Nursing Elites

1. A nurse is caring for a newborn who is 6 hours old and has a bedside glucometer reading of 65 mg/dL. The newborn’s mother has type 2 diabetes mellitus. Which of the following actions should the nurse take?

• A. Obtain a blood sample for a serum glucose level
• B. Feed the newborn immediately
• C. Administer 50 mL of dextrose solution IV
• D. Reassess the blood glucose level prior to the next feeding

Correct answer: D

Rationale: A bedside glucometer reading of 65 mg/dL is within the normal range for a newborn. Reassessing the blood glucose level prior to the next feeding ensures ongoing monitoring without unnecessary intervention. Obtaining a blood sample for a serum glucose level (Choice A) is not necessary as the initial reading is normal. Feeding the newborn immediately (Choice B) may not be indicated and could lead to unnecessary interventions. Administering dextrose solution IV (Choice C) is not warranted as the glucose level is within the normal range and does not require immediate correction.

2. 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.

3. What is the central layer of the embryo from which the bones and muscles develop?

• A. neural tube
• B. mesoderm
• C. ectoderm
• D. umbilical cord

Correct answer: B

Rationale: The correct answer is mesoderm. The mesoderm is the middle layer of the embryo that gives rise to the bones, muscles, and other connective tissues. The neural tube (choice A) develops into the nervous system, not bones and muscles. The ectoderm (choice C) forms the skin and nervous system, not bones and muscles. The umbilical cord (choice D) is a structure that connects the developing fetus to the placenta; it is not a layer of the embryo that gives rise to bones and muscles.

4. Which FHR finding is the most concerning to the nurse providing care to a laboring client?

• A. Accelerations with fetal movement.
• B. Early decelerations.
• C. Average FHR of 126 beats per minute.
• D. Late decelerations.

Correct answer: D

Rationale: Late decelerations are caused by uteroplacental insufficiency, resulting in fetal hypoxemia. They are considered ominous if persistent, indicating compromised oxygen supply to the fetus. Accelerations with fetal movement (Choice A) are reassuring signs of fetal well-being. Early decelerations (Choice B) are typically benign, associated with head compression during contractions. An average FHR of 126 beats per minute (Choice C) falls within the normal range for fetal heart rate and is not concerning. Therefore, the most concerning FHR finding in a laboring client is late decelerations (Choice D).

5. Do dizygotic (DZ) twins run in families?

• A. Yes
• B. No
• C. Rarely
• D. Never

Correct answer: A

Rationale: Yes, dizygotic (DZ) twins can run in families. This is due to genetic factors that influence hyperovulation, where a woman releases multiple eggs during her menstrual cycle. This genetic predisposition can be passed down through generations, increasing the likelihood of having dizygotic twins. Choices B, C, and D are incorrect because the statement that dizygotic twins run in families is true, as supported by scientific evidence. It is important to note that while the genetic predisposition for dizygotic twins can run in families, it does not guarantee that every generation will have twins, as other factors also play a role in twin pregnancies.

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