Nursing Elites

1. When discussing risk factors for gestational diabetes mellitus (GDM) with a group of pregnant clients, which ethnicity should the nurse identify as having the lowest incidence of GDM?

• A. Asian
• B. Non-Hispanic White American
• C. Hispanic
• D. African American

Correct answer: B

Rationale: Non-Hispanic White Americans have the lowest incidence of gestational diabetes mellitus (GDM) compared to other ethnicities. This is because GDM is more prevalent among certain ethnic groups, such as Asian, Hispanic, and African American populations. Asian individuals have an increased risk of developing GDM due to genetic factors, while Hispanic and African American populations have higher incidences of GDM due to lifestyle and genetic predispositions. Therefore, the correct answer is B, as Non-Hispanic White Americans generally have a lower risk of developing GDM.

2. What should be the primary focus of nursing care in the transitional phase of labor for a client who anticipates an unmedicated delivery?

• A. Assessing the strength of uterine contractions
• B. Re-evaluating the need for medication
• C. Reminding her to push 3 times with each contraction
• D. Assisting her to maintain control

Correct answer: D

Rationale: During the transitional phase of labor, which is the most intense phase, the primary focus of nursing care for a client who anticipates an unmedicated delivery should be assisting her to maintain control. This is essential to help her manage the intense pain and anxiety associated with this phase without the use of medication. Assessing the strength of uterine contractions (Choice A) is important but not the primary focus during the transitional phase. Re-evaluating the need for medication (Choice B) is not applicable as the client anticipates an unmedicated delivery. Reminding her to push 3 times with each contraction (Choice C) is more related to the pushing stage of labor and not the transitional phase.

3. According to a study conducted in 2013 by Fellman, what affects the chances of having twins?

• A. Increase when a woman conceives at a younger age.
• B. Increase with parental age.
• C. Decrease with the frequency of intercourse before conception.
• D. Decrease with the use of fertility drugs.

Correct answer: B

Rationale: The correct answer is B. According to the study by Fellman in 2013, the chances of having twins actually increase with parental age. Choice A is incorrect as the study does not specify a younger age for conceiving to increase the chances of twins. Choice C is incorrect as the frequency of intercourse before conception is not a highlighted factor in the study. Choice D is also incorrect as the study does not discuss the impact of fertility drugs on the likelihood of having twins.

4. According to a study in 2013 by van Gameren-Oosterom, individuals with Down syndrome:

• A. are unlikely to die from cardiovascular problems by middle age.
• B. have no specific characteristic features.
• C. show deficits in cognitive development.
• D. are likely to have only 46 chromosomes.

Correct answer: C

Rationale: The correct answer is C. According to a study in 2013 by van Gameren-Oosterom, individuals with Down syndrome often exhibit deficits in cognitive development. This is a common characteristic of Down syndrome, along with other health challenges. Choice A is incorrect because individuals with Down syndrome are at a higher risk of cardiovascular problems, contrary to being unlikely to die from them. Choice B is incorrect as Down syndrome is associated with specific characteristic features such as distinctive facial characteristics, making the statement that they have no specific features incorrect. Choice D is incorrect as individuals with Down syndrome have an extra copy of chromosome 21, resulting in a total of 47 chromosomes, not 46.

5. A nurse is teaching about clomiphene citrate to a client who is experiencing infertility. Which of the following adverse effects should the nurse include?

• A. Tinnitus
• B. Urinary Frequency
• C. Breast Tenderness
• D. Chills

Correct answer: C

Rationale: The correct answer is C: 'Breast Tenderness.' Clomiphene citrate is known to cause breast tenderness as a common side effect due to its hormonal effects on the body. Tinnitus (choice A), which is a ringing in the ears, is not typically associated with clomiphene citrate. Urinary frequency (choice B) is not a common adverse effect of this medication. Chills (choice D) are also not commonly linked to clomiphene citrate use.

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