Nursing Elites

1. What is the most common genetic cause of intellectual disability?

• A. Down syndrome
• B. Fragile X syndrome
• C. Prader-Willi syndrome
• D. Turner syndrome

Correct answer: B

Rationale: The correct answer is Fragile X syndrome because it is the most common inherited cause of intellectual disability, resulting from a mutation in the FMR1 gene. Down syndrome, Prader-Willi syndrome, and Turner syndrome are not the most common genetic causes of intellectual disability. Down syndrome is caused by the presence of an extra chromosome 21, Prader-Willi syndrome results from specific genetic abnormalities on chromosome 15, and Turner syndrome is characterized by the absence of part or all of one of the X chromosomes.

2. The nurse and UAP enter a client's room and find the client lying on the bed. The nurse determines that the client is unresponsive. Which instruction should the nurse give the UAP first?

• A. Obtain emergency help
• B. Feel for a carotid pulse
• C. Bring a glucometer to the room
• D. Check the blood pressure

Correct answer: A

Rationale: The correct answer is to instruct the UAP to obtain emergency help first. In a situation where a client is unresponsive, the priority is to ensure that help is summoned promptly. This allows for the availability of necessary resources and assistance for resuscitation or other emergency interventions. Feeling for a carotid pulse or checking the blood pressure can be important assessments but are secondary to obtaining immediate help. Bringing a glucometer to the room, while relevant in certain situations, is not the priority when the client's unresponsiveness indicates a need for urgent intervention.

3. A client with a prescription for a transcutaneous electrical nerve stimulator (TENS) unit for pain management asks how it works. What information should the nurse reinforce?

• A. The discharge of electricity will distract the client's focus from the pain
• B. An infusion of medication in the spinal canal will block pain perception
• C. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus
• D. A mild electrical stimulus on the skin surface closes the gates of nerve conduction for severe pain

Correct answer: D

Rationale: The correct answer is D. TENS works by delivering a mild electrical stimulus that can block pain signals from reaching the brain, effectively reducing the perception of pain. Choice A is incorrect because TENS does not distract from pain but rather interferes with pain signals. Choice B is incorrect as TENS does not involve infusing medication into the spinal canal. Choice C is also incorrect because TENS does not target the cerebral cortex to dull pain perception but rather works at the level of nerve conduction.

4. What should the nurse do to complete a focused assessment for a female client with inflamed and painful hemorrhoids?

• A. Determine if the client uses any over-the-counter preparations for hemorrhoids
• B. Place the client in a standing position, leaning over the exam bed for inspection
• C. Position the client in the left lateral position to inspect the perineal area for fissures or sacs
• D. Ask the client how long she has experienced discomfort related to hemorrhoids

Correct answer: D

Rationale: Asking the client about the duration of discomfort related to hemorrhoids is the best intervention to implement for a focused assessment. This information provides important context for assessing the severity and chronicity of the condition, which is crucial for developing an appropriate care plan. Choices A, B, and C do not directly address the need to gather information about the duration of symptoms, which is essential for understanding the client's condition.

5. Which of the following is a priority for the nurse to include in the teaching of a client who was recently prescribed alprazolam (Xanax) as an oral medication?

• A. Monitor heart rate before taking the medication
• B. Monitor temperature daily
• C. Avoid unprotected exposure to sunlight
• D. Avoid alcohol

Correct answer: D

Rationale: The correct answer is D: 'Avoid alcohol.' Alprazolam (Xanax) can have central nervous system depressant effects, which are exacerbated by alcohol. It is crucial to avoid alcohol while taking this medication to prevent severe sedation and respiratory depression. Monitoring heart rate (choice A) is not directly related to alprazolam administration. Monitoring temperature daily (choice B) is not a priority teaching point for a client prescribed alprazolam. Avoiding unprotected exposure to sunlight (choice C) is not specifically linked to the use of alprazolam.

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