Question 1
Pregnant women with diabetes often have problems related to the effectiveness of insulin in controlling
their glucose levels during their second half of pregnancy.
The nurse teaches the client that this is due to:
A. Decreased glomerular filtration and increased tubular absorption
B. Decreased estrogen levels
C. Decreased progesterone levels
D. Increased human placental lactogen levels
Correct Answer: D
(A) There is a rise in glomerular filtration rate in the kidneys in conjunction with decreased tubular
glucose reabsorption, resulting in glycosuria.
(B) Insulin is inhibited by increased levels of estrogen. (C) Insulin is inhibited by increased levels of
progesterone. (D) Human placental lactogen levels increase later in pregnancy. This hormonal
antagonist reduces insulins effectiveness, stimulates lipolysis, and increases the circulation
of free fatty acids.
Question 2
Provide the 1-minute Apgar score for an infant born with the following findings: Heart rate: Above 100
Respiratory effort: Slow, irregular Muscle
tone: Some flexion of extremities Reflex irritability: Vigorous cry Color: Body pink, blue extremities
A.7
B. 10
C.8
D.9
Correct Answer: A
(A) Seven out of a possible perfect score of 10 is correct. Two points are given for heart rate above 100;
1 point is given for slow, irregular respiratory effort; 1 point is given for some flex- ion of extremities in
assessing muscle tone; 2 points are given for vigorous cry in assessing reflex irritability; 1 point is
assessed for color when the body is pink with blue extremities (acrocyanosis).
(B) For a perfect Apgar score of 10, the infant would have a heart rate over 100 but would also have a
good cry, active motion, and be completely pink.
(C) For an Apgar score of 8 the respiratory rate, muscle tone, or color would need to fall into the 2-point
rather than the 1-point category.
For this infant to receive an Apgar score of 9, four of the areas evaluated would need ratings of 2points
and one area, a rating of 1 point.
Question 3
A client is 6 weeks pregnant. During her first prenatal visit, she asks, "How much alcohol is safe to drink
during pregnancy?" The nurse's response
is:
A. Up to 1 oz daily
B. Up to 2 oz daily
C. Up to 4 oz weekly
D. No alcohol
Correct Answer: D
(A, B, C) No amount of alcohol has been determined safe for pregnant women. Alcohol should be
avoided owing to the risk of fetal alcohol syndrome. (D) The recommended safe dosage of alcohol
consumption during pregnancy is none.
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