Day 3: Test Taking Strategy

Efavirenz, an antiviral medication, is prescribed for a client diagnosed with human immunodeficiency virus (HIV) infection. The nurse should educate the client that it is best to take the medication at which time? 1. At bedtime 2. With lunch 3. With dinner 4. Just before breakfast

1. At bedtime Rationale:Because the medication causes temporary nervous system side effects during the first 2 to 4 weeks of therapy, the client is instructed to take the medication at bedtime. The time periods in options 2, 3, and 4 are not the best times for administration. Test-Taking Strategy(ies):Focus on the subject, time for administration of efavirenz. Note the strategic word, best. Eliminate options 2, 3, and 4 that are comparable or alike in that they represent time periods that are associated with food intake.Review:Efavirenz.

A patient presents with recurrent symptoms of allergy, specifically hives and rashes. What type of allergy test would the nurse expect to be performed on this patient? 1. ELISA 2. Skin testing 3. CBC with differential 4. Testing bronchial secretions

2. Skin testing Skin testing is the preferred method for specific allergy testing. Enzyme linked-immunosorbent assay (ELISA) is performed in specific conditions when the patient cannot undergo skin allergy testing. A complete blood count (CBC) with differential helps determine the level of eosinophils, which are elevated in type I hypersensitivity reactions. However, CBC with differential does not help to identify the allergens. Testing bronchial secretions does not help in allergy testing, because bronchial secretions are not highly specific.

The client diagnosed with acquired immunodeficiency syndrome has begun therapy with zidovudine. Which laboratory result should the nurse carefully monitor during treatment with this medication? 1. Blood culture 2. Blood glucose level 3. Complete blood count 4.Blood urea nitrogen level

3. Complete blood count Rationale:Common side effects of zidovudine are leukopenia and anemia. The nurse monitors the complete blood count results for these changes. The other options are unrelated to the use of this medication. Test-Taking Strategy(ies):Focus on the subject, zidovudine. It is necessary to recall that zidovudine causes leukopenia to direct you to the correct option.Review:Zidovudine

A patient receiving long-term antiretroviral therapy (ART) for HIV has developed lipodystrophy, hyperlipidemia, insulin resistance, and bone disease. Which should be the first intervention? 1. Change antiretroviral medications. 2. Promote weight loss through exercise. 3. Advocate use of calcium supplements. 4. Suggest dietary changes to lower lipid levels

1. Change antiretroviral medications. Long-term therapy with antiretroviral drugs may lead to development of certain metabolic disorders, including lipodystrophy, hyperlipidemia, insulin resistance and hyperglycemia, bone disease, lactic acidosis, renal disease, and cardiovascular disease. Therefore the first intervention should be to change the antiretroviral drug and start medications that have fewer side effects. Other interventions like dietary changes, weight loss through exercise, and taking calcium supplements are general measures and may not contribute directly to the reduction of side effects.

A patient is receiving allergy skin testing and has itching and swelling at the injection site. What intervention should the nurse prioritize? 1. Administer epinephrine. 2. Assess for systemic rash. 3. Establish intravenous (IV) access. 4. Apply a topical antihistamine to the injection site

1. Administer epinephrine. The nurse should administer epinephrine in response to an allergic reaction, which is indicated by the itching and swelling. A topical antihistamine will not be as effective. The assessment of a systemic rash can wait until the patient has received epinephrine to prevent further allergic response. IV access may be necessary, but only if the epinephrine is ineffective.

What are the specific clinical symptoms of anaphylaxis? Select all that apply. 1. Hives 2. Fever 3. Stridor 4. Dyspnea 5. Urticaria 6.Wheezing

1. Hives 3. Stridor 4. Dyspnea 5. Urticaria 6.Wheezing Rationale:Hives and stridor, which is a high-pitched sound during inspiration, are symptoms of anaphylaxis. Dyspnea occurs as the airway swells. Urticaria is an allergic reaction that presents with wheals that cause intense itching. Wheezing is a musical sound heard as the respiratory lumen narrows. Fever would not be expected. Test-Taking Strategy(ies):Focus on the subject, anaphylaxis. Think about the pathophysiology associated with this severe allergic reaction to answer correctly. Remember that fever would not be associated with this reaction.Review:Anaphylaxis.

The nurse is developing a plan of care for a client diagnosed with acquired immunodeficiency syndrome (AIDS). The nurse should document which goals for the client in the plan of care? Select all that apply. 1. Maintains a normal temperature 2. Demonstrates no increased platelet aggregation 3. Produces a urinary output of at least 50 mL per hour 4. No reports of experiencing any type of respiratory distress 5. Presents with no evidence of a dissecting aortic aneurysm

1. Maintains a normal temperature 4. No reports of experiencing any type of respiratory distress Rationale:A common, life-threatening opportunistic infection that occurs in clients with AIDS is Pneumocystis jiroveci pneumonia. Its symptoms include fever, exertional dyspnea, and nonproductive cough. The absence of respiratory distress and that of a fever are two of the goals that the nurse sets as priorities. The remaining options are not specifically related to AIDS. Test-Taking Strategy(ies):Focus on the subject, AIDS. The correct options are the only choices that are directly related to the client's diagnosis. In addition, use the ABCs—airway, breathing, and circulation—to answer the question.Review:care of the client with acquired immunodeficiency syndrome (AIDS).

