Nokea
The client who has engaged in needle-sharing activities has developed a flu-like illness. An HIV antibody test is negative. Which statement best describes the scientific rationale for this finding?
- A. The client is fortunate not to have contracted HIV from an infected needle.
- B. The client must be repeatedly exposed to HIV before becoming infected.
- C. The client may be in the primary infection phase of an HIV infection.
- D. The antibody test is negative because the client has a different flu virus.
Correct Answer: C
Rationale: A negative antibody test during flu-like symptoms may indicate the primary HIV infection phase, before seroconversion. Single exposure can infect, and flu viruses are unrelated.
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The concept of impaired immunity has been identified by the nurse as it applies to the client diagnosed with Acquired Immune Deficiency Syndrome (AIDS). Which interventions should the nurse implement?
- A. Keep fresh flowers and raw vegetables out of the client's room.
- B. Have the Unlicensed Assistive Personnel (UAP) assist with ADLs.
- C. Encourage the client to perform active range of motion.
- D. Teach the client about the cardiovascular medications.
Correct Answer: A
Rationale: Avoiding flowers and raw vegetables reduces infection risk in AIDS. UAP assistance, ROM, and cardiovascular teaching are unrelated to immunity.
The nurse is admitting a client diagnosed with protein-calorie malnutrition secondary to AIDS. Which intervention should be the nurse's first intervention?
- A. Assess the client's body weight and ask what the client has been able to eat.
- B. Place in contact isolation and don a mask and gown before entering the room.
- C. Check the HCP's orders and determine what laboratory tests will be done.
- D. Teach the client about total parenteral nutrition and monitor the subclavian IV site.
Correct Answer: A
Rationale: Assessing weight and dietary intake provides baseline data for malnutrition management. Isolation is unnecessary, lab orders are secondary, and TPN teaching is premature.
Which signs/symptoms make the nurse suspect the most common opportunistic infection in the female client diagnosed with acquired immunodeficiency syndrome (AIDS)?
- A. Fever, cough, and shortness of breath.
- B. Oral thrush, esophagitis, and vaginal candidiasis.
- C. Abdominal pain, diarrhea, and weight loss.
- D. Painless violet lesions on the face and tip of nose.
Correct Answer: A
Rationale: Fever, cough, and shortness of breath indicate Pneumocystis pneumonia, the most common AIDS opportunistic infection. Candidiasis, GI symptoms, and Kaposi’s sarcoma are less frequent.
The nurse on a medical unit has received the morning shift report. Which client should the nurse assess first?
- A. The client who has a 0730 sliding-scale insulin order.
- B. The client who received an initial dose of IV antibiotic at 0645.
- C. The client who is having back pain at a '4' on a 1-to-10 scale.
- D. The client who has dysphagia and needs to be fed.
Correct Answer: A
Rationale: The 0730 insulin order is time-sensitive to prevent hyperglycemia or hypoglycemia. Antibiotic monitoring, mild pain, and dysphagia are less urgent.
The client with RA has nontender, movable nodules in the subcutaneous tissue over the elbows and shoulders. Which statement is the scientific rationale for the nodules?
- A. The nodules indicate a rapidly progressive destruction of the affected tissue.
- B. The nodules are small amounts of synovial fluid that have become crystallized.
- C. The nodules are lymph nodes which have proliferated to try to fight the disease.
- D. The nodules present a favorable prognosis and mean the client is better.
Correct Answer: B
Rationale: RA nodules are granulomas, sometimes containing synovial fluid, due to chronic inflammation. They do not indicate rapid destruction, lymph node proliferation, or better prognosis.