NUR 332 EXAM 3 | PRACTICE QUESTIONS & ANSWERS | COMPREHENSIVE NCLEX NURSING
STUDY GUIDE 2026/2027
Type 1 diabetes - correct answer ✔✔-5-10% of all diabetes: caused by pancreatic islet Beta cell
destruction
-absolute insulin deficiency
Type 2 diabetes - correct answer ✔✔·-Most prevalent accounting for 90-95% of DM cases; -
relative insulin deficiency
Gestational diabetes mellitus (GDM) - correct answer ✔✔·-carbohydrate intolerance with the
onset or first recognition occurring during pregnancy
-ADA definition does not include type 1 or 2 DM diagnosed during pregnancy
-DM diagnosed during pregnancy that is clearly not preexisting DM
Metabolic changes associated with pregnancy (pregestational DM & pregnancy) - correct
answer ✔✔·-Normal pregnancy is characterized by alterations in maternal glucose metabolism,
insulin production, and metabolic homeostasis
-hypoglycemia is present in the first trimester
-dibetogenic effect in second and third
-normal hormonal adaptations of pregnancy affect glycemic control, and pregnancy may
accelerate the process of vascular complications
What is the primary fuel for the fetus - correct answer ✔✔-glucose, it also crossed the placenta
while insulin does not
Maternal risks and complications as most are associated with - correct answer ✔✔-poor
glycemic control: • miscarriage, preeclampsia, Polyhydramnios, PROM, PP hemorrhage,
Infections (UTI), operative delivery, macrosomia (birthweight >4000 grams or >90th percentile,
postpartum infections, and WOUND DEHISCENCE
,-ketoacidosis: DKA, increases the risk of intrauterine fetal demise (IUFD)
-Pregnancy increases metabolic demands
-Tocolytic drugs (Terbutaline) may lead to increase blood sugar
Risks for fetal and neonate - correct answer ✔✔-miscarriage, IUFD, congenital malformations,
macrosomia, hypoglycemia at birth
root cause of congenital malformation - correct answer ✔✔-maternal hyperglycemia in the first
trimester --> cardiovascular and CNS abnormalities
Fetal pancreas starts to secrete insulin at - correct answer ✔✔-10-14 weeks gestation
Insulin acts as a growth hormone causing the fetus to produce excess stores of - correct answer
✔✔-glycogen, protein, and adipose tissue
Brachial plexus nerve injury, facial nerve injury, humerus or clavicle fracture, and
cephalhematoma usually due to complicated - correct answer ✔✔-vaginal delivery and/or
shoulder dystocia
Neonatal ___________ at birth is a significant risk - correct answer ✔✔-hypoglycemia
Antepartum assessment - correct answer ✔✔-complete PE
-prenantal visit every 1-2 weeks
-monitoring fasting blood glucose levels
-targeted glycosolated hemoglobin HbA1C = <7 (6-6.5%)
-urine testing: (UA & culture and 24-hr collection for total protein and creatine clearance)
-complications requiring hospitalization
, Care Management: Antepartum - correct answer ✔✔-education
-insulin therapy
-maintain/achieve euglycemia
-measures 6-8 times/day
-KNOW THESE:
-60-105 before meals
-less than/equal to 140 one hr after meals
-less than/equal to 120 2 hours after meals
-2-6am >60
Exercise - correct answer ✔✔-30-60 mins aerobic
-check blood sugar and if <100, consume 15-30 grams CHO
Education for insulin therapy - correct answer ✔✔-premixed (short and intermediate) rarely
used
-usually 3-5 injections/day required
-insuline pumps ok
-first trimester reduced by 10-25%
-second and third: insulin will go up and be tailored to the ind client & the peak of insulin
resistance is around 36 W tapers after that gestation
antepartum fetal survelliance - correct answer ✔✔-NST twice weekly @ 32 W
-BPP
-fetal kick counts
-determination of birth date and mode
-fetal echocardiograph at 20-22 weeks (r/t increased risk of congenital cardiac defects KNOW)
