Nursing Elites

1. A client with Crohn's disease is receiving parenteral nutrition. Which of the following interventions should the nurse not include in the care of this client?

• A. Remove the parenteral nutrition solution from the refrigerator 2 hours before infusion.
• B. Remove unused parenteral nutrition after 12 hours of use.
• C. Monitor daily laboratory values and report abnormalities as needed.
• D. Monitor the flow rate of the parenteral nutrition carefully and adjust it if necessary.

Correct answer: B

Rationale: In caring for a client receiving parenteral nutrition, it is important to follow proper guidelines to ensure safety and effectiveness. Unused parenteral nutrition should be removed after 24 hours, not 12 hours, to prevent contamination and reduce the risk of infection. Option A is correct as it ensures the solution is at room temperature before infusion. Option C is essential for monitoring the client's response to parenteral nutrition. Option D is important to maintain the correct flow rate and adjust it as needed. Therefore, option B is the incorrect choice among the options provided.

2. Which type of fatty acid has carbon atoms connected by two or more double bonds?

• A. Saturated fatty acids
• B. Monounsaturated fatty acids
• C. Trans fatty acids
• D. Polyunsaturated fatty acids

Correct answer: D

Rationale: The correct answer is D. Polyunsaturated fatty acids. Polyunsaturated fatty acids have two or more double bonds in their carbon chains, making them less stable and more prone to oxidation. This characteristic distinguishes them from saturated fatty acids (Choice A), which have single bonds between carbon atoms providing stability. Monounsaturated fatty acids (Choice B) contain only one double bond, and trans fatty acids (Choice C) can have varying numbers of double bonds but are not specifically defined by having two or more double bonds.

3. 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.

4. What is the name of the record that shows all medications and treatments provided on a repeated basis?

• A. Nursing Health History and Assessment Worksheet
• B. Discharge Summary
• C. Nursing Kardex
• D. Medicine and Treatment Record

Correct answer: D

Rationale: The 'Medicine and Treatment Record' is the document that maintains a comprehensive log of all medications and treatments provided on a routine basis. It does not refer to the 'Discharge Summary', which is a clinical report prepared by healthcare professionals at the end of a hospital stay or series of treatments. The 'Nursing Health History and Assessment Worksheet' is used to gather comprehensive data about the patient's health history and current health status, but it does not record ongoing treatment details. The 'Nursing Kardex' is a patient care information system used to quickly communicate patient needs, but it does not consistently record all medications and treatments provided.

5. A client is being educated by a nurse on snacks suitable for a low-fat, low-sodium, and low-cholesterol diet. Which of the following food choices by the client indicates the need for further teaching?

• A. A slice of cheese
• B. A jam sandwich
• C. A cup of plain popcorn
• D. A small container of applesauce

Correct answer: A

Rationale: The correct answer is A: A slice of cheese. Cheese is high in fat, sodium, and cholesterol, making it unsuitable for a low-fat, low-sodium, and low-cholesterol diet. Choices B, C, and D are more appropriate for such a diet. B: A jam sandwich can be low in fat, sodium, and cholesterol if made with whole grain bread and a low-sugar jam. C: A cup of plain popcorn is a good choice as it is low in fat and can be made without added salt. D: A small container of applesauce is also a suitable option for a low-fat, low-sodium, and low-cholesterol diet.

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