Nokea
A female client with human immunodeficiency virus (HIV) receives family-planning counseling. Which statement about safer sex practices for persons with HIV is accurate?
- A. If the client and her sexual partners are HIV positive, unprotected sex is permitted
- B. A latex condom with spermicide provides the best protection against HIV transmission during sexual intercourse
- C. Contraceptive methods like birth control pills, implants, and injections are recommended to prevent HIV transmission
- D. The intrauterine device is recommended for a client with HIV
Correct Answer: B
Rationale: The correct answer is B: A latex condom with spermicide provides the best protection against HIV transmission during sexual intercourse.
Rationale:
1. Latex condoms create a physical barrier that helps prevent the exchange of bodily fluids containing HIV.
2. Spermicide can further reduce the risk of HIV transmission by killing some viruses and bacteria.
3. Research shows that consistent and correct use of condoms is highly effective in reducing the risk of HIV transmission.
4. Other choices are incorrect:
- A: Unprotected sex between HIV-positive individuals can lead to the transmission of drug-resistant strains or different strains of HIV.
- C: Contraceptive methods like birth control pills do not protect against HIV transmission.
- D: The intrauterine device is not specifically recommended for clients with HIV due to potential risks of infection.
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The primary underlying disorder of pulmonary edema is:
- A. Decreased left ventricular pumping
- B. Increased left atrial contractility
- C. Decreased right ventricular elasticity
- D. Increased right atrial pressure
Correct Answer: A
Rationale: Step 1: Pulmonary edema is caused by fluid accumulation in the lungs due to increased pressure in the pulmonary vasculature.
Step 2: Decreased left ventricular pumping leads to congestive heart failure, causing increased pressure in pulmonary circulation.
Step 3: This increased pressure forces fluid from the capillaries into the alveoli, causing pulmonary edema.
Step 4: Increased left atrial contractility (B) would not directly lead to pulmonary edema.
Step 5: Decreased right ventricular elasticity (C) and increased right atrial pressure (D) are not directly related to the pathophysiology of pulmonary edema.
Summary: The correct answer is A because decreased left ventricular pumping directly contributes to the increased pressure in the pulmonary circulation that leads to pulmonary edema. Choices B, C, and D do not align with the primary underlying disorder of pulmonary edema.
Which gauge IV cannula should the nurse choose when preparing to initiate a blood transfusion?
- A. 18
- B. 24
- C. 22
- D. 28
Correct Answer: A
Rationale: The correct choice is A: 18 gauge IV cannula for blood transfusion. Larger gauge allows for faster flow rate, crucial for transfusions to prevent clotting. 24, 22, and 28 gauge cannulas are too small for adequate blood flow, leading to potential complications like hemolysis or slowed infusion.
The patient is having difficulty coping with her new diagnosis of lymphoma. Which response by the nurse is most helpful?
- A. “Don’t worry. You’ll be okay.”
- B. “The treatments you are receiving will make you feel better very soon.”
- C. “Who do you usually go to when you have a problem?”
- D. “Have you made end-of-life decisions?”
Correct Answer: C
Rationale: The correct answer is C because it helps the patient explore her support system. By asking who she usually goes to when facing problems, the nurse encourages the patient to identify her sources of emotional support, which can help her cope with the new diagnosis. This response acknowledges the patient's need for support and fosters a therapeutic relationship.
Explanation for incorrect choices:
A: "Don't worry. You'll be okay." - This response dismisses the patient's feelings and offers false reassurance, which may not address her emotional needs.
B: "The treatments you are receiving will make you feel better very soon." - While this statement provides information about treatment, it does not directly address the patient's difficulty in coping with the diagnosis.
D: "Have you made end-of-life decisions?" - This response may be premature and could unnecessarily increase the patient's anxiety about her prognosis.
The nurse should include in the patient’s teaching plan that if the patient does not take the vitamin B12, which one of the following will develop?
- A. Iron deficiency anemia
- B. Sickle cell anemia
- C. Pernicious anemia
- D. Acquired haemolytic anemia
Correct Answer: C
Rationale: The correct answer is C: Pernicious anemia. Vitamin B12 is essential for the production of red blood cells, and its deficiency can lead to pernicious anemia, characterized by decreased red blood cell production. Without adequate vitamin B12, the body cannot properly utilize iron, leading to anemia. Iron deficiency anemia (choice A) is a result of insufficient iron levels, not vitamin B12 deficiency. Sickle cell anemia (choice B) is a genetic disorder affecting hemoglobin, not related to vitamin B12 deficiency. Acquired haemolytic anemia (choice D) is caused by the premature destruction of red blood cells, not by vitamin B12 deficiency.
Which initial intervention is most appropriate for a patient who has a new onset of chest pain?
- A. Reassess the patient.
- B. Notify the health care provider.
- C. Administer a prn medication for pain.
- D. Call radiology for a portable chest x-ray.
Correct Answer: B
Rationale: The correct answer is B, notifying the health care provider. This is the most appropriate initial intervention because chest pain can be a symptom of a serious medical condition like a heart attack. The health care provider needs to be informed immediately to assess the situation and provide appropriate treatment. Reassessing the patient (A) may delay crucial medical intervention. Administering pain medication (C) without knowing the cause of chest pain can be dangerous. Calling radiology for a chest x-ray (D) is not the initial step in managing new onset chest pain.