Nursing Elites

1. Tim, a 27-year-old man, has unusually narrow shoulders, low muscle mass, and has no facial and body hair. His doctor recently prescribed testosterone replacement therapy to him. Tim is most likely suffering from:

• A. Phenylketonuria (PKU).
• B. Cystic fibrosis.
• C. Klinefelter syndrome.
• D. Huntington’s disease (HD).

Correct answer: C

Rationale: Tim's physical characteristics, such as narrow shoulders, low muscle mass, and lack of facial and body hair, are typical signs of Klinefelter syndrome, a genetic condition where males have an extra X chromosome (XXY). This leads to underdeveloped testes and reduced testosterone production, resulting in features like gynecomastia, sparse facial and body hair, and reduced muscle mass. Testosterone replacement therapy is commonly used to address the hormonal imbalance in individuals with Klinefelter syndrome. Phenylketonuria (PKU) is a metabolic disorder unrelated to the symptoms described in Tim's case. Cystic fibrosis is a genetic respiratory condition that does not present with the physical characteristics mentioned. Huntington’s disease (HD) is a neurodegenerative disorder primarily affecting motor function and cognition, not physical appearance and muscle mass.

2. Monozygotic (MZ) twins share _________ percent of their genes.

• A. 100
• B. 75
• C. 50
• D. 25

Correct answer: A

Rationale: Monozygotic (MZ) twins share 100% of their genes because they originate from the same fertilized egg that splits into two, resulting in identical genetic material for both twins. Choice B (75%) is incorrect as it implies a partial genetic similarity, which is not the case for MZ twins. Choice C (50%) is incorrect as it suggests half of the genes are shared, which is applicable to dizygotic (DZ) twins, not MZ. Choice D (25%) is incorrect as it indicates minimal genetic sharing, which is not true for MZ twins.

3. Which of the following statements is true of Down’s syndrome?

• A. Down’s syndrome is usually caused by an extra copy of chromosome 21 in an individual.
• B. The symptoms of Down’s syndrome are similar to those of sickle-cell anemia.
• C. Down’s syndrome is caused by a sexually transmitted infection (STI) during conception.
• D. The probability of having a child with Down’s syndrome increases with the age of the parents.

Correct answer: D

Rationale: The correct answer is D. The likelihood of having a child with Down’s syndrome increases as the age of the parents increases, particularly the mother's age. Choice A is incorrect because Down’s syndrome is caused by an extra copy of chromosome 21, not a defect in the sex chromosomes. Choice B is incorrect as the symptoms of Down’s syndrome and sickle-cell anemia are different. Choice C is also incorrect as Down’s syndrome is not caused by a sexually transmitted infection during conception.

4. A client has bacterial vaginosis. Which of the following medications should the nurse expect to administer?

• A. Metronidazole
• B. Fluconazole
• C. Acyclovir
• D. Clindamycin

Correct answer: A

Rationale: Metronidazole is the correct choice for treating bacterial vaginosis as it is the first-line medication recommended for this condition. Metronidazole works by disrupting the DNA structure of bacteria, making it an effective treatment. Choice B, Fluconazole, is an antifungal medication primarily used for treating fungal infections, not bacterial vaginosis. Choice C, Acyclovir, is an antiviral medication used to treat viral infections, not bacterial vaginosis. Choice D, Clindamycin, is also used to treat bacterial infections but is not the first-line treatment for bacterial vaginosis, making it an incorrect choice in this scenario.

5. After a mother was diagnosed with gonorrhea immediately after delivery, what is an important goal of the nurse when providing care for her baby?

• A. Prevent the development of ophthalmia neonatorum.
• B. Lubricate the eyes.
• C. Prevent the development of infection.
• D. Teach about the risks of breastfeeding with gonorrhea.

Correct answer: A

Rationale: The correct answer is A: Prevent the development of ophthalmia neonatorum. When a mother has gonorrhea, the baby can be infected during delivery, leading to ophthalmia neonatorum, which can cause permanent blindness. Therefore, it is crucial for the nurse to prevent this condition by treating the baby's eyes with an antibiotic prophylactically after birth. Choice B, lubricating the eyes, is not the primary goal in this situation as preventing infection takes precedence. Choice C, preventing the development of infection, is too broad and does not specifically address the potential complication of ophthalmia neonatorum. Choice D, teaching about the risks of breastfeeding with gonorrhea, is important but not the immediate goal in this scenario where preventing ophthalmia neonatorum and potential blindness is the priority.

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