Gestational Diabetes Hesi Case Study –
2025 Questions and Answers 100% Pass
How should the nurse record Danielle's obstetrical history using the G-T-P-A-L
designation? - ANSWER-5-2-1-1-4
Gravidity (G) is defined as the number of times pregnant, including the current
pregnancy. Term (T) is defined as any birth after the end of the 37th week, and
preterm (P) refers to any births between 20 and 37 weeks. Both term and preterm
describe liveborn and stillborn infants. Abortion (A) is any fetal loss, whether
spontaneous or elective, up to 20 weeks gestation. Living (L) refers to all children
who are living at the time of the interview. Multiple fetuses such as twins, triplets,
and beyond are treated as one pregnancy and one birth when recording the
GTPAL. Danielle's GTPAL is 5 (pregnancies counting current one)- 2 (infants
born at 38 and 41 weeks) - 1 (twins born at 35 weeks) - 1 (spontaneous abortion at
10 weeks) - 4 (each twin and the 2 singletons, all living).
Which information does the nurse recognize in the client's history to support a
diagnosis of gestational diabetes? - ANSWER-Child weighed 9 lbs (4.08 kg) at 41
weeks' gestation.
©️COPYRIGHT 2025, ALL RIGHTS RESERVED. 1
, Birth of an infant weighing more than 9 lbs (4.08 kg) is a risk factor for gestational
diabetes. Other risk factors include maternal age older than 25, obesity, history of
unexplained stillborn, family history of Type 1 diabetes in a first-degree relative,
strong family history of Type 2 diabetes, and history of gestational diabetes in a
previous pregnancy. Ethnic groups at increased risk include Hispanic, Native-
American, Asian, and African-American.
Which instruction should the nurse give the client? - ANSWER-Follow an
unrestricted diet and exercise pattern for at least 3 days before the test.
When the client follows an unrestricted diet and exercise pattern the test is a true
determination of the body's ability to handle the glucose load given after the FBG
is drawn.
The nurse's response should be based on the understanding of which normal
physiologic change of pregnancy? - ANSWER-Hormonal changes in the second
and third trimesters result in increased maternal insulin resistance.
Increased levels of hormones increase insulin resistance because they act as insulin
antagonists. This serves as a glucose-sparing mechanism to ensure an adequate
glucose supply to the fetus. While most pregnant women's bodies are able to
©️COPYRIGHT 2025, ALL RIGHTS RESERVED. 2
2025 Questions and Answers 100% Pass
How should the nurse record Danielle's obstetrical history using the G-T-P-A-L
designation? - ANSWER-5-2-1-1-4
Gravidity (G) is defined as the number of times pregnant, including the current
pregnancy. Term (T) is defined as any birth after the end of the 37th week, and
preterm (P) refers to any births between 20 and 37 weeks. Both term and preterm
describe liveborn and stillborn infants. Abortion (A) is any fetal loss, whether
spontaneous or elective, up to 20 weeks gestation. Living (L) refers to all children
who are living at the time of the interview. Multiple fetuses such as twins, triplets,
and beyond are treated as one pregnancy and one birth when recording the
GTPAL. Danielle's GTPAL is 5 (pregnancies counting current one)- 2 (infants
born at 38 and 41 weeks) - 1 (twins born at 35 weeks) - 1 (spontaneous abortion at
10 weeks) - 4 (each twin and the 2 singletons, all living).
Which information does the nurse recognize in the client's history to support a
diagnosis of gestational diabetes? - ANSWER-Child weighed 9 lbs (4.08 kg) at 41
weeks' gestation.
©️COPYRIGHT 2025, ALL RIGHTS RESERVED. 1
, Birth of an infant weighing more than 9 lbs (4.08 kg) is a risk factor for gestational
diabetes. Other risk factors include maternal age older than 25, obesity, history of
unexplained stillborn, family history of Type 1 diabetes in a first-degree relative,
strong family history of Type 2 diabetes, and history of gestational diabetes in a
previous pregnancy. Ethnic groups at increased risk include Hispanic, Native-
American, Asian, and African-American.
Which instruction should the nurse give the client? - ANSWER-Follow an
unrestricted diet and exercise pattern for at least 3 days before the test.
When the client follows an unrestricted diet and exercise pattern the test is a true
determination of the body's ability to handle the glucose load given after the FBG
is drawn.
The nurse's response should be based on the understanding of which normal
physiologic change of pregnancy? - ANSWER-Hormonal changes in the second
and third trimesters result in increased maternal insulin resistance.
Increased levels of hormones increase insulin resistance because they act as insulin
antagonists. This serves as a glucose-sparing mechanism to ensure an adequate
glucose supply to the fetus. While most pregnant women's bodies are able to
©️COPYRIGHT 2025, ALL RIGHTS RESERVED. 2
