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. The nurse is providing care for a newborn who was delivered vaginally assisted by forceps. The nurse observes red marks on the head with swelling that does not cross the suture line. Which condition should the nurse document in the medical record?

• A. Caput succedaneum
• B. Hydrocephalus
• C. Cephalhematoma
• D. Microcephaly

Correct answer: C

Rationale: The correct answer is Cephalhematoma. Cephalhematoma is a collection of blood between the skull bone and periosteum that does not cross the suture line. It often occurs due to birth trauma, such as forceps delivery, leading to localized swelling. Caput succedaneum (Choice A) is diffuse swelling of the scalp that may cross suture lines and is typically present at birth. Hydrocephalus (Choice B) is an abnormal accumulation of cerebrospinal fluid within the brain's ventricles. Microcephaly (Choice D) is a condition characterized by a smaller than average head size and may be present at birth or develop later in infancy.

3. A newborn is being assessed by a nurse who was born post-term. Which of the following findings should the nurse expect?

• A. Nails extending over tips of fingers
• B. Large deposits of subcutaneous fat
• C. Pale, translucent skin
• D. Thin covering of fine hair on shoulders and back

Correct answer: A

Rationale: Post-term newborns often have longer nails that extend over the tips of their fingers due to the extended gestation period. This occurs because the baby continues to grow in utero past the typical 40 weeks of gestation. Choices B, C, and D are incorrect as large deposits of subcutaneous fat, pale translucent skin, and a thin covering of fine hair on shoulders and back are not typically associated with post-term newborns. Longer nails are a common finding in post-term newborns due to the prolonged time spent in the womb, allowing for more nail growth compared to infants born at term.

4. Monozygotic (MZ) twins are known as fraternal twins.

• A. TRUE
• B. FALSE
• C. Possibly
• D. Never

Correct answer: B

Rationale: The correct answer is B: 'FALSE.' Monozygotic (MZ) twins are identical twins, not fraternal. Fraternal twins are dizygotic (DZ). The statement in the question is incorrect as MZ twins are genetically identical, while fraternal twins actually refer to dizygotic twins who develop from two separate fertilized eggs. Therefore, monozygotic twins are not known as fraternal twins, making option B the correct choice. Options A, C, and D are incorrect as they do not accurately describe the relationship between monozygotic and fraternal twins.

5. A new parent is receiving discharge teaching about car seat safety from a nurse. Which statement by the parent indicates an understanding of the teaching?

• A. “I should position my baby’s car seat at a 45-degree angle in the car.”
• B. “I should place the car seat rear-facing until my baby is 12 months old.”
• C. “I should place the harness snugly in a slot above my baby’s shoulders.”
• D. “I should position the retainer clip at the top of my baby’s abdomen.”

Correct answer: A

Rationale: The correct answer is A. Positioning the car seat at a 45-degree angle is crucial to prevent the baby's head from falling forward, which can obstruct the airway. Choice B is incorrect because the recommendation is to keep the car seat rear-facing until the baby reaches the height or weight limit set by the car seat manufacturer, typically beyond 12 months. Choice C is incorrect as the harness should be snugly placed at or below the baby's shoulders, not above. Choice D is incorrect as the retainer clip should be positioned at armpit level to secure the harness straps properly.

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