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. An older adult woman with a long history of COPD is admitted with progressive shortness of breath and a persistent cough, is anxious, and is complaining of dry mouth. Which intervention should the nurse implement?

• A. Administer a prescribed sedative
• B. Encourage client to drink water
• C. Apply a high flow venturi mask
• D. Assist her to an upright position

Correct answer: D

Rationale: Assisting the client to an upright position is the most appropriate intervention in this situation. Placing the client upright helps improve lung expansion by reducing diaphragmatic pressure, facilitating better air exchange, and increasing oxygenation. This position also aids in easing breathing efforts. Administering a sedative (Choice A) may further depress the respiratory system, worsening the breathing problem. Encouraging the client to drink water (Choice B) may not directly address the respiratory distress caused by COPD. Applying a high flow venturi mask (Choice C) may be beneficial in some cases but assisting the client to an upright position should be the priority to optimize respiratory function.

3. An infant has been diagnosed with cradle cap. What is the correct intervention to treat the scalp?

• A. Alcohol
• B. Mineral oil
• C. Calamine
• D. A&D ointment

Correct answer: B

Rationale: Cradle cap is a common condition in infants characterized by crusty patches on the scalp. The correct intervention to treat cradle cap is to apply mineral oil. Mineral oil helps soften the crusty patches, making it easier to remove them gently. Alcohol (Choice A) can be too harsh for an infant's sensitive skin and may cause irritation. Calamine (Choice C) is used to relieve itching associated with conditions like chickenpox or insect bites, not for treating cradle cap. A&D ointment (Choice D) is typically used for diaper rash and minor skin irritations, not for cradle cap.

4. A client with chronic heart failure is experiencing dyspnea and has an oxygen saturation of 88%. Which position is most appropriate to improve oxygenation?

• A. Supine with legs elevated
• B. High Fowler's position
• C. Prone with pillows under the chest
• D. Side-lying with head flat

Correct answer: B

Rationale: The correct answer is B: High Fowler's position. High Fowler's position is the most appropriate for a client with chronic heart failure experiencing dyspnea and low oxygen saturation. This position helps improve lung expansion and oxygenation by maximizing chest expansion and allowing better ventilation. Choice A, supine with legs elevated, may worsen dyspnea by reducing lung expansion. Choice C, prone with pillows under the chest, is not suitable for a client experiencing dyspnea as it may further compromise breathing. Choice D, side-lying with head flat, does not facilitate optimal lung expansion and is not the best choice for improving oxygenation in this scenario.

5. A client with chronic obstructive pulmonary disease (COPD) presented with shortness of breath. Oxygen therapy was started at 2 liters/minute via nasal cannula. The arterial blood gases (ABGs) after treatment were pH 7.36, PaO2 52, PaCO2 59, HCO3 33. Which statement describes the most likely cause of the simultaneous increase in both PaO2 and PaCO2?

• A. The client is hyperventilating due to anxiety.
• B. The hypoxic drive was reduced by the oxygen therapy.
• C. The client is experiencing respiratory alkalosis.
• D. The client is experiencing metabolic acidosis.

Correct answer: B

Rationale: Oxygen therapy can reduce the hypoxic drive in COPD patients, leading to increased PaCO2 levels while improving oxygenation (PaO2). In this case, the increase in PaO2 and PaCO2 is due to the reduction of the hypoxic drive by the supplemental oxygen. Choice A is incorrect because hyperventilation would lead to decreased PaCO2. Choice C is incorrect as the ABG values do not indicate respiratory alkalosis. Choice D is incorrect as the ABG values do not support metabolic acidosis.

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