A client at 28 weeks' gestation with gestational diabetes is undergoing a nonstress test. What is a reassuring result?

Correct Answer: A

Rationale: The correct answer is A: Two accelerations in 20 minutes. Accelerations in fetal heart rate during a nonstress test indicate fetal well-being and adequate oxygenation. Two accelerations in 20 minutes are reassuring as they show a normal response to fetal movement and suggest a healthy fetal nervous system. Option B is incorrect because a fetal heart rate of 170 beats/minute may indicate fetal distress or tachycardia. Option C is incorrect as decreased fetal movement can be a sign of fetal compromise. Option D is incorrect as variable decelerations can indicate umbilical cord compression and require further evaluation.

Correct Answer: C

Rationale: The correct answer is C: Fever of 101°F and foul-smelling lochia. This combination indicates a possible infection like endometritis, which can be life-threatening if not promptly treated. Fever is a sign of systemic infection, and foul-smelling lochia suggests an infected uterus. Immediate medical attention is crucial to prevent complications. A: Increased lochia after breastfeeding is common and not necessarily alarming unless it is excessive or accompanied by other symptoms. B: Perineal discomfort on day 3 postpartum is expected due to the healing process and does not typically require immediate medical attention. D: Mild fatigue and trouble sleeping are common postpartum symptoms but do not indicate a medical emergency unless they are severe or persistent.

Correct Answer: B

Rationale: The correct answer is B: Are you allergic to any metals? This is crucial because some IUDs contain metals like copper, which can trigger allergic reactions in individuals with metal allergies. It is important to assess for metal allergies to prevent potential adverse reactions. Incorrect Choices: A: Family history of heart disease is not directly relevant to IUD placement. C: Previous IUD insertions are important for clinical history but do not impact the initial assessment for a new insertion. D: History of hypertension is important for overall health assessment but does not directly affect IUD placement.

Correct Answer: B

Rationale: The correct answer is B: depression and anxiety. Unintended pregnancies can lead to mental health issues like depression and anxiety due to the emotional, financial, and social stress associated with unplanned parenthood. This aligns with the goal of Healthy People 2030 to improve pregnancy planning. Choice A is incorrect because while lost jobs can be a consequence of unintended pregnancy, it is not directly related to the mental health aspect targeted by this HP goal. Choice C is incorrect as increased BMI and weight gain are not typically cited as negative outcomes directly related to unintended pregnancy prevention. Choice D is incorrect as while unintended pregnancies can lead to increased healthcare costs, it does not specifically address the mental health aspect targeted by the HP goal.

Correct Answer: B

Rationale: The correct answer is B: There could be a decrease in bone mineral density over time. Progesterone-only pills have been associated with a potential decrease in bone density, especially with long-term use. This is because progesterone can have a negative impact on calcium absorption, leading to bone weakening. A: Side effects could be increased for persons who are underweight - This is not a specific disadvantage of progesterone-only pills and can apply to any contraceptive method. C: They may cause irregular bleeding and spotting - This is a common side effect of progesterone-only pills but not a significant disadvantage compared to bone density issues. D: Return to fertility after discontinuing the pill may take several months - This is a temporary effect and not a long-term disadvantage like decreased bone density.