Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
31. A client, who is gravida 3, para 1, is diagnosed with diabetes at 28 weeks' gestation. A nurse is providing instruction about the role of insulin in managing the client's diabetes. Which statement by the nurse is true regarding insulin needs during pregnancy?
. Insulin requirements are moderate as the pregnancy progresses.
. A decreased need for insulin occurs during the second trimester.
. Insulin requirements will increase as the pregnancy progresses.
. Elevations in human placental lactogen decrease the need for insulin.
Test-Taking Tip
Remember that insulin needs decrease during the first trimester, steadily increase during the second and third trimesters, then decrease after delivery.
Content Area: Maternity, Antepartum; Integrated Process: Teaching and Learning; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Alterations in Body Systems
Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
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Answer 1 is incorrect because insulin requirements increase as the pregnancy progresses. Increasing amounts of human placental lactogen cause the client to be more insulin resistant, increasing the need for insulin. Answer 2 is incorrect because insulin needs decrease during the first trimester, but steadily increase as the pregnancy progresses. Answer 3 is correct because insulin requirements will increase as the pregnancy progresses. The placenta creates increasing amounts of human placental lactogen, causing the client to be more insulin resistant, increasing the need for insulin. Answer 4 is incorrect because elevations in human placental lactogen increase, not decrease, the need for insulin.