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. A client who is pregnant and follows a vegan diet asks a nurse for guidance on foods high in calcium. Which of the following foods has the highest amount of calcium?

• A. ½ cup cubed avocado
• B. 1 large banana
• C. 1 medium potato
• D. 1 cup cooked broccoli

Correct answer: D

Rationale: The correct answer is D: 1 cup of cooked broccoli. Broccoli is an excellent source of calcium, making it a suitable choice for a vegan diet. Avocado (Choice A), banana (Choice B), and potato (Choice C) are not significant sources of calcium compared to broccoli. Avocado and banana are primarily sources of other nutrients like healthy fats and potassium, respectively. Potato is a good source of vitamin C and potassium but not calcium. Therefore, for a pregnant client following a vegan diet and seeking calcium-rich foods, cooked broccoli is the most appropriate choice.

3. What causes Down's syndrome?

• A. Alcohol abuse by the mother at the time of conception.
• B. Sex-linked chromosomal abnormalities.
• C. An extra chromosome on the 21st pair.
• D. Drug abuse by the mother during pregnancy.

Correct answer: C

Rationale: Down's syndrome, also known as trisomy 21, is caused by the presence of an extra chromosome on the 21st pair. Choice A is incorrect as alcohol abuse is not the cause of Down's syndrome. Choice B is incorrect because Down's syndrome is not related to sex-linked chromosomal abnormalities. Choice D is also incorrect as drug abuse by the mother during pregnancy is not the cause of Down's syndrome.

4. Daisy was always unusually short for her age. She was unable to conceive a child after marriage, and upon visiting a doctor, she was prescribed estrogen replacement therapy. Daisy is most likely suffering from:

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

Correct answer: C

Rationale: Daisy's symptoms of short stature and infertility, along with the prescription of estrogen replacement therapy, are indicative of Turner syndrome. Turner syndrome is a genetic condition in which a female is partially or completely missing one X chromosome. This results in short stature, infertility, and other physical characteristics. Phenylketonuria (PKU) is a metabolic disorder caused by a mutation in the gene responsible for the breakdown of the amino acid phenylalanine. Cystic fibrosis is a genetic disorder affecting the respiratory and digestive systems. Huntington's disease (HD) is a neurodegenerative disorder that affects muscle coordination and leads to cognitive decline.

5. The healthcare provider is planning care for a client at 30 weeks gestation who is experiencing preterm labor. Which medication is most important in preventing this fetus from developing respiratory distress syndrome?

• A. Ampicillin 1 gram IV push every 8 hours
• B. Betamethasone 12 mg deep IM
• C. Terbutaline 0.25 mg subcutaneously every 15 minutes for 3 doses
• D. Butorphanol tartrate 1 mg IV push every 2 hours as needed

Correct answer: B

Rationale: Betamethasone is a corticosteroid given to stimulate fetal lung maturity and reduce the risk of respiratory distress syndrome in preterm infants. Ampicillin (Choice A) is an antibiotic and does not prevent respiratory distress syndrome. Terbutaline (Choice C) is a tocolytic used to inhibit contractions and does not directly prevent respiratory distress syndrome. Butorphanol tartrate (Choice D) is an opioid analgesic and does not have a role in preventing respiratory distress syndrome in preterm infants.

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