein, healthy fats, and complex carbohydrates that can help regulate blood glucose levels for a client with gestational diabetes.

Choice A is wrong because fried chicken and French fries are high in saturated fat and simple carbohydrates that can raise blood glucose levels and increase the risk of cardiovascular complications.

Choice B is wrong because processed deli meats and white bread are high in sodium, nitrates, and refined flour that can also increase blood glucose levels and blood pressure.

Choice D is wrong because sugary cereal and whole milk are high in sugar and lactose that can spike blood glucose levels and cause digestive issues.

A client with gestational diabetes should follow a balanced meal plan that includes lean protein, healthy fats, fiber, and complex carbohydrates that are low on the glycemic index.

The client should also limit intake of simple sugars, refined grains, fried foods, and processed meats.The client should monitor blood glucose levels regularly and consult with a dietitian for individualized recommendations.