The correct answer is choice A.“I should have the oral glucose tolerance test between 24 and 28 weeks of gestation.” This statement indicates understanding because it reflects the current recommendation for gestational diabetes screening for all pregnant women.The oral glucose tolerance test (OGTT) measures how the body handles glucose after a glucose load and can detect impaired glucose tolerance or diabetes.

Choice B is wrong because the woman does not need to eat a high-carbohydrate meal before the screening test.In fact, she should fast for at least 8 hours before the test.

Choice C is wrong because the screening process is necessary even if the woman has no family history of diabetes.Gestational diabetes can occur in any pregnant woman, especially if she has risk factors such as obesity, advanced maternal age, previous history of gestational diabetes, or a history of polycystic ovary syndrome.

Choice D is wrong because the screening test should not be done at any time during the pregnancy.The optimal time for screening is between 24 and 28 weeks of gestation, when insulin resistance peaks due to placental hormones.If the test is done too early or too late, it may miss some cases of gestational diabetes or give false-positive results.

The correct answer is choice A.“Consume regular meals and snacks to maintain stable blood glucose levels.” This is because eating at regular intervals helps prevent blood sugar spikes and drops, which can be harmful for both the mother and the baby.A healthy diet for gestational diabetes should include a variety of foods from different food groups, such as fruits, vegetables, whole grains, lean proteins, and low-fat dairy products.

Choice B is wrong because “Avoid fruits and vegetables to minimize carbohydrate intake.” Fruits and vegetables are rich in vitamins, minerals, antioxidants, and fiber, which are beneficial for both the mother and the baby.Carbohydrates are not bad for gestational diabetes, as long as they are complex carbohydrates that are digested slowly and do not cause rapid blood sugar spikes.Examples of complex carbohydrates are whole wheat bread, brown rice, oats, quinoa, beans, and lentils.

Choice C is wrong because “Focus on consuming high-fat foods to meet nutritional needs.” High-fat foods can increase the risk of weight gain, high cholesterol, high blood pressure, and heart disease, which can complicate gestational diabetes.

Moreover, not all fats are healthy.Saturated fats and trans fats should be avoided or limited, as they can raise bad cholesterol levels and increase inflammation.Examples of saturated fats are butter, cheese, cream, fatty meats, and coconut oil.Examples of trans fats are margarine, shortening, baked goods, fried foods, and processed snacks.Healthy fats are unsaturated fats that can lower bad cholesterol levels and provide essential fatty acids.

Examples of unsaturated fats

The correct answer is choice A.“I should engage in moderate-intensity exercises like walking or swimming.” This statement indicates that the client understands the benefits of physical activity for gestational diabetes, such as improving glucose metabolism, reducing insulin resistance, and preventing excessive weight gain.Moderate-intensity exercises are recommended for pregnant women with gestational diabetes, as long as they are medically cleared and have no contraindications.

Choice B is wrong because physical activity does not cause complications for gestational diabetes, but rather helps to prevent them.Avoiding physical activity can lead to poor glycemic control, increased risk of hypertension, preeclampsia, and cesarean delivery.

Choice C is wrong because exercise should be done throughout pregnancy, not only in the third trimester.Starting exercise early in pregnancy can help to prevent or delay the onset of gestational diabetes, and continuing exercise until delivery can help to maintain glucose levels and prevent fetal macrosomia.

Choice D is wrong because high-intensity exercises are not recommended for pregnant women with gestational diabetes, as they can cause hypoglycemia, dehydration, and fetal distress.High-intensity exercises can also increase the production of stress hormones, which can impair glucose metabolism and increase insulin resistance.

The correct answer is choice A. “Perform self-monitoring of blood glucose using a glucometer.” This instruction will help the pregnant woman with gestational diabetes to monitor her blood glucose levels and adjust her insulin dosage accordingly.Self-monitoring of blood glucose is recommended at least four times a day for women with gestational diabetes.

Choice B is wrong because “Check blood glucose levels once a week.” is not frequent enough to ensure adequate glycemic control.Women with gestational diabetes need to check their blood glucose levels daily or more often.

Choice C is wrong because “Maintaining blood glucose levels within the recommended range is not necessary.” is false and dangerous.Maintaining blood glucose levels within the recommended range is essential to prevent maternal and fetal complications such as macrosomia, hypoglycemia, congenital anomalies, and preeclampsia.

Choice D is wrong because “Ignore symptoms of hypoglycemia and hyperglycemia.” is also false and dangerous.

Symptoms of hypoglycemia and hyperglycemia should not be ignored, but reported to the health care provider and treated promptly.

Hypoglycemia can cause maternal seizures, coma, and death.Hyperglycemia can cause fetal distress, stillbirth, and neonatal death.

The normal range for fasting blood glucose in pregnancy is 60 to 95 mg/dL.The normal range for postprandial blood glucose in pregnancy is 100 to 129 mg/dL.

The correct answer is choice A. Insulin administration may be necessary if dietary modifications and physical activity alone are insufficient.

This is because gestational diabetes mellitus (GDM) is a condition that affects the way the body uses glucose during pregnancy, and it can cause high blood sugar levels that can affect the health of both the mother and the baby.Insulin is a hormone that helps the body use glucose for energy, and some women with GDM may need to take insulin injections to keep their blood sugar levels within normal range.

Choice B is wrong because skipping insulin doses can lead to dangerously high blood sugar levels that can cause complications such as ketoacidosis, fetal distress, preterm labor, or stillbirth.

Women with GDM should follow their prescribed insulin regimen and monitor their blood sugar levels regularly.

Choice C is wrong because insulin therapy is not the first-line treatment for GDM.The first-line treatment for GDM is lifestyle changes such as eating a balanced diet, limiting carbohydrates and sweets, increasing fiber intake, and exercising moderately for at least 30 minutes a day.

These measures can help lower blood sugar levels and reduce the need for insulin therapy.

However, if lifestyle changes are not enough to control blood sugar levels, insulin therapy may be added as a second-line treatment.

Choice D is wrong because insulin cannot be administered at any time during the day.

Insulin therapy for GDM requires careful timing and dosing to match the blood sugar patterns and needs of each woman.Insulin therapy for GDM usually involves a combination of short-acting and intermediate-acting insulin that are given before meals and at bedtime.

The timing and dosage of insulin depend on factors such as the woman’s weight, blood sugar levels, diet, activity level, and fetal growth.

Women with GDM should consult their health care provider or diabetes educator about their individualized insulin regimen.

The correct answer is choice B. Drink water only for 8 hours before the test.This is because the oral glucose tolerance test (OGTT) requires fasting for about 8 hours before the test to get accurate results.

The woman should not eat or drink anything except water during this time.

Choice A is wrong because eating a high-carbohydrate meal the night before can raise the blood glucose level and affect the test results.

Choice C is wrong because caffeine and smoking can also affect the blood glucose level and interfere with the test results.

Choice D is wrong because some medications can alter the blood glucose level and cause false-positive or false-negative results.The woman should consult her doctor about taking her usual medications before the test.

Normal ranges for OGTT vary depending on the laboratory and the type of glucose solution used.Generally, a normal fasting blood glucose level is less than 100 mg/dL, a normal 1-hour level is less than 180 mg/dL, a normal 2-hour level is less than 155 mg/dL, and a normal 3-hour level is less than 140 mg/dL.