Choice A rationale:

Down syndrome is primarily caused by the presence of an extra copy of chromosome 21, not chromosome 22.

This condition is known as Trisomy 21, where an individual has three copies of chromosome 21 instead of the usual two.

This extra genetic material disrupts normal development and results in the characteristic features of Down syndrome.

Choice B rationale:

Down syndrome is not caused by an error in cell division resulting in an extra copy of chromosome 20.

Trisomy 20 is not associated with Down syndrome.

The genetic basis of Down syndrome is the extra copy of chromosome 21.

Choice D rationale:

Down syndrome is not primarily due to a deletion of chromosome 18.

Deletion of chromosome 18 results in a different genetic disorder known as Edwards syndrome, not Down syndrome.

The primary genetic anomaly in Down syndrome is the presence of an extra chromosome 21.

Choice A rationale:

Trisomy 20 is not the most common type of Down syndrome.

The most prevalent form of Down syndrome is Trisomy 21, where there is an extra copy of chromosome 21, resulting in the typical features and characteristics associated with Down syndrome.

Choice B rationale:

Translocation Down syndrome is not the most common type.

Translocation Down syndrome occurs when a part of chromosome 21 attaches to another chromosome, but it is not the most common form.

Trisomy 21 is more common.

Choice C rationale:

Mosaic Down syndrome is not the most common type.

Mosaic Down syndrome is a rarer form in which not all cells have the extra chromosome 21.

The most common type is Trisomy 21, where all cells have the extra chromosome 21.

Choice A rationale:

Almond-shaped eyes are a common physical characteristic associated with Down syndrome.

These distinctive eye features are often seen in individuals with the condition.

Choice B rationale:

Low muscle tone is another common physical characteristic of Down syndrome.

This condition, also known as hypotonia, results in reduced muscle strength and can impact motor skills and coordination in individuals with Down syndrome.

Choice C rationale:

While an extra copy of chromosome 21 is the underlying genetic cause of Down syndrome, this is not a physical characteristic that can be observed directly.

It is a genetic abnormality that leads to the physical features associated with Down syndrome.

Choice D rationale:

A prominent nasal bridge is not a common physical characteristic of Down syndrome.

Individuals with Down syndrome may have flatter nasal bridges, which is one of the facial features associated with the condition.

Choice E rationale:

High muscle tone is not a common characteristic of Down syndrome.

In fact, low muscle tone (hypotonia) is more typical in individuals with Down syndrome and can affect their motor development and physical abilities.

Choice A rationale:

The statement that "cognitive impairment is not related to genetics" is incorrect.

Down syndrome is a genetic condition caused by the presence of an extra copy of chromosome 21, which directly impacts cognitive functioning.

Choice B rationale:

The statement that "cognitive impairment is primarily due to a lack of intellectual stimulation" is also incorrect.

While early intervention and intellectual stimulation can have a positive impact on individuals with Down syndrome, the condition itself is primarily caused by genetic factors.

Choice C rationale:

The correct answer is choice C, "The impact on brain development and functioning is a key factor.”.

Down syndrome results from an extra copy of chromosome 21, which leads to abnormalities in brain development and functioning.

This genetic anomaly directly affects cognitive abilities.

Individuals with Down syndrome typically have intellectual disabilities due to these genetic factors.

Choice D rationale:

The statement that "cognitive impairment in Down syndrome is caused by a lack of social interaction" is not accurate.

Social interaction can be beneficial for individuals with Down syndrome, but the primary cause of cognitive impairment in Down syndrome is genetic, not social interaction.

Choice A rationale:

The statement that "there are no specific health issues associated with Down syndrome" is incorrect.

Individuals with Down syndrome are at an increased risk for several health issues, including congenital heart defects, respiratory problems, and gastrointestinal issues.

Choice B rationale:

The statement that "common health issues include an extra copy of chromosome 22" is incorrect.

Down syndrome is caused by an extra copy of chromosome 21, not chromosome 22.

This extra chromosome leads to the characteristic features and health concerns associated with the condition.

Choice C rationale:

The correct answer is choice C, "Individuals with Down syndrome often experience congenital heart defects.”.

Congenital heart defects are one of the most common health issues in individuals with Down syndrome.

These heart defects can vary in severity and may require medical intervention.

Choice D rationale:

The statement that "the primary health concern is related to a lack of physical activity" is not accurate.