The home care nurse visits a client who has recently been diagnosed with human immunodeficiency virus (HIV). The client is experiencing difficulty accepting the diagnosis. What topic should the nurse initially focus on during the assessment? 1. The client's coping skills and understanding of the disease 2. The life expectancy of a client newly diagnosed with (HIV) 3.Assuring the client that over time she or he will be able to accept the diagnosis 4.Psychosocial problems that are related to the client's feeling of hopelessness

1. The client's coping skills and understanding of the disease Rationale:The diagnosis of HIV is difficult to accept. The nurse must focus on the knowledge deficit of a disease process and the existing coping skills. None of the remaining options are initially important. Test-Taking Strategy(ies):Note the strategic word, initially. Focus on the subject, a client having difficulty accepting the diagnosis of HIV. Using the steps of the nursing process, option 1 is the only option that addresses assessment.Review:The psychosocial reactions of a client diagnosed with human immunodeficiency virus (HIV).

While working in the emergency department, the unit secretary says, "We just got a call that someone with a severe peanut allergy accidentally ate peanuts and is on the way." Which emergency equipment should the nurse gather to prepare for the client's arrival? Select all that apply. 1. epinephrine 2. Foley catheter 3.Blood administration equipment 4.Intubation equipment and oxygen 5.Equipment to initiate intravenous therapy

1. epinephrine 4.Intubation equipment and oxygen 5.Equipment to initiate intravenous therapy Rationale:The nurse should gather equipment that could or will be used with a life-threatening anaphylaxis. Intubation equipment and oxygen will be needed for airway management. Epinephrine will be needed to constrict blood vessels, increase myocardial contractility, and dilate bronchioles. Intravenous access will also be necessary. A Foley catheter is not priority equipment, and blood administration is not required for anaphylaxis Test-Taking Strategy(ies):Focus on the subject, possible anaphylaxis because of allergy to peanuts. Think about the pathophysiology of this life-threatening situation and the immediate actions that are taken to direct you to the correct options. Also note that the correct options relate to the ABCs—airway, breathing, and circulation.Review:Anaphylaxis.

A client diagnosed with acquired immunodeficiency syndrome (AIDS) gets recurrent Candida infections of the mouth (thrush). The nurse has given the client instructions to minimize the occurrence of thrush and determines that the client understands the instructions if which statement is made by the client? 1. "I should use a mouthwash at least once a week." 2. "I should use warm saline or water to rinse my mouth." 3."I should brush my teeth and rinse my mouth once a day." 4."Increasing the amount of red meat in my diet will keep this from recurring."

2. "I should use warm saline or water to rinse my mouth." Rationale:When a client is in a state of immunosuppression or has decreased levels of some normal oral flora, an overgrowth of the normal flora Candida can occur. Careful routine mouth care is helpful to prevent the recurrence of Candida infections. The client should use a mouthwash that consists of warm saline or water. The time frames given for oral hygiene in options 1 and 3 are too infrequent. Red meat will not prevent thrush. Test-Taking Strategy(ies):Eliminate options 1 and 3 because they are comparable or alike and the time frames are too infrequent. From the remaining options, recalling that red meat is not likely to minimize the occurrence of thrush will direct you to the correct option.Review:the teaching points related to the prevention of Candida infections.

The nurse is caring for a client diagnosed with acquired immunodeficiency syndrome (AIDS). Which sign/symptom indicates the presence of an opportunistic respiratory infection? 1. Nausea and vomiting 2. Fever and exertional dyspnea 3. An arterial blood gas pH of 7.40 4. A respiratory rate of 20 breaths per minute

2. Fever and exertional dyspnea Rationale:Fever and exertional dyspnea are signs of Pneumocystis jiroveci pneumonia, which is a common, life-threatening opportunistic infection that afflicts those with AIDS. Option 1 is not associated with respiratory infection. Options 3 and 4 are normal findings. Rationale:Fever and exertional dyspnea are signs of Pneumocystis jiroveci pneumonia, which is a common, life-threatening opportunistic infection that afflicts those with AIDS. Option 1 is not associated with respiratory infection. Options 3 and 4 are normal findings.

The nurse is preparing to disconnect IV fluid tubing from the access port so the patient can ambulate to the bathroom. What will the nurse wear to prevent the spread of pathogens? 1. A cap 2. Gloves 3. Shoe covers 4. An isolation gown

2. Gloves When disconnecting IV fluid tubing, the nurse may come in contact with blood. Therefore personal protective equipment such as gloves should be used. This also helps the nurse avoid an infection by not touching contaminated items or surfaces. Caps, gowns, and boots are not required when removing IV tubing.

