Nursing Elites

1. 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.

2. When children who are reared by adoptive parents are nonetheless more similar to their natural parents in a trait, it can be concluded that:

• A. the genetic characteristics of the children change over time.
• B. heredity is solely responsible for how a child grows.
• C. the environment is solely responsible for the development of those characteristics.
• D. genetics play a role in the development of those characteristics.

Correct answer: D

Rationale: When children exhibit traits that are more similar to their biological parents than their adoptive parents, it indicates a strong genetic influence on those traits. This similarity suggests that genetics play a significant role in the development of the observed characteristics. Choice A is incorrect because genetic characteristics do not change over time in this context. Choice B is incorrect as it implies that heredity is the only factor, disregarding the impact of the environment. Choice C is also incorrect as it suggests that only the environment influences trait development, overlooking the genetic contribution.

3. _____ is a type of estrogen, prescribed in the 1940s and 1950s to pregnant women, that is said to have caused testicular, vaginal, and cervical cancer in some offspring.

• A. Androsterone
• B. Adiponectin
• C. Progestin
• D. Diethylstilbestrol

Correct answer: D

Rationale: Diethylstilbestrol (DES) is a synthetic estrogen that was prescribed to pregnant women in the 1940s and 1950s to prevent miscarriages. However, it was later discovered that DES exposure in utero could lead to health issues in offspring, including an increased risk of testicular, vaginal, and cervical cancer. Choice A, Androsterone, is a steroid hormone produced in small amounts in humans and unlikely to be associated with the adverse effects described. Choice B, Adiponectin, is a protein hormone that plays a role in regulating glucose levels and fatty acid breakdown, not related to the adverse effects mentioned. Choice C, Progestin, is a synthetic form of progesterone used in birth control and hormone therapy, not linked to the specific health concerns associated with DES exposure.

4. A client who is receiving prenatal care is at her 24-week appointment. Which of the following laboratory tests should the nurse plan to conduct?

• A. Group B strep culture
• B. 1-hour glucose tolerance test
• C. Rubella titer
• D. Blood type and Rh

Correct answer: B

Rationale: The correct answer is B: 1-hour glucose tolerance test. At around 24-28 weeks of gestation, a pregnant individual is typically screened for gestational diabetes. The 1-hour glucose tolerance test helps in identifying elevated blood sugar levels during pregnancy. Choice A, Group B strep culture, is not typically performed at the 24-week appointment but later in the third trimester to screen for Group B streptococcus colonization. Choice C, Rubella titer, is usually checked early in pregnancy to determine immunity to rubella. Choice D, Blood type and Rh, is important for determining the client's blood type and Rh status, but it is usually done earlier in pregnancy and not specifically at the 24-week appointment.

5. The nurse is providing care for a newborn who was delivered vaginally assisted by forceps. The nurse observes red marks on the head with swelling that does not cross the suture line. Which condition should the nurse document in the medical record?

• A. Caput succedaneum
• B. Hydrocephalus
• C. Cephalhematoma
• D. Microcephaly

Correct answer: C

Rationale: The correct answer is Cephalhematoma. Cephalhematoma is a collection of blood between the skull bone and periosteum that does not cross the suture line. It often occurs due to birth trauma, such as forceps delivery, leading to localized swelling. Caput succedaneum (Choice A) is diffuse swelling of the scalp that may cross suture lines and is typically present at birth. Hydrocephalus (Choice B) is an abnormal accumulation of cerebrospinal fluid within the brain's ventricles. Microcephaly (Choice D) is a condition characterized by a smaller than average head size and may be present at birth or develop later in infancy.

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