While physical activity is essential for overall health, it is not the primary health concern associated with Down syndrome.

Congenital heart defects and other medical issues are more significant health concerns for individuals with this condition.

Choice A rationale:

The physical characteristics to observe for in a newborn with Down syndrome include upward slanting eyes, a flat nasal bridge, and a small mouth.

These features are part of the characteristic facial appearance associated with Down syndrome.

It's important to note that not all infants with Down syndrome will exhibit these features to the same degree.

Choice B rationale:

The statement that infants with Down syndrome have "high muscle tone and joint stiffness" is not accurate.

In fact, infants with Down syndrome often exhibit low muscle tone (hypotonia), which can affect their motor development.

Choice C rationale:

The statement that infants with Down syndrome have "above-average height and weight" is not typically observed.

Growth patterns can vary among individuals with Down syndrome, but there is no consistent pattern of above-average height and weight associated with the condition.

Choice D rationale:

The statement that infants with Down syndrome have "perfectly symmetrical facial features" is not accurate.

Infants with Down syndrome typically have distinct facial features, including the upward slanting eyes and a flatter nasal bridge, which are characteristic of the condition.

Evaluate growth parameters, including height, weight, and head circumference.

Choice A rationale:

It is essential to evaluate growth parameters when assessing a child with Down syndrome for several reasons.

Children with Down syndrome often have growth-related concerns, including growth delays and potential issues with weight management.

By monitoring height, weight, and head circumference, the nurse can assess whether the child is following a growth curve that is appropriate for their age.

Deviations from normal growth patterns may indicate underlying health issues that need to be addressed.

Furthermore, assessing head circumference is important because changes in head size can be indicative of conditions such as hydrocephalus, which is more common in individuals with Down syndrome.

Choice B rationale:

Monitoring for speech and language delays is relevant when assessing children with Down syndrome, as they often experience communication challenges.

However, in the context of the presented case where low muscle tone and joint laxity are observed, focusing on growth parameters is more immediately relevant.

Speech and language delays can be assessed in a separate part of the assessment.

Choice C rationale:

Assessing for above-average motor skills development is not a priority in this scenario.

Children with Down syndrome typically experience low muscle tone, which can affect their motor skills development.

It is important to address the observed low muscle tone first before assessing motor skills.

Choice D rationale:

Screening for heart defects and gastrointestinal abnormalities is crucial in the overall care of a child with Down syndrome.

However, in the context of the initial assessment of low muscle tone and joint laxity, evaluating growth parameters is more directly related to the observed physical findings.

Heart defects and gastrointestinal abnormalities can be assessed as part of a comprehensive evaluation but are not the primary focus at this stage.

Cognitive abilities and intellectual functioning.

B. Hearing or vision impairments.

C. Social interactions and ability to form relationships.

E. Emotional well-being of the child and their family members.

Choice A rationale:

Evaluating cognitive abilities and intellectual functioning is crucial when assessing a child with Down syndrome.

These individuals may have varying degrees of cognitive impairment, and understanding their intellectual capabilities is essential for tailoring educational and therapeutic interventions.

Choice B rationale:

Assessing hearing and vision impairments is vital because children with Down syndrome are at an increased risk of sensory deficits, including hearing and vision problems.

Identifying and addressing these issues early can significantly impact the child's development and overall well-being.

Choice C rationale:

Evaluating social interactions and the ability to form relationships is important for assessing the child's social and emotional development.

Children with Down syndrome may face challenges in socialization and communication, and the nurse should assess their progress in developing relationships with peers and caregivers.

Choice D rationale:

High muscle tone and joint stiffness are not typical characteristics of individuals with Down syndrome.

In fact, as mentioned in the question stem, low muscle tone and joint laxity are more common in this population.

Therefore, assessing for high muscle tone and joint stiffness is not relevant in this context.

Choice E rationale:

Assessing the emotional well-being of the child and their family members is important as it can have a significant impact on the overall quality of life.

However, the assessment of emotional well-being should be conducted alongside the evaluation of other developmental aspects, as it is not a direct developmental milestone like cognitive abilities, social interactions, or sensory impairments.

Performing a physical examination to assess characteristic features.

Choice A rationale:

Monitoring for gastrointestinal abnormalities is an important aspect of caring for a child with Down syndrome but is not a component of the initial assessment for diagnosing Down syndrome.

