A pregnant woman is newly diagnosed with diabetes at 28 weeks of gestation. She has no prior history of diabetes, but despite dietary modification, her fasting and postprandial glucose levels remain elevated, requiring insulin therapy for glycemic control. There is no evidence of end-organ disease. According to White’s classification, how should this pregnancy be classified?

A set of intrapartum practices is intended to support physiologic labor while minimizing unnecessary medical intervention. Which practice best reflects the core evidence-based strategy shown to improve labor outcomes across the entire childbirth process?

A nurse in a fertility clinic is reviewing intake histories to determine which couple should be referred earliest for specialized infertility evaluation. Which scenario most accurately reflects evidence-based criteria for initiating infertility workup?

A nurse is assessing a newborn following a difficult vertex birth complicated by shoulder dystocia. Which findings and nursing actions are most consistent with a brachial plexus injury involving the upper plexus (Erb palsy) rather than another peripheral nerve injury?Select all that apply.

A nurse is assessing a client 2 hours postpartum following a vaginal birth. The client has heavy vaginal bleeding, but the uterine fundus is firm, midline, and at the level of the umbilicus. The bladder is not distended. Which interpretation by the nurse is most accurate?

A nurse is caring for a client at 31 weeks’ gestation receiving magnesium sulfate IV for stabilization of spontaneous preterm labor. The client has completed the loading dose and is receiving a maintenance infusion. Which assessment finding requires the most immediate nursing action?

A nurse is caring for a pregnant client from a cultural background unfamiliar with Western prenatal care practices. The client presents late in pregnancy and expresses discomfort with certain examinations. Which nursing response best demonstrates culturally sensitive, evidence-based care while avoiding ethnocentric and heteronormative assumptions?

A nurse is caring for a client at 30 weeks’ gestation admitted with signs of spontaneous preterm labor. The provider prescribes antenatal glucocorticoid therapy. Which nursing action is most appropriate to ensure the therapeutic goal of this medication is achieved?

A nurse educator is teaching graduate nursing students about the integration of genetics and genomics into contemporary health care. Which statement most accurately reflects the conceptual shift from traditional genetics to genomic and precision medicine, including its clinical and ethical implications?

A 35-year-old client at 29 weeks’ gestation with a history of rheumatic heart disease and moderate mitral stenosis (mitral valve area 1.3 cm², NYHA functional class III) presents to a high-risk obstetric clinic reporting worsening exertional dyspnea, difficulty breathing when lying flat, and intermittent palpitations. On assessment, the nurse notes bibasilar crackles and a low-pitched diastolic murmur. Electrocardiogram reveals atrial fibrillation with rapid ventricular response at 138 beats/min. According to American Heart Association / European Society of Cardiology 2024 guidelines for valvular heart disease in pregnancy (WHO class III), which nursing intervention is the highest priority to reduce the risk of maternal decompensation and adverse fetal outcomes?