HESI Exit LPN Proctored Exam 1
The client is a 32-year-old multigravida at 28 weeks' gestation, who presents to the obstetrician's office for a routine has given burn three times; once at 35 weeks (twins), once at 38 weeks (singleton) and once at 41 weeks (singleton). All of these children are alive and well. She had one spontaneous abortion at 10 weeks' gestation. Her fourth child weighed 9 pounds (4.08 kg) at 41 weeks gestation. The client is at 28 weeks. She has been receiving prenatal care since 8 weeks gestation. Her fasting 1-hour glucose screening level, which was done 1 week prior, is 164 mg/dL (9.1 mmol/L). Her 3-hour oral glucose tolerance test results reveal a fasting blood sugar of 168 mg/dL (9.3 mmol and a two-hour postprandial of 220 mg/dL (12...mol/L). Scheduled the client to meet with the obstetrician, Diabetic Nurse Educator, and a Registered Dietician for the next day. After a discussion about gestational diabetes and seeking the client's input, a suggested plan of care is outlined, which includes dietary control and glucose self-monitoring. The registered dietician (RD) discusses the need to Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. The diabetic nurse educator instructs the client to perform fingerstick blood glucose (FSBG) monitoring Select Response
Explanation & Rationale
A) Incorrect- While bedtime monitoring is important, the frequency described in this choice is not consistent with FSBG monitoring before meals. B) Correct- Performing FSBG monitoring before each meal helps the client track her blood glucose levels before consuming food, allowing her to adjust her diet or insulin regimen if necessary. C) Incorrect- Monitoring every two hours may be excessive and not necessary for managing gestational diabetes. D) Incorrect- Monitoring during the night is important for glycemic control, but it doesn't specifically address the need to monitor before meals.
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