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. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

3. Which systemic disease is best controlled with the DASH diet, monitoring blood pressure, limiting sodium, alcohol, and caffeine, reducing stress, and losing weight?

• A. Hypertension
• B. Diabetes mellitus
• C. Parkinson's disease
• D. Anemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. The DASH diet is specifically designed to control hypertension by reducing sodium intake, managing blood pressure, and promoting overall cardiovascular health. Choice B, Diabetes mellitus, is managed through monitoring blood sugar levels and a balanced diet rich in whole grains, fruits, and vegetables. Choice C, Parkinson's disease, is a neurological disorder that is not primarily managed through diet modifications. Choice D, Anemia, is a condition characterized by a lack of healthy red blood cells and is typically managed by addressing the underlying cause and sometimes iron supplementation, not by the methods mentioned in the question.

4. Each statement is true of rickets, except one. Which is the exception?

• A. Rickets is being diagnosed more frequently in the United States.
• B. Rickets is caused by vitamin C deficiency.
• C. Tachetic deformities such as bow legs or knock-knees develop.
• D. A narrow and distorted chest occurs.

Correct answer: B

Rationale: Rickets is caused by vitamin D deficiency, not vitamin C deficiency. It usually occurs in children who are 1 to 3 years old. The name rickets came from the word 'wrikken,' meaning 'to bend or twist.' Common manifestations of rickets include tachetic deformities like bow legs or knock-knees, a narrow and distorted chest, and failure of the epiphyses of bones to develop normally, resulting in twisted and warped bones. While the diagnosis of rickets may be increasing in the United States, it is not caused by a lack of vitamin C.

5. An essential nutrient must:

• A. be eaten every day
• B. be obtained by the diet
• C. be water soluble
• D. be eaten at every meal

Correct answer: B

Rationale: The correct answer is B: 'be obtained by the diet.' Essential nutrients are those that the body cannot synthesize in sufficient quantities and must therefore be obtained through the diet. Choice A is incorrect because not all essential nutrients need to be consumed daily; the frequency of consumption varies. Choice C is incorrect because not all essential nutrients are water-soluble; they can be water-soluble or fat-soluble. Choice D is incorrect because essential nutrients do not need to be consumed at every meal, but rather need to be included in the overall diet regularly.

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