Nursing Elites

1. Which enzyme is most essential for hydrolyzing large protein molecules?

• A. Gastric lipase
• B. Pepsin
• C. Mucus
• D. Intrinsic factor

Correct answer: B

Rationale: Pepsin, choice B, is the correct answer as it is a proteolytic enzyme that is essential for the breakdown of large protein molecules in the stomach. Gastric lipase, choice A, is incorrect because it primarily targets fats, not proteins, hence it is not involved in protein hydrolysis. Mucus, choice C, is incorrect as it serves to protect the stomach lining from acidic gastric juices and does not play a direct role in protein digestion. Intrinsic factor, choice D, is incorrect as it is vital for the absorption of Vitamin B12 in the small intestine and doesn't participate in the process of hydrolyzing proteins.

2. Which animal-derived food contains the most significant level of carbohydrates?

• A. Egg
• B. Beef
• C. Milk
• D. Poultry

Correct answer: C

Rationale: Milk contains the most significant level of carbohydrates among animal-derived foods. Milk and milk products supply significant quantities of carbohydrate in the form of lactose. Eggs, beef, and poultry are not significant sources of carbohydrates compared to milk. In cheese making, lactose is removed as a by-product, reducing the carbohydrate content further.

3. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

4. Which of the following best represents the goal of reflective listening?

• A. Repeating what the patient says
• B. Informing using direct advice
• C. Keeping the patient talking
• D. Warning the patient

Correct answer: C

Rationale: The correct answer is C. The goal of reflective listening is to keep the patient talking, allowing them to express their thoughts and concerns fully. Choice A, 'Repeating what the patient says,' is incorrect as reflective listening involves paraphrasing or summarizing rather than verbatim repetition. Choice B, 'Informing using direct advice,' is incorrect because reflective listening focuses on understanding the patient's perspective rather than providing direct advice. Choice D, 'Warning the patient,' is also incorrect as reflective listening aims to create a safe and open environment for the patient to share without feeling judged or warned.

5. Muscle weakness due to wasting would most likely be evaluated by which test?

• A. recall of food intake
• B. skinfold thickness
• C. handgrip strength
• D. red blood cell levels

Correct answer: C

Rationale: Handgrip strength is a reliable test to assess muscle function and detect muscle weakness due to wasting. It is often used to identify conditions like sarcopenia in clinical settings. Options A, B, and D are not suitable for evaluating muscle weakness. Food intake recall does not directly measure muscle function, skinfold thickness assesses body fat but not muscle strength, and red blood cell levels are unrelated to muscle wasting.

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