which of the following statements should the nurse use to best describe a very low calorie diet vlcd to a client

NCLEX-PN

NCLEX PN Exam Cram

1. Which of the following statements should the nurse use to best describe a very low-calorie diet (VLCD) to a client?

A. "This diet can be used when there is close medical supervision."?
B. "This is a long-term treatment measure that assists obese people who can't lose weight."?
C. "The VLCD consists of solid food items that are pureed to facilitate digestion and absorption."?
D. "A VLCD contains very little protein."?

Correct answer: A

Rationale: The correct answer is, "This diet can be used when there is close medical supervision."? Very low-calorie diets (VLCDs) are used in the clinical treatment of obesity under close medical supervision. The diet is low in calories, high in quality protein, and has a minimum of carbohydrates to spare protein and prevent ketosis. Choice B is incorrect because VLCDs are typically short-term interventions. Choice C is incorrect because VLCDs usually consist of nutritionally complete liquid formulations, not solid food items that are pureed. Choice D is incorrect because VLCDs actually contain a high quality of protein, although the overall caloric content is very low.

2. What is one characteristic of human immunodeficiency virus (HIV)?

A. The presence of circulating antibodies that neutralize HIV is evidence of exposure to HIV.
B. HIV replication occurs intracellularly.
C. HIV integrates its genetic material into the host cell's DNA.
D. DNA replication is irrelevant to HIV.

Correct answer: C

Rationale: The correct answer is C. HIV integrates its genetic material into the host cell's DNA. The virus uses the enzyme reverse transcriptase to make a DNA copy of its RNA, which is then inserted into the genetic material of the infected cell. Choice A is incorrect because the presence of antibodies does not indicate immunity to HIV but rather exposure to the virus. Choice B is incorrect as HIV replication occurs intracellularly, inside the host cell. Choice D is irrelevant to the characteristics of HIV.

3. The power a healthcare professional exerts when working to accomplish goals and effect change in an agency or policy is considered what type of power?

A. political
B. personal
C. positional
D. professional

Correct answer: A

Rationale: Political power is the correct answer in this scenario. It stems from the ability to navigate systems, agencies, or policies to bring about change. Personal power is related to charisma and self-confidence in informal leadership roles. Positional power comes from holding a specific authority in a formal position. Professional power is derived from expertise in a particular area of practice. Therefore, in the context of effecting change in an agency or policy, political power is the most relevant type of power.

4. Which client should be seen first by the Emergency Department nurse?

A. A six-year-old with a femur fracture.
B. A two-year-old with a fever of 102 degrees F.
C. A three-year-old with wheezes in the right lower lobe.
D. A two-year-old whose gastrostomy tube came out.

Correct answer: C

Rationale: The priority in the emergency department is to assess and manage clients based on the severity of their condition. In this scenario, the three-year-old with wheezes in the right lower lobe should be seen first because respiratory distress takes precedence over other conditions. Wheezing indicates potential airway compromise, which requires immediate attention to ensure adequate oxygenation. The other options are important but do not pose an immediate threat to the client's airway and breathing. A femur fracture, fever, or a dislodged gastrostomy tube can be addressed after ensuring the child with respiratory distress is stable.

5. Elderly persons with pernicious anemia should be instructed:

A. to increase their dietary intake of foods high in B12.
B. that they do not need to return for follow-up for at least a month after initiation of treatment.
C. that oral B12 is safer and less expensive than parenteral replacement.
D. that diarrhea can be a transient side effect of B12 injections.

Correct answer: D

Rationale: Elderly persons with pernicious anemia, a condition characterized by vitamin B12 deficiency due to lack of intrinsic factor, should be informed about the potential side effects of B12 injections. Diarrhea is a known transient side effect of B12 injections, along with pain and burning at the injection site, and peripheral vascular thrombosis. Increasing dietary intake of B12-rich foods would not be sufficient due to the malabsorption issue in pernicious anemia. Follow-up is essential in managing pernicious anemia, so instructing patients they do not need to return for follow-up is incorrect. While oral B12 may be a suitable option for some cases, it is not the preferred choice for pernicious anemia where malabsorption is the primary issue.