Which of the following conditions results primarily from mutation in the gene encoding Vitamin D receptor?
- A. Vitamin D dependent rickets type 1
- B. Vitamin D dependent rickets type 2
- C. X-linked hypophosphatemic rickets
- D. Autosomal dominant hypophosphatemic rickets
Correct Answer: B
Rationale: Vitamin D dependent rickets type 2 is caused by mutations in the vitamin D receptor gene, leading to resistance to vitamin D.
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A characteristic sign of hypercalcaemia is:
- A. Trousseau's sign
- B. Chvostek's sign
- C. Homan's sign
- D. Kussmaul's sign
Correct Answer: A
Rationale: Trousseau's sign, which involves muscle spasms when a blood pressure cuff is inflated, is a common indicator of hypocalcemia, not hypercalcemia.
Klinefelter's syndrome:
- A. Has a karyotype XXV
- B. Is the result of meiotic non-dysjunction
- C. Shows delay in bone age/maturation
- D. Is a recognised cause of hypogonadotrophic hypogonadism
Correct Answer: B
Rationale: Klinefelter's syndrome is caused by meiotic non-dysjunction, resulting in an extra X chromosome (karyotype XXY). It is not inherited as an X-linked recessive trait, and it is not a cause of hypogonadotrophic hypogonadism.
A client with type 2 diabetes mellitus (DM) is admitted to the hospital for uncontrolled DM. Insulin therapy is initiated with an initial dose of Humulin N insulin at 0800. At 1600, the client complains of diaphoresis, rapid heartbeat, and feeling shaky. What should the nurse do first?
- A. Determine the client's current glucose level
- B. Administer 10 units of fast-acting insulin.
- C. Offer the client a snack with high protein.
- D. Increase the IV infusion rate of normal saline.
Correct Answer: A
Rationale: The symptoms suggest hypoglycemia. Checking the glucose level confirms the diagnosis and guides appropriate treatment.
An adult client is admitted with diabetic ketoacidosis (DKA) and a urinary tract infection (UTI). Prescriptions for intravenous antibiotics and an insulin infusion are initiated. Which serum laboratory value warrants the most immediate intervention by the nurse?
- A. Glucose of 350 mg/dl
- B. White blood cell count of 15,000 mm3
- C. Blood PH of 7.30
- D. Potassium of 2.5 mEq/L
Correct Answer: D
Rationale: A potassium level of 2.5 mEq/L is dangerously low and must be corrected immediately to prevent cardiac arrhythmias.
A nursing action that promotes ideal nutrition in an infant with congestive heart failure (CHF) is:
- A. Feeding formula that is supplemented with additional calories.
- B. Allowing the infant to nurse at each breast for 20 minutes.
- C. Providing large feedings every 5 hours.
- D. Using firm nipples with small openings to slow feedings.
Correct Answer: A
Rationale: Supplementing formula with extra calories increases the caloric density to support growth in infants with CHF.