The diagnosis of Down syndrome is typically based on clinical features and genetic testing, not on the presence of gastrointestinal abnormalities.

Choice B rationale:

Performing a physical examination to assess characteristic features is indeed an essential component of the assessment process for diagnosing Down syndrome.

There are specific physical characteristics associated with Down syndrome, including a characteristic facial appearance, low muscle tone, joint laxity, and other features.

A physical examination helps confirm the clinical signs of Down syndrome, which can then be confirmed through genetic testing.

Choice C rationale:

Administering psychological tests to assess cognitive abilities is a valuable assessment for children with Down syndrome, but it is not a primary component of the diagnostic process.

The diagnosis is typically made based on clinical features and genetic testing.

Psychological tests may be conducted after the diagnosis to assess the child's cognitive abilities and inform their educational plan.

Choice D rationale:

Conducting DNA sequencing tests is not typically the first step in diagnosing Down syndrome.

The diagnosis is often based on clinical evaluation, including the physical examination of characteristic features, and confirmed through genetic testing such as karyotyping or chromosomal microarray analysis.

Choice A rationale:

Fine and gross motor skills are important aspects to assess in a child's developmental evaluation, but these primarily pertain to physical abilities and coordination.

When assessing the cognitive abilities of a child with Down syndrome, it's essential to focus on intellectual functioning and developmental milestones, which include cognitive aspects such as problem-solving, memory, and language development.

Choice A is not the most appropriate answer in this context.

Choice B rationale:

Speech and language delays are certainly important to consider when assessing a child with Down syndrome, as many children with this condition may experience delays in their speech and language development.

However, this choice only addresses one aspect of cognitive abilities, while the question asks for what aspects the nurse should consider during the assessment.

Therefore, choice B is not comprehensive enough to address the full scope of cognitive abilities in a child with Down syndrome.

Choice C rationale:

The emotional well-being of the child and their family members is undoubtedly important, but this relates more to the psychosocial aspects of care rather than the assessment of cognitive abilities.

While addressing emotional well-being is crucial, it is not the primary focus when assessing cognitive abilities.

Therefore, choice C is not the most appropriate answer in this context.

Choice D rationale:

Intellectual functioning and developmental milestones are the key areas that the nurse should consider during the assessment of a child with Down syndrome.

Children with Down syndrome often have unique cognitive profiles, and assessing their intellectual abilities and developmental progress is essential for tailoring educational and therapeutic interventions.

This choice provides the most comprehensive and relevant answer to the question.

Choice A rationale:

Creating a safe environment, encouraging physical activity, and offering counseling are appropriate nursing interventions to promote the well-being of an individual with Down syndrome.

Safety is essential to prevent injuries, and physical activity can support overall health and well-being.

Additionally, counseling can address emotional and psychological needs, which are often important for individuals with Down syndrome.

This choice covers a wide range of well-being aspects.

Choice B rationale:

Administering medications, monitoring vital signs, and facilitating communication are important aspects of nursing care, but they may not be the top priorities for promoting the well-being of an individual with Down syndrome.

Medications and vital signs monitoring are specific to medical conditions, and communication is important but does not cover all aspects of well-being.

Choice C rationale:

Providing emotional support, promoting cognitive development, and offering early intervention services are indeed relevant interventions for individuals with Down syndrome.

However, choice A is more comprehensive as it not only includes these but also emphasizes creating a safe environment and counseling, which are essential aspects of overall well-being.

Choice D rationale:

Collaborating with therapists, addressing health conditions, and advocating for inclusive education are important interventions for individuals with Down syndrome, but they may not be the top priorities for promoting overall well-being.

These interventions focus more on specific domains of care, whereas choice A offers a broader perspective on well-being.

Choice A rationale:

Using age-appropriate educational materials and visual aids is a sound recommendation to support the development of a child with Down syndrome.

These tools can enhance learning and provide valuable resources for educational activities, which are essential for their cognitive development.

Choice B rationale:

Administering medications and monitoring vital signs regularly may be necessary for managing specific health conditions in a child with Down syndrome, but it is not a general recommendation for supporting their development.

This choice is more medically oriented and does not directly address developmental support.

Choice C rationale:

Encouraging regular exercise and creating a nurturing environment are important recommendations for supporting a child's development, including those with Down syndrome.

Physical activity is beneficial for their overall health, and a nurturing environment can provide emotional support and a conducive atmosphere for growth.

