Nursing Elites

1. Twenty-year-old Jack is extremely tall and has very thick facial hair. Most of his male secondary sex characteristics are also more pronounced than men of his age. In this scenario, Jack is most likely:

• A. an XYY male.
• B. diagnosed with Klinefelter syndrome.
• C. an XXY male.
• D. diagnosed with Down syndrome.

Correct answer: A

Rationale: The correct answer is A: an XYY male. Individuals with XYY syndrome often exhibit increased height and more pronounced secondary male characteristics, such as thick facial hair. Choice B, Klinefelter syndrome (XXY), typically presents with less prominent male secondary sex characteristics due to the presence of an extra X chromosome. Choice C, XXY male, refers to Klinefelter syndrome, which does not align with the description of Jack having more pronounced male secondary sex characteristics. Choice D, Down syndrome, is caused by a trisomy of chromosome 21 and is not associated with the physical characteristics described in the scenario.

2. The _____ is the inner layer of the embryo from which the lungs and digestive system develop.

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

Correct answer: C

Rationale: The endoderm is the correct answer. It is the innermost layer of the embryo that gives rise to organs such as the lungs, digestive system, liver, and pancreas. The neural tube (Choice A) forms the brain and spinal cord, not the lungs or digestive system. Mesoderm (Choice B) develops into structures like muscles, bones, and circulatory system, not the lungs or digestive system. The umbilical cord (Choice D) serves as a connection between the embryo and the placenta, providing nutrients and oxygen, but it is not the layer from which lungs and digestive system develop.

3. Which drug was marketed in the 1960s to pregnant women and caused birth defects such as missing or stunted limbs in infants?

• A. Progestin
• B. Estrogen
• C. Thalidomide
• D. Oxytocin

Correct answer: C

Rationale: Thalidomide is the correct answer. Thalidomide was a drug marketed in the 1960s to pregnant women as a sedative and anti-nausea medication but tragically led to severe birth defects, including limb deformities, when taken during pregnancy. Progestin (Choice A) and Estrogen (Choice B) are hormones that are not associated with causing birth defects like Thalidomide. Oxytocin (Choice D) is a hormone that plays a role in labor and breastfeeding and is not known to cause birth defects like Thalidomide.

4. A client is preparing to administer methylergonovine 0.2 mg orally to a client who is 2 hr postpartum and has a boggy uterus. For which of the following assessment findings should the nurse withhold the medication?

• A. Blood pressure 142/92 mm Hg
• B. Urine output 100 mL in 1 hr
• C. Pulse 58/min
• D. Respiratory rate 14/min

Correct answer: A

Rationale: The correct answer is A. Methylergonovine can increase blood pressure, so it should be withheld if the client has hypertension. A blood pressure reading of 142/92 mm Hg indicates hypertension and is a contraindication for administering methylergonovine. Choices B, C, and D are within normal limits and not contraindications for administering this medication. Urine output, pulse rate, and respiratory rate are not factors that determine the appropriateness of administering methylergonovine in this situation.

5. According to a study in 2014 by Skakkebaek et al., who among the following is most likely to have gynecomastia?

• A. Jennifer, a dancer, who has Down syndrome
• B. Frank, a teacher, who is diagnosed with XYY syndrome
• C. Peter, a fashion designer, who has Klinefelter syndrome
• D. Ria, a gym instructor, who is diagnosed with Turner syndrome

Correct answer: C

Rationale: Individuals with Klinefelter syndrome have an extra X chromosome (XXY) and typically have reduced testosterone levels, which can lead to gynecomastia (enlarged breasts). This condition is not usually associated with Down syndrome (choice A), XYY syndrome (choice B), or Turner syndrome (choice D), making them less likely to have gynecomastia.

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