A client is diagnosed with idiopathic autoimmune hemolytic anemia. The nurse expects the health care provider to write prescriptions for which first-line therapy to treat this disorder? 1. Radiation therapy 2. Platelet transfusion 3.Corticosteroid medication 4.Immunosuppressive agents

3.Corticosteroid medication Rationale:Idiopathic autoimmune hemolytic anemia is treated with corticosteroids, particularly prednisolone. Other treatments that can be initiated as necessary include splenectomy; transfusions; and, sometimes, immunosuppressive agents. Radiation therapy and platelet transfusion are not used to treat this clinical problem. Test-Taking Strategy(ies):Focus on the subject, idiopathic autoimmune hemolytic anemia. Note the words autoimmune and first-line in the question. This tells you that the immune system is involved. Recalling that corticosteroids are commonly used to suppress the immune response will direct you to option 3.Review:Idiopathic autoimmune hemolytic anemia

The student nurse is listening to a lecture on the different types of allergic reactions. Which statement by the student nurse indicates that teaching has been effective? 1. "Atopic allergic reactions are the most life threatening." 2. "Hemolytic allergic reactions are the most life threatening." 3. "Anaphylaxis is the most life-threatening allergic reaction." 4. "Hypersensitivity is the most life-threatening allergic reaction."

3. "Anaphylaxis is the most life-threatening allergic reaction." Rationale:Anaphylactic reactions occur within minutes and can be life threatening because of bronchial constriction, potential airway obstruction, and circulatory collapse. Atopic reactions are relatively common and are not life threatening. Examples of atopic reactions include atopic dermatitis, allergic rhinitis, asthma, and angioedema. Hemolytic reactions, although considered to be a medical emergency, are not the most life threatening of all presented in the options. This type of reaction can result in hemorrhage. Hypersensitivity reactions occur when the immune system overresponds against foreign antigens or against its own tissues. Test-Taking Strategy(ies):Note the strategic word, effective and focus on the subject, allergic reactions. Think about the pathophysiology of each type of reaction. Use the ABCs—airway, breathing, and circulation. Note that the correct option addresses airway.Review:Allergic reactions.

A client being tested for human immunodeficiency virus (HIV) antibody has a CD4+ T-cell count of 300 cells/mL. Which intervention should the nurse implement for this client? 1. Assess skin for sign/symptoms of Kaposi's sarcoma. 2.Increase fluids to minimize the risk of hypovolemic shock. 3.Monitor temperature for indications of a possible infection. 4.Encourage the client to call for assistance when ambulating.

3.Monitor temperature for indications of a possible infection. Rationale:Clients who test positive for HIV antibody are at risk for opportunistic infection. The normal CD4+ T-cell count is between 500 and 1600 cells/mL. As the CD4+ T-cell count falls, the client's risk for infection increases. Clients with HIV infection or acquired immunodeficiency syndrome (AIDS) are commonly afflicted with diarrhea, not constipation. The remaining options are incorrect because they are not interventions associated with the data presented in the question. Test-Taking Strategy(ies):Focus on the subject, the CD4+ T-cell count in a client who has tested positive for HIV. Recalling that a low CD4+ T-cell count places the client at risk for infection will direct you to the correct option.Review:Human immunodeficiency virus (HIV).

On assessment of the client diagnosed with stage III Lyme disease, which clinical manifestation should the nurse expect to note? 1. Palpitations 2. A cardiac dysrhythmia 3. A generalized skin rash 4. Enlarged and inflamed joints

4. Enlarged and inflamed joints Rationale:Stage III Lyme disease develops within a month to several months after initial infection. It is characterized by arthritic symptoms such as arthralgia and enlarged or inflamed joints, which can persist for several years after the initial infection. A rash occurs during stage I, and cardiac and neurological dysfunction occur during stage II. Test-Taking Strategy(ies):Eliminate options that are comparable or alike and are cardiac symptoms. Focusing on the subject of signs and symptoms of stage III Lyme disease will direct you to the correct option.Review:the clinical manifestations associated with Lyme disease.

An HIV patient is on long-term antiretroviral therapy (ART). Of what side effects of the antiretroviral therapy should the nurse instruct the patient to be aware? 1. Nausea 2. Vomiting 3. Diarrhea 4. Lipodystrophy

4. Lipodystrophy HIV-infected patients on antiretroviral therapy may develop a metabolic disorder called lipodystrophy, which is the deposition of fat in the abdomen, upper back, and breasts. There may simultaneously be a loss of fat in the arms, legs, and face. Nausea, vomiting, and diarrhea are short-term side effects of ART and tend to subside with regular use.

