A client with pregestational type 1 diabetes mellitus is being taught by a nurse about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer: C

Rationale: The correct answer is C because continuing to take insulin during nausea and vomiting is crucial for maintaining blood glucose control in clients with diabetes. Nausea and vomiting can lead to decreased food intake, risking hypoglycemia if insulin is not adjusted. Choice A is incorrect because fasting blood glucose levels should ideally be maintained between 60-90 mg/dL in pregnant clients with diabetes for optimal outcomes, not 100-120 mg/dL. Choice B is incorrect because engaging in moderate exercise when blood glucose is high (250 or higher) can exacerbate hyperglycemia rather than help in lowering blood glucose levels. Choice D is incorrect because avoiding exercise when blood glucose exceeds 250 is not recommended. Exercise can help lower blood glucose levels and improve insulin sensitivity.

Correct Answer: D

Rationale: The correct answer is D: All of the above. Magnesium sulfate toxicity can lead to respiratory depression (respirations less than 12/min), decreased urinary output (less than 25 mL/hr), and altered mental status (decreased level of consciousness). Respiratory depression occurs due to the impact of magnesium on the central nervous system. Decreased urinary output is a result of magnesium's effects on renal blood flow. Altered mental status is a common sign of magnesium toxicity affecting brain function. Reporting these signs promptly is crucial to prevent serious complications. The other choices (A, B, C) are incorrect because they are all potential signs of magnesium sulfate toxicity and should be reported.

Correct Answer: D

Rationale: The correct answer is D: Place the newborn skin-to-skin on the mother's chest. This technique promotes bonding, warmth, and comfort, which can help minimize the newborn's pain perception during the procedure. Skin-to-skin contact releases oxytocin, which has analgesic effects. It also provides emotional support and reduces stress for both the newborn and the mother. A, applying a cool pack, may cause vasoconstriction and increase pain perception. B, requesting an IM analgesic, is not typically necessary for a routine heel stick and may have potential adverse effects. C, using a manual lancet, does not address the emotional and psychological aspects of pain perception in newborns.

Correct Answer: D

Rationale: The correct answer is D because during the taking-hold phase, the client is focused on learning and mastering new skills related to caring for the newborn. Demonstrating how to perform a newborn bath aligns with this phase as it helps the client gain confidence and competence in newborn care. Discussing contraceptive options (choice A) is more appropriate during the let-go phase. Repeating information (choice B) may be necessary but is not the priority during the taking-hold phase. Listening to the client and her partner reflect on the birth experience (choice C) is important for emotional support but not specifically related to the behavioral adjustments in the taking-hold phase.

Correct Answer: C

Rationale: The correct answer is C: Shortness of breath. This is because shortness of breath can indicate a potentially serious side effect like a blood clot, which is a rare but serious complication associated with oral contraceptives. Reduced menstrual flow (A) is a common side effect and not typically a cause for concern. Breast tenderness (B) is a common but generally benign side effect of oral contraceptives. Increased appetite (D) is also a common side effect but not typically a sign of a serious complication. Therefore, the healthcare provider should emphasize the importance of reporting shortness of breath promptly.

Correct Answer: A

Rationale: Step 1: In idiopathic thrombocytopenic purpura (ITP), there is a decreased platelet count due to immune-mediated destruction of platelets. Step 2: This leads to an increased risk of bleeding and bruising in the postpartum client. Step 3: Other choices are incorrect because in ITP, there is no increase in ESR or WBC. Also, megakaryocytes may be normal or increased due to compensatory production.

Correct Answer: A

Rationale: The correct answer is A: Vaginal bleeding. This is crucial to report promptly as it could indicate serious issues like placental abruption or miscarriage. Swelling of the ankles (B) is common in pregnancy but not typically an urgent concern. Heartburn (C) is common and can be managed with lifestyle changes. Lightheadedness when lying on the back (D) is likely due to inferior vena cava compression and can be relieved by changing position. Reporting vaginal bleeding is vital for timely intervention in pregnancy complications.

Correct Answer: C

Rationale: The correct answer is C because counting the fetal heart rate after a contraction helps determine baseline changes, which is essential for identifying fetal distress. This method allows for accurate assessment of fetal well-being in response to contractions. Choice A is incorrect as 15 seconds is not enough time to establish a baseline. Choice B is incorrect as auscultating every 5 minutes may not provide timely information during the active phase. Choice D is incorrect because auscultating every 30 minutes in the second stage may miss important changes in fetal status. Therefore, option C is the most appropriate choice for intermittent fetal heart monitoring.

Correct Answer: A

Rationale: The estimated date of delivery (EDD) is calculated by adding 280 days to the first day of the last menstrual period (LMP). In this case, April 1st + 280 days = January 8, which is the correct EDD. Choice A is correct. Choices B, C, and D are incorrect because they do not account for the 280-day gestation period from the LMP.