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 client has a small-bore jejunostomy and is receiving a continuous tube feeding with a high-viscosity formula. Which of the following actions should the nurse take to prevent the tubing from clogging?

• A. Replace the bag and tubing every 24 hours
• B. Flush the tubing with 10 mL water every 6 hours
• C. Administer the feeding by gravity drip
• D. Heat the formula prior to infusion

Correct answer: B

Rationale: To prevent clogging when using high-viscosity formulas in a small-bore jejunostomy, the nurse should flush the tubing with 10 mL of water every 6 hours. This action helps maintain tube patency and prevent blockages. Replacing the bag and tubing every 24 hours (Choice A) is unnecessary and does not specifically address preventing clogging. Administering the feeding by gravity drip (Choice C) or heating the formula prior to infusion (Choice D) are not effective interventions for preventing tubing clogging.

3. How many grams of protein per day are recommended for a person weighing 150 lbs?

• A. 120
• B. 85
• C. 187.5
• D. 54

Correct answer: D

Rationale: The Recommended Dietary Allowance (RDA) for protein is 0.8 grams per kilogram of body weight. To convert pounds to kilograms, divide the weight in pounds by 2.2. Therefore, a 150 lb person weighs approximately 68 kg (150 / 2.2 = 68). Multiplying 68 kg by 0.8 grams gives us 54 grams of protein per day. Choices A, B, and C are incorrect as they do not align with the RDA calculation based on body weight.

4. For a patient on a ketogenic diet, which macronutrient is primarily increased?

• A. Carbohydrates
• B. Protein
• C. Fats
• D. Fiber

Correct answer: C

Rationale: The correct answer is C: Fats. A ketogenic diet is characterized by high fat intake, moderate protein intake, and very low carbohydrate intake. This diet aims to shift the body's metabolism to use fat as the primary source of energy instead of carbohydrates. Increasing fat intake while reducing carbohydrates is essential for achieving and maintaining a state of ketosis. Therefore, choices A, B, and D are incorrect as they do not align with the macronutrient adjustments required for a ketogenic diet.

5. Discharge plans of diabetic clients include injection site rotation. You should emphasize that the space between sites should be:

• A. 6.0 cm.
• B. 5.0 cm.
• C. 2.5 cm.
• D. 4.0 cm.

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.

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