A client diagnosed with acquired immunodeficiency syndrome (AIDS) reports dyspnea on exertion, tachypnea, and a dry cough. On auscultation of the lungs, the nurse notes crackles. The nurse reports the findings to the primary health care provider, knowing that these signs/symptoms are most likely the result of which complication associated with AIDS? 1. Toxoplasmosis 2. Cryptosporidiosis 3. Malignant lymphoma 4. Pneumocystis jiroveci pneumonia

4. Pneumocystis jiroveci pneumonia Rationale:Signs/symptoms of Pneumocystis jiroveci pneumonia include dyspnea on exertion, tachypnea, and a persistent dry cough. Crackles are heard on auscultation. Signs/symptoms of toxoplasmosis include changes in mental status, neurological deficits, headaches, and fever. Signs/symptoms of cryptosporidiosis range from mild diarrhea to a cholera-like syndrome with body wasting and electrolyte imbalances. There can be a voluminous diarrhea with a volume loss of up to 15 to 20 L per day. Signs/symptoms of malignant lymphoma include weight loss, fever, and night sweats. Test-Taking Strategy(ies):Focus on the strategic words, most likely, and cause of the presenting signs/symptoms. Note that the signs/symptoms presented in the question are respiratory in nature. Note the relationship between the signs/symptoms in the question and the words "Pneumocystis jiroveci pneumonia" in the correct option.Review:Assessment findings related to Pneumocystis jiroveci pneumonia and acquired immunodeficiency syndrome (AIDS).

Which statement by a client identified as being neutropenic indicates a need for further teaching? 1. "I will include plenty of fresh fruits in my diet." 2. "If I develop a fever over 100, I will call my doctor." 3."Petting my dog is fine as long as I wash my hands after doing so." 4."My husband will just have to take over cleaning the cat's litter box."

1. "I will include plenty of fresh fruits in my diet." Rationale:Fresh fruits and vegetables are eliminated from the diet to avoid the introduction of pathogens. Fever of 38° C (100.4° F) or greater should be immediately reported. Feeding and petting cats and dogs are fine as long as hand washing follows. Handling pet excrement must be avoided to avoid exposure to pathogens. Test-Taking Strategy(ies):Note the strategic words, need for further teaching. These words indicate a negative event query and ask you to select an option that is an incorrect client statement. Focus on the subject, a neutropenic client and recall that these clients are at risk for infection. This will direct you to the correct option.Review:Neutropenia.

The new nurse is attending a clinical conference focusing on type 1 and type 2 hypersensitivity reactions. When asked to explain specific complications associated a type 1 reaction, which response indicates an understanding of this type of reaction? 1. "It results in an anaphylaxis reaction." 2. "Hemolytic anemia is a common outcome." 3. "Clients can develop Goodpasture's syndrome as a result." 4. "Thrombocytopenic purpura is often associated with a type 1 reaction."

1. "It results in an anaphylaxis reaction." Rationale:A type 1 (hypersensitivity) reaction occurs as a result of exposure to an allergen. Anaphylaxis is a life-threatening complication of a type 1 (hypersensitivity) reaction. A type 2 (cytotoxic) reaction occurs when the body makes autoantibodies directed at self-cells. Clinical examples include hemolytic anemia, Goodpasture's syndrome, and thrombocytopenic purpura. Test-Taking Strategy(ies):Focus on the subject, a type 1 hypersensitivity reaction. Note that the incorrect options all indicate disorders in which self-directed destruction of cells occurs; this will assist you in eliminating these options.Review:Type 1 and type 2 hypersensitivity reactions.

The nurse is planning to teach a client diagnosed with multiple allergies about measures to reduce allergens in the home. Which measures should the nurse include in the teaching plan? Select all that apply. 1. Avoid having pets with hair. 2.Use a humidifier year round. 3.Use a damp cloth for dusting. 4.Clean air conditioners periodically. 5.Maintain a dedicated smoking area outside.

1. Avoid having pets with hair. 3.Use a damp cloth for dusting. 4.Clean air conditioners periodically. Rationale:Use of a humidifier year round is of no particular benefit. It could be contraindicated in summer months when a dehumidifier is needed to reduce environmental moisture (and subsequent mold growth). Common allergens in the home include animal dander, dust, smoke, fumes, and mold. Animal dander can be eliminated by not having pets with hair. Use of a damp cloth will prevent dust from being dispersed in the air with dusting. Air conditioners and furnace humidifiers are sources of mold that could be allergenic. These should be cleaned periodically to prevent accumulation of mold. The client should be encouraged to quit smoking and avoid an environment that could be a potential for exposure. Test-Taking Strategy(ies):Focus on the subject, reducing allergens in the home. Begin to answer this question by eliminating option 5. Exposure to smoke needs to be completely avoided. Next eliminate option 2 that advocates year-round humidification, which could result in overhumidification of air, leading to growth of mold and fungus.Review:Ways to reduce allergens in the home.

A client diagnosed with acquired immunodeficiency syndrome (AIDS) has a problem with nutrition resulting in a weight loss. The nurse has instructed the client regarding methods of increasing weight for health maintenance. The nurse determines that there is a need for further instruction if the client states the need to implement which measure? 1. Eat low-calorie snacks between meals. 2. Eat small, frequent meals throughout the day. 3. Consume nutrient-dense foods and beverages. 4.Keep easy-to-prepare foods available in the home.

