Obstetric Nurse Test Obstetric Nurse High-Risk Pregnancy Management

Question 1

A patient's 1-hour glucose challenge test (GCT) result is 152 mg/dL. What is the appropriate next step?

Accepted Answer

Perform a 3-hour 100g oral glucose tolerance test (OGTT)

Answer

A 1-hour GCT result ≥140 mg/dL (some use ≥130 mg/dL) is abnormal and requires a diagnostic 3-hour 100g OGTT to confirm or rule out gestational diabetes.

Question 2

What is the fasting blood glucose target for a patient with gestational diabetes managed with diet and exercise?

Accepted Answer

Less than 95 mg/dL

Answer

ACOG recommends a fasting glucose target of less than 95 mg/dL for women with gestational diabetes to reduce the risk of macrosomia and perinatal complications.

Question 3

A neonate born to a mother with poorly controlled gestational diabetes is at highest immediate risk for which complication?

Accepted Answer

Neonatal hypoglycemia

Answer

Maternal hyperglycemia causes fetal hyperinsulinemia; after delivery and removal of the maternal glucose source, the elevated insulin causes neonatal hypoglycemia.

Question 4

Macrosomia in infants of mothers with gestational diabetes is primarily caused by:

Accepted Answer

Fetal hyperinsulinemia secondary to maternal hyperglycemia

Answer

Maternal glucose crosses the placenta, stimulating the fetal pancreas to produce excess insulin, which acts as a growth factor and results in macrosomia.

Question 5

Which insulin type is traditionally preferred for use during pregnancy due to its established safety profile?

Accepted Answer

NPH and regular human insulin

Answer

NPH and regular human insulin have the longest safety records in pregnancy; however, insulin lispro and detemir are also considered acceptable per recent guidelines.

Obstetric Nurse Test Practice Test

Obstetric Nurse Test Practice Test

Obstetric Nurse Test Obstetric Nurse High-Risk Pregnancy Management