Nursing intervention for pregnant patients with diabetes is based on the knowledge that the need for insulin is

Correct Answer: A

Rationale: The correct answer is A because insulin needs vary during pregnancy due to hormonal changes affecting insulin sensitivity. In early pregnancy, insulin needs may decrease due to increased insulin sensitivity, but in late pregnancy, insulin needs may increase due to insulin resistance. Choice B is incorrect as insulin needs do not consistently increase throughout pregnancy and postpartum. Choice C is incorrect as insulin needs typically increase rather than decrease during pregnancy. Choice D is incorrect as the fetus does not produce its own insulin to regulate the mother's blood sugar levels.

Correct Answer: B

Rationale: The correct answer is B because a postpartum patient with Class II heart disease complaining of frequent coughing requires further assessment due to the risk of exacerbating heart failure. Coughing can increase cardiac workload, leading to potential complications. Choice A may indicate excessive postpartum bleeding, which would require immediate intervention. Choice C has a slightly elevated blood sugar level but is not immediately concerning. Choice D may require monitoring and possibly treatment for active herpes lesions, but it is not as urgent as assessing a patient with heart disease and coughing.

Correct Answer: B

Rationale: The correct answer is B because perinatal mortality is two to three times more likely in multiple gestation pregnancies compared to single births. This is due to the increased risk of complications such as preterm birth, low birth weight, and other neonatal issues. Postpartum hemorrhage (A) is a potential complication but not specific to multiple gestation pregnancies. Optimal psychological adjustment (C) and maternal mortality during the prenatal period (D) are not directly related to the increased risks associated with multiple gestation pregnancies.

Correct Answer: A

Rationale: The correct answer is A: Twin gestation. In twin gestation, there is an increased risk of hypotonic uterine dystocia due to the higher likelihood of uterine overdistention. This can lead to decreased uterine muscle tone and ineffective contractions, resulting in difficulty in the progress of labor. Summary: B: Gestational anemia does not directly increase the risk for hypotonic uterine dystocia. C: Hypertonic contractions are associated with hyperactivity of the uterus, not hypotonic uterine dystocia. D: Gestational hypertension may lead to other complications but is not directly related to hypotonic uterine dystocia in a postpartum client.

Correct Answer: C

Rationale: Late decelerations of the fetal heart rate are most commonly associated with uteroplacental insufficiency. During contractions, there is reduced blood flow to the placenta, leading to hypoxia and acidosis in the fetus, resulting in late decelerations. Head compression (A) typically causes early decelerations. Maternal hypothyroidism (B) does not directly affect fetal heart rate. Umbilical cord compression (D) can cause variable decelerations, not late decelerations. Therefore, the correct answer is C.