1. Eat low-calorie snacks between meals. Rationale:The client who has a problem with nutrition and is losing weight should take in nutrient-dense and high-calorie meals and snacks. The client should also eat small, frequent meals throughout the day. The client is encouraged to eat favorite foods to keep intake up and plan meals that are easy to prepare. The client should also avoid taking fluids with meals in order to increase food intake before satiety occurs. Test-Taking Strategy(ies):Note the strategic words, need for further instruction. These words indicate a negative event query and ask you to select an option that is an incorrect statement. Also focus on the data in the question and note that the client has a problem with nutrition and is losing weight. Recalling that the client should choose snacks that are high in calories (rather than low in calories) will direct you to the correct option. Review:the care of the client with imbalanced nutrition. Tip for the Nursing Student:Acquired immunodeficiency syndrome (AIDS) is manifested by opportunistic infections and neoplasms.

When collecting psychosocial assessment data on a client infected with the human immunodeficiency virus (HIV), what should the nurse focus upon first? 1. The presence of any concerns or fears 2. Identifying factors that delayed treatment 3. Determining if the client's home is a safe environment 4. Assessing whether the client has adequate support at home

1. The presence of any concerns or fears Rationale:When collecting data about the psychosocial needs of the client with HIV, the nurse should address the issue of client concerns or fears. Although the other options are not inappropriate, none have priority over assessing concerns and fears. Test-Taking Strategy(ies):Focus on the subject, psychosocial assessment of a human immunodeficiency virus (HIV)-infected client. Note the strategic word, first. Recalling that the primary intervention when addressing psychosocial needs is to address the client's feelings will direct you to the correct option.Review:Human immunodeficiency virus (HIV)

A client who was tested for human immunodeficiency virus (HIV) after a recent exposure had a negative test result. What information should the nurse include in post-test counseling? 1. The test should be repeated in 6 months. 2.The client probably has immunity to HIV. 3.The client's sexual partners were obviously not infected. 4.This ensures that the client is not infected with the HIV virus.

1. The test should be repeated in 6 months. Rationale:A negative test result indicates that no human immunodeficiency virus (HIV) antibodies were detected in the blood sample. A repeat test in 6 months is recommended because false-negative results can occur early in the infection. Options 2, 3, and 4 are incorrect. Test-Taking Strategy(ies):Focus on the subject, HIV. Begin to answer this question by eliminating options 2 and 3, because they are incorrect statements. Even without specific knowledge of the implications of test results, you would choose option 1 over option 4, because of the word ensures in option 4.Review:Human immunodeficiency virus (HIV)

A client being tested for human immunodeficiency virus (HIV) has had 2 positive enzyme-linked immunosorbent assay (ELISA) tests. The nurse anticipates that which diagnostic test will be prescribed next? 1. Western blot 2. CD4 cell count 3. Bone marrow biopsy 4. T-helper lymphocyte count

1. Western blot Rationale:If the results of two ELISA tests are positive, the Western blot is done to confirm the findings. If the result of the Western blot is positive, then the client is considered to be positive for HIV and infected with the HIV virus. The CD4 count identifies the T-helper lymphocyte count and is performed to determine progression and treatment. A bone marrow biopsy is not a component of the diagnostic studies for HIV. Test-Taking Strategy(ies):Focus on the subject, confirmation of human immunodeficiency virus (HIV) infection. Specific knowledge of the procedural steps in diagnosing HIV is needed to answer this question. Eliminate options 2 and 4 because they are comparable or alike relating to the same cell count. From the remaining options, it is necessary to know that the Western blot is used to confirm the diagnosis.Review:Human immunodeficiency virus (HIV) and Western blot.

A patient is diagnosed with acquired immunodeficiency syndrome (AIDS). Which opportunistic infections should the nurse monitor for in the patient? Select all that apply. 1. Legionnaires' disease 2. Candidiasis of bronchi 3. Ebola hemorrhagic fever 4. Toxoplasmosis of the brain 5. Mycobacterium avium (MAC) complex

2. Candidiasis of bronchi 4. Toxoplasmosis of the brain 5. Mycobacterium avium (MAC) complex Candidiasis of bronchi, toxoplasmosis of the brain, and Mycobacterium avium complex are opportunistic infections in AIDS, because the immune system is too weak to fight back. Candidiasis of the bronchi is a fungal infection caused by Candida albicans. It rarely causes problems in healthy adults because they have strong immune systems, but is common in people with HIV due to weakened immunity. Toxoplasmosis of the brain is a protozoal infection, and Mycobacterium avium complex is a bacterial infection. Ebola hemorrhagic fever is caused by Ebola virus, and Legionnaires' disease is caused by Legionella pneumophila; these are not opportunistic diseases. They are emerging infections that have recently increased in incidence.

A client diagnosed with acquired immunodeficiency syndrome (AIDS) is reporting fatigue. The nurse educates the client on ways to conserve energy. Which statement indicates that the teaching was effective? 1. "Bathe before eating breakfast." 2. "Sit for as many activities as possible." 3. "Stand in the shower instead of taking a bath." 4."Group all tasks to be performed early in the morning."

