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The nurse is caring for a client who was recently diagnosed with human immunodeficiency virus (HIV). Which of the following statements, if made by the client, would indicate a knowledge deficit? Select all that apply.
- A. I started researching ways to tell my family that I have AIDS.
- B. I recently stopped sharing household utensils and towels.
- C. I will need periodic blood tests to measure the amount of virus.
- D. I will not be able to continue my job as a phlebotomist.
- E. If I achieve undetectable viral load status, I won't be able to transmit the virus to others.
Correct Answer: A,B,E
Rationale: A: HIV does not equate to AIDS; this indicates a misunderstanding. B: HIV is not transmitted through household items. E: Undetectable viral load reduces but does not eliminate transmission risk.
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The nurse is providing discharge instructions to a client with Clostridium difficile. Which of the following instructions should the nurse include?
- A. Your family will need prophylactic antibiotics for two weeks.
- B. Disinfect your countertops and other surfaces with isopropyl alcohol.
- C. Wear a disposable surgical mask when you are out in public.
- D. If possible, use chlorine bleach when laundering underwear.
Correct Answer: D
Rationale: Chlorine bleach is effective in killing Clostridium difficile spores during laundering, which is critical for preventing reinfection and spread.
A nurse is caring for a client who has Lyme disease. The nurse should request a prescription for which medication from the primary healthcare provider?
- A. finasteride
- B. doxycycline
- C. valacyclovir
- D. diphenhydramine
Correct Answer: B
Rationale: Doxycycline is the first-line antibiotic for treating Lyme disease due to its efficacy against Borrelia burgdorferi.
The nurse has instructed a client newly diagnosed with the human immunodeficiency virus (HIV). Which of the following statements by the client would indicate effective understanding? This disease is caused by a retrovirus leading to?
- A. encapsulation of CD4+ T-cells.
- B. inflammation of the CD4+ T-cells.
- C. abnormal proliferation of CD4+ T-cells.
- D. viral integration into the CD4+ T-cells.
Correct Answer: D
Rationale: HIV, a retrovirus, integrates its genetic material into CD4+ T-cells, leading to immune dysfunction.
The nurse has just completed a continuing education lecture regarding the human immunodeficiency virus (HIV). Which of the following statements by the nurse indicate correct understanding? Select all that apply.
- A. I will clean contaminated surfaces with soap and hot water.
- B. The goal of treatment is for the client's viral load to increase and CD4 cells to decrease.
- C. Pre-exposure prophylaxis (PREP) is available to those with risk factors for HIV.
- D. Vertical transmission (mother to fetus) may be reduced with the use of antiretrovirals.
- E. It is possible to spread the infection through contaminated water.
Correct Answer: C,D
Rationale: Pre-exposure prophylaxis (PrEP) is effective for high-risk individuals, and antiretrovirals reduce vertical transmission. HIV is not spread through water, and the treatment goal is to decrease viral load and increase CD4 cells.
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.
Item 1 of 1
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.