HESI CASE STUDIES-GESTATIONAL
DIABETES 2025/2026 EXAMINABLE
QUESTIONS WITH CORRECT ANSWERS’
The clinic nurse reviews Danielle's prenatal record prior to performing a nursing assessment.
Danielle has given birth 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.
How should the nurse record Danielle's obstetrical history using the G-T-P-A-L designation? -
ANSWER-5-2-1-1-4
Gravida (no. pregnancies, including current)
Term (after wk 37) {live and stillborn}
Preterm (between 20-37 wk) {live and stillborn}
Abortion (fetal loss, up to 20 weeks)
Living (all alive at time of interview)
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
Risk Factors:
- previous birth over 9 lbs
- maternal age > 25
- obesity
, - hx. of unexplained stillborn
- fam hx of Type 1 diabetes in a first-degree relative
- strong fam hx of type 2 DM
- hx of gest diabetes.
Which instruction should the nurse give the client? - ANSWER-Follow an unrestricted diet and
exercise pattern for at least 3 days before the test.
this allows the test to be a true determination of the body's ability to handled the glucose load
given after the fasting BG 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 H increase insulin resistance bc they act as insulin antagonists --> glucose-
sparing mechanism to ensure an adequate glucose supply to the fetus. Most pregnant women
can handle this insulin resistance, but gest diabetes cannot and demonstrate an impaired
tolerance to glucose during pregnancy --> hyperglycemia
Which response should the nurse give to the client?
Select all that apply - ANSWER-"Hyperglycemia often presents as increased thirst and
urination."
"Hyperglycemia causes a headache and flushed, dry skin."
Which responses should the nurse give to the client? - ANSWER-Choose complex carbohydrates
that are high in fiber content.
Avoid foods high in refined sugars.
DIABETES 2025/2026 EXAMINABLE
QUESTIONS WITH CORRECT ANSWERS’
The clinic nurse reviews Danielle's prenatal record prior to performing a nursing assessment.
Danielle has given birth 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.
How should the nurse record Danielle's obstetrical history using the G-T-P-A-L designation? -
ANSWER-5-2-1-1-4
Gravida (no. pregnancies, including current)
Term (after wk 37) {live and stillborn}
Preterm (between 20-37 wk) {live and stillborn}
Abortion (fetal loss, up to 20 weeks)
Living (all alive at time of interview)
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
Risk Factors:
- previous birth over 9 lbs
- maternal age > 25
- obesity
, - hx. of unexplained stillborn
- fam hx of Type 1 diabetes in a first-degree relative
- strong fam hx of type 2 DM
- hx of gest diabetes.
Which instruction should the nurse give the client? - ANSWER-Follow an unrestricted diet and
exercise pattern for at least 3 days before the test.
this allows the test to be a true determination of the body's ability to handled the glucose load
given after the fasting BG 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 H increase insulin resistance bc they act as insulin antagonists --> glucose-
sparing mechanism to ensure an adequate glucose supply to the fetus. Most pregnant women
can handle this insulin resistance, but gest diabetes cannot and demonstrate an impaired
tolerance to glucose during pregnancy --> hyperglycemia
Which response should the nurse give to the client?
Select all that apply - ANSWER-"Hyperglycemia often presents as increased thirst and
urination."
"Hyperglycemia causes a headache and flushed, dry skin."
Which responses should the nurse give to the client? - ANSWER-Choose complex carbohydrates
that are high in fiber content.
Avoid foods high in refined sugars.