-MSAFP
STUDY GUIDE 2026/2027
Type 1 diabetes - correct answer ✔✔-5-10% of all diabetes: caused by pancreatic islet Beta cell
destruction
-absolute insulin deficiency
Type 2 diabetes - correct answer ✔✔·-Most prevalent accounting for 90-95% of DM cases; -
relative insulin deficiency
Gestational diabetes mellitus (GDM) - correct answer ✔✔·-carbohydrate intolerance with the
onset or first recognition occurring during pregnancy
-ADA definition does not include type 1 or 2 DM diagnosed during pregnancy
-DM diagnosed during pregnancy that is clearly not preexisting DM
Metabolic changes associated with pregnancy (pregestational DM & pregnancy) - correct
answer ✔✔·-Normal pregnancy is characterized by alterations in maternal glucose metabolism,
insulin production, and metabolic homeostasis
-hypoglycemia is present in the first trimester
-dibetogenic effect in second and third
-normal hormonal adaptations of pregnancy affect glycemic control, and pregnancy may
accelerate the process of vascular complications
What is the primary fuel for the fetus - correct answer ✔✔-glucose, it also crossed the placenta
while insulin does not
Maternal risks and complications as most are associated with - correct answer ✔✔-poor
glycemic control: • miscarriage, preeclampsia, Polyhydramnios, PROM, PP hemorrhage,
Infections (UTI), operative delivery, macrosomia (birthweight >4000 grams or >90th percentile,
postpartum infections, and WOUND DEHISCENCE
,-ketoacidosis: DKA, increases the risk of intrauterine fetal demise (IUFD)
-Pregnancy increases metabolic demands
-Tocolytic drugs (Terbutaline) may lead to increase blood sugar
Risks for fetal and neonate - correct answer ✔✔-miscarriage, IUFD, congenital malformations,
macrosomia, hypoglycemia at birth
root cause of congenital malformation - correct answer ✔✔-maternal hyperglycemia in the first
trimester --> cardiovascular and CNS abnormalities
Fetal pancreas starts to secrete insulin at - correct answer ✔✔-10-14 weeks gestation
Insulin acts as a growth hormone causing the fetus to produce excess stores of - correct answer
✔✔-glycogen, protein, and adipose tissue
Brachial plexus nerve injury, facial nerve injury, humerus or clavicle fracture, and
cephalhematoma usually due to complicated - correct answer ✔✔-vaginal delivery and/or
shoulder dystocia
Neonatal ___________ at birth is a significant risk - correct answer ✔✔-hypoglycemia
Antepartum assessment - correct answer ✔✔-complete PE
-prenantal visit every 1-2 weeks
-monitoring fasting blood glucose levels
-targeted glycosolated hemoglobin HbA1C = <7 (6-6.5%)
-urine testing: (UA & culture and 24-hr collection for total protein and creatine clearance)
-complications requiring hospitalization
, Care Management: Antepartum - correct answer ✔✔-education
-insulin therapy
-maintain/achieve euglycemia
-measures 6-8 times/day
-KNOW THESE:
-60-105 before meals
-less than/equal to 140 one hr after meals
-less than/equal to 120 2 hours after meals
-2-6am >60
Exercise - correct answer ✔✔-30-60 mins aerobic
-check blood sugar and if <100, consume 15-30 grams CHO
Education for insulin therapy - correct answer ✔✔-premixed (short and intermediate) rarely
used
-usually 3-5 injections/day required
-insuline pumps ok
-first trimester reduced by 10-25%
-second and third: insulin will go up and be tailored to the ind client & the peak of insulin
resistance is around 36 W tapers after that gestation
antepartum fetal survelliance - correct answer ✔✔-NST twice weekly @ 32 W
-BPP
-fetal kick counts
-determination of birth date and mode
-fetal echocardiograph at 20-22 weeks (r/t increased risk of congenital cardiac defects KNOW)
-MSAFP
