Enhancing medical-surgical nursing practice: using practice tests and clinical examples to promote active learning and program evaluation.

In a 14-week medical-surgical nursing review course, two teaching strategies are used to promote active learning and assess the transfer of knowledge to nursing practice. Practice tests and clinical examples provide opportunities for participants to engage in self-assessment and reflective learning and enhance their nursing knowledge, skills, and practice. These strategies also contribute to program evaluation and are adaptable to a variety of course formats, including traditional classroom, web conference, and online self-study.

Atypical 18p- syndrome associated with partial trisomy 16p in a chromosomally unbalanced child of consanguineous parents with an identical balanced translocation.

A 2 month old male infant was found to have mild growth retardation, prominent forehead, low set ears, low nasal bridge, rounded facies, cleft palate, webbed neck, shawl scrotum, and absent right kidney. The propositus, a product of a consanguineous marriage, had extremely rare abnormal cytogenetic findings. His karyotype contained three derivative chromosomes that originated from a familial translocation, t(16;18)(p13.3;p11.2) carried by both parents. Based on parental studies, the infant's unbalanced karyotype was defined as: [46,XY,t(16;18)(p13.3;p11.2), der(18)t(16;18).ish t(16;18)(16ptel-,16qtel+,18ptel+,wcp16+,wcp18+;16ptel+,18ptel-,wcp16+,wcp18+), der(18)t(16;18)(16ptel+,18ptel-,wcp16+,wcp18+)]. We describe this child at 2 months of age with a follow up at 4 1/2 years, exhibiting a mixed clinical picture with features of both 18p- and partial trisomy 16p13.3.