Choice D rationale:

Collaborating with healthcare providers and managing chronic health conditions is certainly important, but it is not the primary recommendation for supporting a child's development.

This choice focuses more on health management rather than developmental support, which is the main concern in this context.

Choice A rationale:

Collaborating with educators and therapists for individualized education is a crucial part of caring for individuals with Down syndrome.

These individuals often have unique learning needs, and individualized education plans (IEPs) can help address their specific challenges and strengths.

By working with educators and therapists, the nurse can ensure that the individual receives appropriate educational support tailored to their needs.

Choice B rationale:

Administering medications as prescribed for comorbidities is not typically a nursing responsibility.

Medication administration is usually the role of a healthcare provider, such as a physician or nurse practitioner.

While the nurse may need to monitor and report on the individual's response to medications, they should not be responsible for prescribing or administering them.

Choice C rationale:

Encouraging regular physical activity and exercise is important for individuals with Down syndrome.

Physical activity can help improve muscle tone, cardiovascular health, and overall well-being.

It can also support weight management, which is important as obesity is a common issue in this population.

However, it's essential to tailor exercise recommendations to the individual's abilities and needs, and this should be done in collaboration with healthcare providers and therapists.

Choice D rationale:

Providing counseling and guidance to the individual and family is a crucial aspect of caring for individuals with Down syndrome.

This population may face unique social and emotional challenges, and offering support and guidance can help them navigate these issues effectively.

Counseling can address concerns related to behavior, communication, and family dynamics, promoting a higher quality of life for both the individual and their family.

Choice E rationale:

Monitoring and managing associated health conditions are essential in caring for individuals with Down syndrome.

This population is at an increased risk of various medical issues, including congenital heart defects, thyroid disorders, and gastrointestinal problems.

Regular monitoring and timely intervention are necessary to address these health conditions and prevent complications.

However, this is not solely the nurse's responsibility; it involves collaboration with healthcare providers.

Choice A rationale:

Facilitating communication and collaboration among healthcare providers is important, but it may not directly address the parent's concerns about advocating for their child's rights and inclusive educational opportunities.

While healthcare providers play a role in the overall care of a child with Down syndrome, advocating for inclusive education and rights involves a different set of actions.

Choice B rationale:

Advocating for community integration and support networks is a crucial step in ensuring that a child with Down syndrome receives the necessary support and educational opportunities.

Inclusive education and social inclusion can significantly benefit these individuals.

Advocacy efforts should focus on building connections with local organizations and support networks that can help the child access the resources and opportunities they need.

Choice C rationale:

Implementing individualized intervention plans with therapists is important for the child's development and well-being.

However, this option is more about the child's therapy and intervention, and it doesn't directly address the parent's role in advocating for their child's rights and inclusive educational opportunities.

Choice D rationale:

Educating themselves about resources and available support networks is an essential step for parents of children with Down syndrome.

Knowledge empowers parents to advocate effectively for their child's rights and educational opportunities.

By understanding available resources and support networks, parents can make informed decisions and connect with the right organizations and individuals to support their child.

Choice A rationale:

Administering medications as prescribed with no concerns is an oversimplified approach to managing associated health conditions in individuals with Down syndrome.

While medication adherence is important, it is not the sole responsibility of the nurse, and it doesn't encompass the holistic approach needed for managing the complex health issues often associated with Down syndrome.

Choice B rationale:

Collaborating with healthcare providers to manage chronic health conditions is a comprehensive and appropriate approach.

Many individuals with Down syndrome have chronic health conditions such as heart defects, thyroid issues, and gastrointestinal problems.

Managing these conditions requires a multidisciplinary approach, including input from physicians, therapists, and nurses.

Collaboration ensures that the individual receives the best possible care and support for their specific health needs.

Choice C rationale:

Offering counseling and guidance to the individual and their family is valuable but may not directly address the management of associated health conditions.

Counseling and guidance can support emotional well-being, but the primary focus in managing health conditions should be on medical interventions and coordination of care.

Choice D rationale:

Facilitating communication and collaboration among healthcare providers is essential in managing associated health conditions in individuals with Down syndrome.

Effective communication among the healthcare team ensures that all aspects of the individual's care are addressed, and that interventions are coordinated to provide the best possible outcomes.

This choice complements choice B and is part of the overall strategy for managing complex health conditions.