Nursing Elites

1. Each statement is true of proteins, except one. Which is the exception?

• A. Proteins are composed of building blocks called amino acids
• B. The classification of the 20 common amino acids is based on the properties of their side chains
• C. The general structure of an amino acid varies considerably
• D. Amino acids polymerize to form long chains called polypeptides

Correct answer: B

Rationale: The correct answer is B. The classification of the 20 common amino acids is not based on the properties of their side chains, but rather on the structure of their amino and carboxyl groups. These groups are consistent among all amino acids, while the side chains, also known as R groups, are what vary and give each amino acid its unique properties. Choice A is correct because proteins are indeed composed of amino acids. Choice C is incorrect because while the side chains of amino acids can vary, the general structure of an amino acid - a central carbon atom bonded to an amino group, a carboxyl group, a hydrogen atom, and a side chain - is consistent. Choice D is correct because amino acids do polymerize to form long chains called polypeptides, which can then fold into complex shapes to form proteins.

2. Each statement is true of calcium within saliva, except one. Which is the exception?

• A. Saliva is supersaturated with calcium.
• B. Saliva is a source of calcium to mineralize an immature or demineralized enamel surface.
• C. Calcium and phosphate in saliva provide a buffering action.
• D. Calcium within saliva increases dental caries.

Correct answer: D

Rationale: The correct answer is D. Calcium within saliva does not increase dental caries; in fact, the buffering action provided by calcium and phosphate in saliva inhibits caries formation by preventing the dissolution of enamel by plaque biofilm. Choice A is correct as saliva is indeed supersaturated with calcium. Choice B is correct as saliva serves as a source of calcium to mineralize an immature or demineralized enamel surface. Choice C is correct as calcium and phosphate in saliva do provide a buffering action to protect teeth from acids.

3. During the first 24 hours after the thermal injury, you should assess Sergio for:

• A. hypokalemia and hypernatremia
• B. hypokalemia and hyponatremia
• C. hyperkalemia and hyponatremia
• D. hyperkalemia and hypernatremia

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

4. An appropriate nursing diagnosis for clients in the acute manic phase of bipolar disorder is:

• A. Risk for injury directed to self
• B. Risk for injury directed to others
• C. Impaired nutrition less than body requirements
• D. Ineffective individual coping

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

5. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

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