2. "Sit for as many activities as possible." Rationale:The client is taught to conserve energy by sitting for as many activities as possible, including dressing, shaving, preparing food, and ironing. The client should also sit in a shower chair instead of standing while showering. The client needs to prioritize activities such as eating breakfast before bathing, and the client should intersperse each major activity with a period of rest. Test-Taking Strategy(ies):Focus on the strategic word, effective, and the subject of conserving energy. Think about the amount of exertion required by the client to perform each of the activities described in the options. Eliminate options that are obviously taxing for the client. From the remaining choices, recall that bathing may take away energy that could be used for eating and so is not helpful.Review:the measures that conserve energy

A client diagnosed with acquired immunodeficiency syndrome (AIDS) shares with the nurse feelings of social isolation. Which strategy should the nurse suggest as the most useful way to decrease the client's stated loneliness? 1. Reinstituting contact with the client's family, who live in a distant city 2. Contacting a support group for clients with AIDS that is available in the local region 3. Using the Internet or the computer to facilitate communication while maintaining isolation 4. Using the television and newspapers to maintain a feeling of being "in touch" with the world

2. Contacting a support group for clients with AIDS that is available in the local region Rationale:The nurse encourages the client to maintain social contact and support and assists the client with reducing barriers to social contact. This can include educating the client's family about the disease and its transmission, as well as suggesting the use of community resources and support groups. Option 1, although feasible, is less likely to address the client's current feelings of loneliness. Options 3 and 4 will not decrease the client's loneliness. Test-Taking Strategy(ies):Note the strategic word, most. Eliminate options that are comparable or alike in that they relate to keeping socially attached. From the remaining options, note that the wording of option 1 implies that contact has been lost over time, which is not stated in the question.Review:the strategies related to reducing social isolation and acquired immunodeficiency syndrome (AIDS)

The nurse is monitoring a patient who has a past history of blood transfusion reactions. What hypersensitivity reaction does the nurse determine this patient is at risk for? 1. Type I: IgE-mediated 2. Type II: Cytotoxic 3. Type III: Immune-complex. 4. Type IV: Delayed hypersensitivity.

2. Type II: Cytotoxic A classic type II reaction occurs when a recipient receives ABO-incompatible blood from a donor. An example of a Type I-IgE-mediated reaction would be anaphylaxis. A Type III reaction would be seen more with autoimmune disorders (such as systemic lupus erythematosis). A Type IV reaction is contact dermatitis.

The nurse educator is teaching a group of nurses about toxoplasmosis. Which information is appropriate to include in the teaching? Select all that apply. 1. It is caused by an amoeba. 2.It is treated with sulfadiazine. 3.The organism is found in rare pork. 4. It may cause a severe inflammatory response. 5. The spores live up to 2 weeks in the environment. 6. Pregnant individuals should not empty litter boxes.

2.It is treated with sulfadiazine. 3.The organism is found in rare pork. 6. Pregnant individuals should not empty litter boxes. Rationale:Treatment for toxoplasmosis includes pyrimethamine, folinic acid, and sulfadiazine for as long as 6 weeks. The organism is found in undercooked meats such as pork and venison. Symptoms range from flulike symptoms to severe inflammatory responses and may cause central nervous system symptoms. Pregnant women should not empty litter boxes because cat feces are often a source of toxoplasmosis. Toxoplasmosis is caused by a protozoan called Toxoplasmosis gondii. Spores can remain in the environment for up to a year. Test-Taking Strategy(ies):Focus on the subject, toxoplasmosis. Specific knowledge of this organism is needed to answer correctly. Remember that it is caused by a protozoan, not an amoeba, and spores can live in the environment for up to a year.Review:Toxoplasmosis.

The nurse reads the results of a tuberculin skin test performed on a client who is human immunodeficiency virus (HIV) positive and notes a reading of 6-mm induration. What should the nurse determine that this finding indicates? 1. The client is indeed HIV positive. 2.The client may have tuberculosis. 3.The client does not have active tuberculosis. 4.The client definitely has active tuberculosis.

2.The client may have tuberculosis. Rationale:A positive reaction to a tuberculin skin test indicates exposure to tuberculosis infection. Because the response to tuberculin skin testing may be decreased in the immunosuppressed client, induration reactions more than 5 mm are considered positive. A reading of 6-mm induration is a positive result in a client who is HIV positive. A positive result indicates exposure to tuberculosis and possibly the development of tuberculin infection. Further diagnostic tests should be performed to confirm infection with tuberculosis. The remaining option are incorrect interpretations of the tuberculin skin test. Test-Taking Strategy(ies):Focus on the subject, a tuberculin skin test performed on a client who is HIV positive. Eliminate option 1 first because a tuberculin test is not related to diagnosing HIV. From the remaining options, note the closed-ended words "does not" in option 3 and "definitely" in option 4. Use of these words most likely makes an option incorrect.Review:Mantoux tuberculin skin test.

