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 factor contributing to the risk for dehydration in the older adult is that _____.

• A. drinking fluids causes loss of bladder control
• B. older adults do not seem to notice mouth dryness as readily as younger people
• C. increased fluid intake will decrease the intake of nutrient-dense foods
• D. changes in intestinal motility contribute to excess fluid loss

Correct answer: C

Rationale: Older adults may not notice mouth dryness as readily as younger individuals, increasing their risk for dehydration, especially if they do not consciously increase fluid intake.

3. The nurse is completing a nutritional assessment on a client. Which statement made by the client is most concerning to the nurse?

• A. "I notice when I take a vitamin E supplement, I bruise more easily."
• B. "I work nights and rarely go outside during the day."
• C. "I take warfarin, so I need to limit the amount of green leafy vegetables I eat."
• D. "My vitamin supplement has the recommended daily allowance of vitamin A."

Correct answer: A

Rationale: The correct answer is A. Excessive intake of vitamin E can increase the risk of bleeding as it acts as a blood thinner. Bruising easily may indicate too much vitamin E. Choice B is not as concerning as it describes a lifestyle that may lead to vitamin D deficiency due to lack of sunlight exposure. Choice C shows awareness of the interaction between warfarin and vitamin K, which is expected. Choice D indicates knowledge of the vitamin A content in the supplement, which is not a cause for concern.

4. Gina, A client in prolong labor said she cannot go on anymore. The health care team decided that both the child and the mother cannot anymore endure the process. The baby is premature and has a little chance of surviving. Caesarian section is not possible because Gina already lost enough blood during labor and additional losses would tend to be fatal. The husband decided that Gina should survive and gave his consent to terminate the fetus. The principle that will be used by the health care team is:

• A. Beneficence
• B. Non malfeasance
• C. Justice
• D. Double effect

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

5. The nurse is caring for a client taking warfarin. Which meal brought in by the client's family is a priority to remove before the client eats it?

• A. Oriental cabbage salad with chicken
• B. Beef enchilada, rice, and beans
• C. Ham and cheese sandwich
• D. Macaroni salad and grapefruit slices

Correct answer: C

Rationale: The correct answer is C. Ham is high in vitamin K, which can interfere with warfarin. Vitamin K can decrease the effectiveness of warfarin, an anticoagulant medication. Choices A, B, and D do not contain high levels of vitamin K and are less likely to interfere with the client's warfarin therapy.

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