Nursing Elites

1. Patients with congestive heart failure need to restrict their intake of:

• A. fiber
• B. sodium
• C. cholesterol
• D. saturated fat

Correct answer: B

Rationale: Patients with congestive heart failure need to restrict their intake of sodium. This restriction is crucial to prevent fluid retention, which can exacerbate the condition. While fiber is generally beneficial for heart health, sodium restriction is more critical in this scenario. Cholesterol and saturated fat intake should also be monitored, but sodium restriction takes precedence due to its direct impact on fluid balance.

2. During the first 24 hours after the thermal injury, you should assess Sergio for:

• A. hypokalemia and hypernatremia
• B. hypokalemia and hyponatremia
• C. hyperkalemia and hyponatremia
• D. hyperkalemia and hypernatremia

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

3. Considering the statement that communication is most effective when barriers are first removed, which of the following is recognized as an inhibiting factor in communication?

• A. Avoidance of universally accepted abbreviations
• B. Usage of incorrect grammar
• C. Poor handwriting
• D. Advanced age of the client

Correct answer: D

Rationale: The correct answer is 'D: Advanced age of the client.' Age can be a significant obstacle in communication due to factors such as hearing loss, cognitive decline, or memory issues, which all can hamper effective communication. Choices A, B, and C, while they may present challenges in communication, are not directly related to age and its influence on communication, making them incorrect. The issues presented by not using universally accepted abbreviations, incorrect grammar, and poor handwriting can be resolved through clarification, education, or the use of alternative communication methods, unlike the difficulties that can arise from advanced age.

4. 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.

5. What food would most likely be included in Level 1 of the National Dysphagia Diet?

• A. peanut butter
• B. oatmeal
• C. fruit preserves
• D. plain yogurt

Correct answer: D

Rationale: The correct answer is D, plain yogurt. Level 1 of the National Dysphagia Diet includes pureed or smooth foods that are easy to swallow. Plain yogurt fits this criteria as it is smooth and can be easily consumed without posing a risk of choking. Choices A, B, and C are not typically included in Level 1 of the diet. Peanut butter, oatmeal, and fruit preserves are not usually suitable for individuals on Level 1 of the National Dysphagia Diet as they may present a choking hazard or are not in a pureed or smooth form.

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