The nurse is preparing a plan of care for the client diagnosed with acquired immunodeficiency syndrome (AIDS) who is reporting frequent nausea. Which dietary measure should the nurse include in the plan? 1. Eating one serving of red meat daily 2. Including dairy products as between-meal snacks 3. Consuming foods that are cooled or at room temperature 4. Seasoning food with only moderate amounts of herbs and spices

3. Consuming foods that are cooled or at room temperature Rationale:The client diagnosed with AIDS experiencing nausea usually tolerates food best either cold or at room temperature. Clients should avoid fatty products, such as dairy products and red meat. Spices and odorous foods should be avoided because they aggravate nausea. Meals should be small and frequent to lessen the chance of vomiting. Test-Taking Strategy(ies):Focus on the subject, AIDS. Use specific knowledge related to the effects of AIDS on the gastrointestinal system to assist in answering the question. Additionally, general principles related to nutrition in a client with an immunosuppressive disorder will assist in directing

A client receiving chemotherapy has an extremely low white blood cell count and is immediately placed on neutropenic precautions that include a low-bacteria diet. Which food items is the client now allowed to consume? Select all that apply. 1. Raw celery 2. Fresh apple 3. Italian bread 4.Tossed salad 5.Baked chicken 6.Well-cooked cheeseburger

3. Italian bread 5.Baked chicken 6.Well-cooked cheeseburger Rationale:An extremely low white blood cell count places the client at risk for infection. In the immunocompromised client, a low-bacteria diet is implemented. Italian bread, baked chicken, and a well-done cheeseburger are acceptable to consume because all products are thoroughly cooked. The client avoids eating fresh fruits and vegetables. Fresh fruits and vegetables harbor organisms and place the client at risk for infection. Test-Taking Strategy(ies):Focus on the subject, a low-bacteria diet. Read each option carefully and think about the food items that harbor bacteria. Recalling that fresh fruits and vegetables are restricted from a low-bacteria diet will assist in selecting the correct items.Review:interventions for the client on a low-bacteria diet and neutropenic precautions.

The nurse differentiates between the types of hypersensitivity reactions and recognizes that which type is related to cell-mediated immunity? 1. Type I 2. Type II 3. Type III 4. Type IV

4. Type IV Type IV is related to cell-mediated immunity. It is a delayed hypersensitivity reaction. Tissue damage occurs in delayed hypersensitivity reactions. It requires 24 to 48 hours for a response to occur. Type I, Type II, and Type III are immediate reactions and are a part of humoral immunity.

A registered nurse (RN) is providing postmortem care for a deceased client whose eyes will be donated. Which measure should the nurse anticipate will most likely be prescribed that will provide appropriate care of the client's body? 1. Closing the eyes with paper tape 2. Maintaining the client in a supine position 3. Placing gauze pads wet with saline covered by a small ice pack on the eyes 4.Placing the client in a lateral recumbent position rotating right and left sides

3. Placing gauze pads wet with saline covered by a small ice pack on the eyes Rationale:When a corneal donor dies, the eyes are closed and usually the primary health care provider prescribes placing gauze pads wet with saline over them with a small ice pack. Within 2 to 4 hours the eyes are enucleated, and the corneas are usually transplanted within 24 to 48 hours. The head of the bed should be elevated. With the head of the bed elevated, the eyes will likely remain closed. Test-Taking Strategy(ies):Focus on the subject, donation of the eyes. Also note the strategic words, most likely, in the question. These words indicate that a procedure specific to eye harvesting is necessary to preserve the cornea. Visualize each option and think about the subject of preserving the eyes. This will direct you to option 3. Also note that the positions identified in the incorrect options are comparable or alike.Review:corneal transplantation.

Two weeks after being diagnosed positive for human immunodeficiency virus (HIV), a client is referred for a mental health assessment. In assessing the client, the nurse understands that which response is most typical? 1. The shock and disbelief would be resolved by anger, self-pity, and malingering. 2. Anxiety is the prevailing affective response experienced continuously once the diagnosis is known. 3. Extreme anxiety and hypervigilance behaviors beginning approximately 2 weeks after the diagnosis is delivered 4. Demonstration of symptomatology similar to post-traumatic stress disorder (PTSD) during the first few weeks after receiving the diagnosis

4. Demonstration of symptomatology similar to post-traumatic stress disorder (PTSD) during the first few weeks after receiving the diagnosis Rationale:The most common response for the client newly diagnosed with human immunodeficiency virus (HIV) is shock and disbelief, which is followed by guilt, anger, and depression. A complex symptom resembling post-traumatic stress disorder (PTSD) is common during the first few weeks after the diagnosis is learned. The remaining options are inaccurate statements regarding the typical response to a diagnosis of AIDS. Test-Taking Strategy(ies):Focus on the subject, the client's response to being diagnosed with HIV. Note the strategic word, most. Eliminate option 1, because shock and disbelief are not resolved with anger, self-pity, and malingering (although shock and disbelief might be followed by anger, guilt, and depression). Next, eliminate options 2 and 3 because of the word continuously and the suggestion of a specific time for the onset of the symptoms.Review:Human immunodeficiency virus (HIV).

