2024 ATI MATERNAL NEWBORN EXAM 4 NEW
LATEST VERSION WITH ALL QUESTIONS FROM
ACTUAL PAST EXAM, 100& CORRECT ANSWERS AND
RATIONALE
When does gestational diabetes occur? - (ANSWER)gestational diabetes results when the
pancreas is unable to meet the increased demands for insulin production during pregnancy,
typically in the 2nd or 3rd trimester
What are the 4 cardinal signs and symptoms of diabetes? - (ANSWER)-Polyuria
-Polydipsia
-Polyphagia
-Weight loss
How is gestational diabetes treated? - (ANSWER)Nutritional therapy is considered to be the
first-line therapy. If nutritional therapy alone does not achieve desirable fasting blood glucose
levels, oral hypoglycemic agents can be used. (treated like type 2 diabetes)
What are insulin needs during pregnancy? - (ANSWER)-Decrease in early 1st trimester
-Increase in 2nd trimester and throughout rest of pregnancy (due to increased level of hPL by
placenta which is an insulin antagonist)
-Increased need during labor and delivery
-Decreased need in postpartum
What are the maternal risks bc gestational diabetes? - (ANSWER)-Hydramniosis
-Preeclampsia - eclampsia
-Hyperglycemia
-Retinopathy
What are the fetal/neonatal risks bc gestational diabetes? - (ANSWER)-Congenital defects
,-Macrosomia
-IUGR (intrauterine growth restriction)
-Delayed lung maturity >> RDS
-Hypoglycemia after birth
When will pregnant women undergo a 1 hour glucose tolerance test to check for gestational
diabetes? - (ANSWER)Between 24 and 28 weeks gestation
How is a one hour glucose test done? - (ANSWER)To complete this test, pregnant women are
not required to fast. They ingest a 50g oral glucose solution and one hour later plasma glucose is
measured.
What results from a 1 hour glucose test would indicate that a 100-gram, 3-hour glucose test is
needed? - (ANSWER)If plasma glucose levels are elevated (equal to or greater than 140 mg/dL),
a 100-gram, 3-hour glucose test is needed.
How is the 3 hour glucose tolerance test performed? - (ANSWER)Women are encouraged to
consume at least 250 g of carbohydrates per day for three days before her scheduled test. Then
she will complete an overnight fast and ingest 100 gram oral glucose solution.
Gestational diabetes is diagnosed if two or more of the following values are met or exceeded: -
(ANSWER)-Fasting: 95 mg/dL
-1 hour: 180 mg/dL
-2 hours: 155 mg/dL
-3 hours: 140 mg/dL
Anemia indicates low levels of hemoglobin in the blood, what *value* indicates anemia? -
(ANSWER)During pregnancy, anemia is defined as hemoglobin less than 11 g/dL in the first and
third trimesters and less than 10.5 g/dL in the second trimester
,(The common causes of anemia in pregnancy are by either insufficient hemoglobin production
related to nutritional deficiency in iron or folic acid during pregnancy, or by hemoglobin
destruction in an inherited disorder such as sickle cell disease.)
What is Iron Deficiency Anemia in pregnancy? - (ANSWER)Most common complication of
pregnancy - the result of expansion of plasma volume without the expansion of hemoglobin mass
What are maternal & neonatal risks associated with iron deficiency anemia? -
(ANSWER)•Maternal risks
-Susceptible to infections
-Fatigue
-Risk for PIH
-Postpartum hemorrhage
•Fetal/Neonatal risks
-LBW
-Preterm
-Stillbirth
What is the common tx for iron deficiency anemia in pregnant women? - (ANSWER)Prenatal
vitamins usually work well for iron deficiency anemia. However, If she is still anemic we may
need to encourage additional iron supplement of 60 to 120 mg per day and also encouraged her
to eat an iron-rich diet.
What is sickle cell anemia? - (ANSWER)A recessive autosomal disorder in which normal adult
hemoglobin is abnormally formed.
What are the characteristics of sickle cell anemia? - (ANSWER)Red blood cells are sickle or
crescent shaped. These can glob capillaries, especially in the spleen, bone marrow, and placenta.
This can lead to acute painful episodes.
, What are the risks for both mom & baby with sickle cell anemia? - (ANSWER)-mom is at risk
for acute painful episodes, that may be generalized or local. It may include bones, joints, lungs,
abdominal organs, or the spinal cord.
-the risk for fetal death has decreased overall, but the rate is still higher than the norms. The fetal
death can result from the sickling cells in the placenta. Fetuses are also at risk for prematurity
and IUGR, again, associated w the sickle cells.
what is the management for sickle cell anemia? - (ANSWER)Folic acid supplements and we
want to treat maternal infections, as fever and dehydration can cause a crisis.
