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. Wernicke-Korsakoff syndrome is associated with which vitamin deficiency?

• A. Thiamine (B1)
• B. Riboflavin (B2)
• C. Niacin (B3)
• D. Pyridoxine (B6)

Correct answer: A

Rationale: Wernicke-Korsakoff syndrome is indeed associated with thiamine (vitamin B1) deficiency. This syndrome is commonly seen in individuals with chronic alcoholism due to poor diet and impaired thiamine absorption. Thiamine is essential for normal brain function and energy metabolism. Riboflavin (B2) deficiency can lead to symptoms like sore throat and swollen mucous membranes, not Wernicke-Korsakoff syndrome. Niacin (B3) deficiency causes pellagra, characterized by dermatitis, diarrhea, dementia, and death, but not Wernicke-Korsakoff syndrome. Pyridoxine (B6) deficiency can result in dermatitis, glossitis, and peripheral neuropathy, but it is not associated with Wernicke-Korsakoff syndrome.

3. The recommended treatment modality in clients with obsessive-compulsive disorder is:

• A. Psychotherapy
• B. Behavior therapy
• C. Aversion therapy
• D. Psychoanalysis

Correct answer: B

Rationale: The recommended treatment modality for clients with obsessive-compulsive disorder is Behavior Therapy, not Psychoanalysis. Behavior therapy, specifically exposure and response prevention, is considered the first-line treatment for OCD. This therapy focuses on changing the patterns of behavior that contribute to the disorder. Psychotherapy, although beneficial in some cases, is not as effective as behavior therapy for OCD. Aversion therapy involves associating a stimulus with a negative outcome to reduce the frequency of a specific behavior, which is not the primary approach for OCD.

4. Which of the following actions would be of highest priority with regards to the external shunt?

• A. Avoid taking blood pressure or blood sample from the arm with the shunt
• B. Instruct the patient not to exercise the arm with the shunt
• C. Heparinize the shunt daily
• D. Change the dressing of the shunt daily

Correct answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

5. A client says to the nurse “I am worthless person, I should be dead” The nurse best replies:

• A. “Don’t say you are worthless, you are not a worthless person”
• B. “We are going to help you with your feelings”
• C. “What makes you feel you’re worthless?”
• D. “What you say is not true”

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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