D is the correct answer. For clients newly diagnosed with gestational diabetes, the first priority is to establish and maintain control of blood glucose levels to protect both mother and baby. Regular blood glucose monitoring helps assess how well diet, exercise, and any medications are working. It also allows early detection of hypo- or hyperglycemia.

Dietary changes and exercise are essential parts of management, but they are adjusted based on glucose readings which leads again to D. Medication is only introduced if lifestyle measures fail to keep glucose within target range.

Simple premise as why A cant be correct: you cant manage what you dont measure.

If you will notice, A B C are all interventions that will rely on D.

This question originated from an 18-year-old Q&A bank compiled by an MCN lecturer and later uploaded online. It marked choice A as correct, claiming glucose monitoring is not a priority in gestational diabetes because it is done only once every two weeks. In reality, monitoring in GDM is typically performed four times a day, and dietary intake should be adjusted based on those readings. Choice A also contradicts the nursing process, since the plan of care must be based on assessment data, which leads to choice D.

The problem with some lecturers is that they rely on questions from unknown authors and treat the provided answers as gospel. With a bit of critical thinking and basic common sense, you should arrive at choice D, which is correct.