What is folic acid deficiency anemia? - (ANSWER)Second most common cause of anemia in
pregnancy (the result of an absence of folic acid)
What are the maternal and fetal/neonatal risks associated with folic acid deficiency anemia? -
(ANSWER)•Maternal risks
-Need for blood transfusion following birth
-Increased risk for postpartum hemorrhage
-Risk for infection
•Fetal/Neonatal risks
-Risk for infection
-Neural tube defects
What is the management for folic acid deficiency anemia? - (ANSWER)1mg folic acid daily
Substance abuse during pregnancy may adversely affect the health of the woman and the growth
and development of the fetus. In which trimester is the fetus at most risk? - (ANSWER)first
trimester
What substances are commonly abused during pregnancy? - (ANSWER)•Alcohol
LATEST VERSION WITH ALL QUESTIONS FROM
ACTUAL PAST EXAM, 100& CORRECT ANSWERS AND
RATIONALE
When does gestational diabetes occur? - (ANSWER)gestational diabetes results when the
pancreas is unable to meet the increased demands for insulin production during pregnancy,
typically in the 2nd or 3rd trimester
What are the 4 cardinal signs and symptoms of diabetes? - (ANSWER)-Polyuria
-Polydipsia
-Polyphagia
-Weight loss
How is gestational diabetes treated? - (ANSWER)Nutritional therapy is considered to be the
first-line therapy. If nutritional therapy alone does not achieve desirable fasting blood glucose
levels, oral hypoglycemic agents can be used. (treated like type 2 diabetes)
What are insulin needs during pregnancy? - (ANSWER)-Decrease in early 1st trimester
-Increase in 2nd trimester and throughout rest of pregnancy (due to increased level of hPL by
placenta which is an insulin antagonist)
-Increased need during labor and delivery
-Decreased need in postpartum
What are the maternal risks bc gestational diabetes? - (ANSWER)-Hydramniosis
-Preeclampsia - eclampsia
-Hyperglycemia
-Retinopathy
What are the fetal/neonatal risks bc gestational diabetes? - (ANSWER)-Congenital defects
,-Macrosomia
-IUGR (intrauterine growth restriction)
-Delayed lung maturity >> RDS
-Hypoglycemia after birth
When will pregnant women undergo a 1 hour glucose tolerance test to check for gestational
diabetes? - (ANSWER)Between 24 and 28 weeks gestation
How is a one hour glucose test done? - (ANSWER)To complete this test, pregnant women are
not required to fast. They ingest a 50g oral glucose solution and one hour later plasma glucose is
measured.
What results from a 1 hour glucose test would indicate that a 100-gram, 3-hour glucose test is
needed? - (ANSWER)If plasma glucose levels are elevated (equal to or greater than 140 mg/dL),
a 100-gram, 3-hour glucose test is needed.
How is the 3 hour glucose tolerance test performed? - (ANSWER)Women are encouraged to
consume at least 250 g of carbohydrates per day for three days before her scheduled test. Then
she will complete an overnight fast and ingest 100 gram oral glucose solution.
Gestational diabetes is diagnosed if two or more of the following values are met or exceeded: -
(ANSWER)-Fasting: 95 mg/dL
-1 hour: 180 mg/dL
-2 hours: 155 mg/dL
-3 hours: 140 mg/dL
Anemia indicates low levels of hemoglobin in the blood, what *value* indicates anemia? -
(ANSWER)During pregnancy, anemia is defined as hemoglobin less than 11 g/dL in the first and
third trimesters and less than 10.5 g/dL in the second trimester
,(The common causes of anemia in pregnancy are by either insufficient hemoglobin production
related to nutritional deficiency in iron or folic acid during pregnancy, or by hemoglobin
destruction in an inherited disorder such as sickle cell disease.)
What is Iron Deficiency Anemia in pregnancy? - (ANSWER)Most common complication of
pregnancy - the result of expansion of plasma volume without the expansion of hemoglobin mass
What are maternal & neonatal risks associated with iron deficiency anemia? -
(ANSWER)•Maternal risks
-Susceptible to infections
-Fatigue
-Risk for PIH
-Postpartum hemorrhage
•Fetal/Neonatal risks
-LBW
-Preterm
-Stillbirth
What is the common tx for iron deficiency anemia in pregnant women? - (ANSWER)Prenatal
vitamins usually work well for iron deficiency anemia. However, If she is still anemic we may
need to encourage additional iron supplement of 60 to 120 mg per day and also encouraged her
to eat an iron-rich diet.
What is sickle cell anemia? - (ANSWER)A recessive autosomal disorder in which normal adult
hemoglobin is abnormally formed.
What are the characteristics of sickle cell anemia? - (ANSWER)Red blood cells are sickle or
crescent shaped. These can glob capillaries, especially in the spleen, bone marrow, and placenta.
This can lead to acute painful episodes.
, What are the risks for both mom & baby with sickle cell anemia? - (ANSWER)-mom is at risk
for acute painful episodes, that may be generalized or local. It may include bones, joints, lungs,
abdominal organs, or the spinal cord.
-the risk for fetal death has decreased overall, but the rate is still higher than the norms. The fetal
death can result from the sickling cells in the placenta. Fetuses are also at risk for prematurity
and IUGR, again, associated w the sickle cells.
what is the management for sickle cell anemia? - (ANSWER)Folic acid supplements and we
want to treat maternal infections, as fever and dehydration can cause a crisis.
What is folic acid deficiency anemia? - (ANSWER)Second most common cause of anemia in
pregnancy (the result of an absence of folic acid)
What are the maternal and fetal/neonatal risks associated with folic acid deficiency anemia? -
(ANSWER)•Maternal risks
-Need for blood transfusion following birth
-Increased risk for postpartum hemorrhage
-Risk for infection
•Fetal/Neonatal risks
-Risk for infection
-Neural tube defects
What is the management for folic acid deficiency anemia? - (ANSWER)1mg folic acid daily
Substance abuse during pregnancy may adversely affect the health of the woman and the growth
and development of the fetus. In which trimester is the fetus at most risk? - (ANSWER)first
trimester
What substances are commonly abused during pregnancy? - (ANSWER)•Alcohol
