A pregnant patient at 24 weeks gestation is diagnosed with gestational diabetes. What should the nurse emphasize in the patient's care plan?

Correct Answer: A

Rationale: The correct answer is A because maintaining a balanced diet and monitoring blood glucose levels regularly are essential in managing gestational diabetes. A balanced diet helps regulate blood sugar levels, and monitoring glucose levels helps track responses to dietary choices. Choice B is incorrect as physical activity is beneficial for managing blood sugar. Choice C is unnecessary for gestational diabetes unless dietary and lifestyle modifications are insufficient. Choice D is incorrect as carbohydrates are still needed for energy but should be consumed in moderation with monitoring.

Correct Answer: B

Rationale: The correct answer is B because a second-degree perineal laceration extends through the vaginal mucosa and perineal muscles. First, a second-degree laceration involves more than just the vaginal mucosa, as it also affects the perineal muscles. This type of laceration is more severe than a first-degree laceration, which only involves the vaginal mucosa. Second, due to the involvement of deeper structures like the perineal muscles, suturing is typically required to promote proper healing and prevent complications. Therefore, choice B is correct. Choices A and C are incorrect because a second-degree laceration involves more than just the vaginal mucosa and is not the least severe type of laceration. Choice D is incorrect because suturing is usually necessary for second-degree lacerations.

Correct Answer: B

Rationale: The correct answer is B, an increase in blood pressure, which is most likely to indicate the need for further evaluation during the first stage of labor. An increase in blood pressure could signal potential complications like preeclampsia or hypertension, which require immediate attention to ensure the safety of both the laboring person and the baby. A: A decrease in heart rate is not typically concerning during the first stage of labor, as it can be a normal response to relaxation or rest periods between contractions. C: An increase in pulse rate is expected during labor as the body works harder, so it may not necessarily indicate a need for further evaluation unless it is excessively high. D: No change in vital signs could be normal, but it is important to monitor for any signs of distress or complications even if vital signs remain stable.

Correct Answer: A

Rationale: The correct action for a nurse when a birthing person experiences late deceleration in fetal heart rate is to turn the laboring person to the left side. This helps improve placental perfusion by reducing pressure on the vena cava, enhancing blood flow to the uterus, and thus improving oxygenation to the fetus. This action can help alleviate the late deceleration and prevent fetal distress. Increasing maternal oxygen supply (choice B) is important but not the first-line intervention for late decelerations. Emergency cesarean section (choice C) is not typically indicated for late decelerations unless other interventions fail. Administering terbutaline (choice D) is not appropriate for late decelerations as it is a tocolytic used to inhibit uterine contractions and prevent preterm labor.

Correct Answer: C

Rationale: Performing an amniotomy during labor is done to augment labor by releasing amniotic fluid, which can help progress labor by increasing uterine contractions and encouraging the descent of the baby's head. This can help prevent prolonged labor and facilitate a smoother delivery process. Options A, B, and D are incorrect because inducing labor, reducing the risk of infection, and preventing fetal infection are not the primary purposes of performing an amniotomy.