Nokea
The following scenario applies to the next 1 items
The nurse is caring for a client with human immunodeficiency virus (HIV)
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Nurses Note
Medications
23-year-old client following up after initiating antiretrovirals for newly diagnosed HIV infection. The client reports nausea and vomiting if he does not take the medication with meals. He recently joined a support group to help with his coping. His laboratory results are pending. The client reports full adherence to the prescribed medication-reinforced education on the medication, dosing, and side effects
The client should be taught that the overall treatment goal for HIV is to
- A. increase the CD4/CD8 count
- B. raise the level of folic acid
- C. increase production of hemoglobin
- D. lower the viral load (VL)
Correct Answer: A,D
Rationale: The primary goals of HIV treatment are to increase CD4 counts (improving immune function) and lower the viral load to undetectable levels to prevent disease progression.
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The nurse teaches individuals about the human immunodeficiency virus (HIV) at a health fair. It would be correct for the nurse to state which of the following would indicate the need for HIV testing? Select all that apply.
- A. Pregnancy
- B. Engaged in sex work
- C. Have a sexually transmitted infection
- D. The use of injection drugs
- E. Men who have sex with men (MSM)
Correct Answer: A,B,C,D,E
Rationale: Pregnancy, sex work, STIs, injection drug use, and MSM are all risk factors warranting HIV testing to ensure early detection and treatment.
The nurse is performing an assessment on a client suspected of having Lyme disease. Which assessment finding would support the diagnosis of Lyme disease?
- A. chancre lesions
- B. petechial rash
- C. nuchal rigidity
- D. arthralgia
Correct Answer: D
Rationale: Arthralgia (joint pain) is a common symptom of Lyme disease, particularly in early disseminated stages.
The following scenario applies to the next 1 items
The nurse in the emergency department is caring for a 19-year-old male client.
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Nurses' Note
Vital Signs
Client reports right elbow pain and swelling for three days. The client says that he scraped his elbow while rollerblading, and it has become painful and swollen for the past two days. He reports waking up with a fever of 101.3°F (38.5°C) and feeling lightheaded. On assessment, the client appeared lethargic and pale. The client has a full range of motion in the elbow but reports pain with movement. The client reports pain of '7' on a scale from 0-10. The elbow has erythema with a large red bump, swollen and hot to the touch. Clear lung fields bilaterally. S1/S2 heart tones. Normoactive bowel sounds. Denies nausea. History of asthma and seasonal
Allergies.
The nurse reports the assessment findings and vital signs to the primary healthcare provider (PHCP). Click to specify if the potential prescription is anticipated or contraindicated for this client.
- A. Obtain peripheral vascular access
- B. Administer albuterol via nebulizer
- C. Collect blood cultures
- D. Infuse hypertonic saline at 30 mL/kg
- E. Administer broad-spectrum antibiotics
- F. Collect serum lactic acid
Correct Answer: A: Anticipated, B: Contraindicated, C: Anticipated, D: Contraindicated, E: Anticipated, F: Anticipated
Rationale: A: Peripheral access is needed for diagnostics and treatment. B: Albuterol is not indicated without respiratory symptoms. C: Blood cultures identify the infection source. D: Hypertonic saline is inappropriate for this case. E: Broad-spectrum antibiotics treat suspected infection. F: Serum lactic acid assesses for sepsis.
The nurse is assessing a female client with syphilis. Which assessment finding would support this diagnosis?
- A. Dysuria
- B. Vaginal discharge
- C. Chancre lesion
- D. Dyspareunia
Correct Answer: C
Rationale: A chancre lesion is a hallmark sign of primary syphilis, appearing as a painless ulcer at the infection site.
The following scenario applies to the next 1 items
The nurse in the urgent care clinic is caring for a 22-year-old male client.
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Nurses' Notes
Orders
Procedure Note
1400: Client reports swelling, erythema, and painful lesion to the left upper extremity. The client reports that he noticed a pimple-like lesion three days ago that grew in size and became painful over the course of three days. The client has a medical history of diabetes mellitus (type one) and has noticed higher-than-normal blood glucose levels. The client reports that pain has increased to a level where he cannot go to the gym daily. On assessment, the client has a large, reddened pustule in the left upper extremity. Pain rated 7/10 on the Numerical Rating Scale. Vital signs: T 98.7° F (37.1° C) P 88 RR 16 BP 138/84 Pulse oximetry reading 99% on room air.
1519: Bedside I&D performed by physician. Applied 4x4 gauze sponge to the wound and wrapped with rolled sterile gauze. Culture and sensitivity were obtained and sent to the lab.
1610: Discharged client home. Discharge teaching provided. Vital signs: T 98.7° F (37.1° C) P 82 RR 17 BP 133/81 Pulse oximetry reading 98% on room air.
The nurse provides the client with discharge teaching on wound care and the prescribed antibiotic.
The nurse provides the client with discharge teaching on wound care and the prescribed antibiotic. For each of the statements made by the client, click to specify whether the statement indicates an understanding or no understanding of the discharge teaching provided.
- A. I should increase my overall fluid intake to 3 liters daily.
- B. I should wear a broad-spectrum sunscreen while outdoors.
- C. This infection may raise my glucose level.
- D. I may have to change antibiotics depending on the lab test results.
- E. I should keep the wound open to air while sleeping.
- F. I will place soiled bandages in a plastic bag and seal it closed before placing it in the regular trash.
- G. I should wash the infected area before washing the uninfected areas with a washcloth.
Correct Answer: A: Understanding, B: No Understanding, C: Understanding, D: Understanding, E: No Understanding, F: Understanding, G: Understanding
Rationale: A: Adequate fluid intake supports healing and antibiotic efficacy. B: Sunscreen is unrelated to wound care. C: Infections can elevate glucose levels, especially in diabetics. D: Antibiotic adjustments may be needed based on culture results. E: Wounds should be kept covered to prevent contamination. F: Proper disposal of bandages prevents infection spread. G: Washing the infected area first prevents spreading bacteria.