Nursing Elites

1. Which statement correctly explains the etiology of Down syndrome?

• A. There is an extra chromosome on the 21st pair.
• B. There is a missing chromosome on the 21st pair.
• C. There are two pairs of the 21st chromosome.
• D. The 21st chromosome pair is missing.

Correct answer: A

Rationale: The correct answer is A: 'There is an extra chromosome on the 21st pair.' Down syndrome is caused by the presence of an extra copy of chromosome 21, known as trisomy 21. This additional genetic material leads to the characteristics associated with Down syndrome. Choices B, C, and D are incorrect because Down syndrome is not due to a missing chromosome or having two pairs of the 21st chromosome; it results from the presence of an extra chromosome on the 21st pair.

2. When selecting patient problems for the 4-year-old child with nephrosis, what should be a priority for the nurse?

• A. Impaired body image
• B. Skin impairment
• C. Nutritional deficit
• D. Injury

Correct answer: B

Rationale: The correct answer is B: Skin impairment. Nephrosis is characterized by gross edema, making skin care a priority. Skin impairment can result from the edema and needs close monitoring and management. While nutritional deficit and injury are important considerations in patient care, they are not the priority when dealing with a child with nephrosis. Impaired body image is not typically a priority in the immediate care of a young child with nephrosis.

3. A 55-year-old client with symptoms of osteoarthritis asks which form of exercise would be most beneficial. What is the best response by the nurse?

• A. Walking.
• B. Running.
• C. Swimming.
• D. Weight lifting.

Correct answer: C

Rationale: The correct answer is C: 'Swimming.' Swimming is a low-impact exercise that helps maintain joint mobility and reduce pain in clients with osteoarthritis. Unlike running or weight lifting, swimming is gentle on the joints, making it an ideal choice for individuals with osteoarthritis. Walking can be beneficial too, but swimming is often preferred due to its low-impact nature. Running and weight lifting may exacerbate joint pain and should be avoided by individuals with osteoarthritis.

4. An adolescent female asks the nurse about taking retinoic acid (Accutane). What guidance should be provided by the nurse?

• A. The medication should be used for 10 weeks only.
• B. The medication requires that sexually active females use contraception.
• C. The medication lowers hemoglobin levels very quickly.
• D. The medication has few side effects.

Correct answer: B

Rationale: The correct guidance the nurse should provide is that sexually active females must use contraception while taking Accutane and for 1 month after the 20 weeks it is prescribed. Choice A is incorrect because Accutane is typically taken for a longer duration than 10 weeks. Choice C is incorrect because Accutane does not lower hemoglobin levels quickly. Choice D is incorrect as Accutane is known for having many side effects, including the risk of birth defects.

5. What should be included in the medical management of sickle cell crisis?

• A. Information for the parents including home care
• B. Provisions for adequate hydration and pain management
• C. Pain management and administration of iron supplements
• D. Adequate oxygenation and factor VIII

Correct answer: B

Rationale: The correct answer is B: Provisions for adequate hydration and pain management. In managing a sickle cell crisis, it is essential to provide adequate hydration to prevent further sickling of red blood cells and ensure proper pain management to alleviate the severe pain associated with the crisis. While information for parents and home care may be important aspects of overall care, they are not specific to the immediate medical management of a sickle cell crisis. Administration of iron supplements is not recommended during a sickle cell crisis as it can potentially worsen the condition by promoting the production of more sickled red blood cells. Adequate oxygenation is crucial in sickle cell disease, but factor VIII is not typically part of the management of a sickle cell crisis.

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