A client diagnosed with acquired immunodeficiency syndrome (AIDS) is now diagnosed with Pneumocystis jiroveci pneumonia. Which findings should the nurse expect to note during the assessment? 1. Temperature 98.6° F, pulse 80 beats per minute, respiration 32 breaths per minute 2. Temperature 98.6° F, pulse 80 beats per minute, respiration 18 breaths per minute 3. Temperature 101.5° F, pulse 80 beats per minute, respiration 18 breaths per minute 4. Temperature 101.5° F, pulse 120 beats per minute, respiration 32 breaths per minute

4. Temperature 101.5° F, pulse 120 beats per minute, respiration 32 breaths per minute Rationale:The clinical manifestations of Pneumocystis jiroveci pneumonia include fever, tachycardia, and tachypnea. Therefore, option 4 is correct. Option 1 identifies a normal temperature and pulse rate and an elevated respiratory rate. Option 2 identifies normal vital signs. Option 3 identifies an elevated temperature but normal pulse and respiratory rates. Test-Taking Strategy(ies):Focus on the subject, P. jiroveci pneumonia. Recalling the clinical manifestations of P. jiroveci pneumonia will direct you to option 4. Also note that option 4 contains only abnormal vital signs.Review:Signs of Pneumocystis jiroveci pneumonia.

The nurse is assessing a newly admitting client with a diagnosis of acquired immunodeficiency syndrome (AIDS). Considering the client's diagnosis, which assessment finding should most concern the nurse? 1. Depression 2. Poor appetite 3. Urine specific gravity of 1.010 4. White patches in the oral cavity

4. White patches in the oral cavity Rationale:Clients with acquired immunodeficiency syndrome (AIDS) frequently develop opportunistic infections. Candida albicans, the causative organism of thrush, is a common opportunistic infection. Thrush presents as white patches in the oral cavity. Hairy leukoplakia also presents as white patches in the oral cavity. Clients diagnosed with AIDS frequently Experience depression and anxiety. Clients diagnosed with AIDS frequently present with inadequate nutrition and hydration resulting from anorexia and may present with dehydration, resulting in a high specific gravity rather than a low specific gravity. Test-Taking Strategy(ies):Focus on the subject, client's diagnosis of AIDS and the concerning finding, and note the strategic word, most. Recalling that the client with AIDS is immunocompromised and is at risk for developing an infection will direct you to the correct option.Review:The manifestations and complications associated with acquired immunodeficiency syndrome (AIDS)

A client diagnosed with acquired immunodeficiency syndrome (AIDS) has a T4 count of 150/mm3, and a T4:T8 ratio that is less than 2. How should the nurse interpret these results? 1. The client is malnourished. 2.The client is in stable condition. 3.The client has clinically improved. 4.The client is at risk for opportunistic infection.

4.The client is at risk for opportunistic infection. Rationale:A T4 cell count that is less than 200/mm3 and a T4:T8 ratio of less than 2 indicates that the client is exhibiting immunological manifestations of the disease and is at risk for opportunistic infection. The nurse uses this information in planning prevention control measures for the client. The information presented by the remaining options is incorrect. Additionally, these laboratory resu Test-Taking Strategy(ies):Focus on the subject, AIDS. Eliminate options 2 and 3 that are comparable or alike in that they suggest similar client status. From the remaining options, focus on the client's diagnosis to direct you to the correct option. Remember that the client with AIDS is at risk for opportunistic infection.Review:Acquired immunodeficiency syndrome (AIDS)

What assessment data place the client in a high-risk category for contracting human immunodeficiency virus (HIV)? 1. A history of intravenous drug use over the past year 2. A spouse with a history of vulnerability to infections 3. Living in an area where the rate of HIV infection is high 4. A history that includes multiple pregnancies and miscarriages

1. A history of intravenous drug use over the past year Rationale:Human immunodeficiency virus (HIV) is transmitted by intimate sexual contact and the exchange of body fluids, by exposure to infected blood, and by transmission from an infected woman to her fetus. Persons who fall into the high-risk category for HIV infection include those with persistent and recurrent sexually transmitted infections, those with a history of multiple sexual partners, and those who have used intravenous drugs. A spouse with a history of vulnerability to infections, living in an area where the rate of HIV is high, and a history of multiple pregnancies do not place the client at high risk for contracting HIV. Test-Taking Strategy(ies):Focus on the subject, prenatal assessment and high-risk category for developing HIV. Recall that the exchange of blood and body fluids places the client at high risk for HIV infection. This will assist with directing you to the correct option.Review:Risk factors for human immunodeficiency virus (HIV).

A client receiving a dose of intravenous vancomycin develops chills, tachycardia, syncope, and flushing of the face and trunk. How should the nurse interpret these manifestations? 1. The medication is infusing too rapidly. 2. The client is allergic to the medication. 3.The client is experiencing upper airway obstruction. 4.The medication is reacting to another medication the client is receiving.

1. The medication is infusing too rapidly. Rationale:The client is experiencing signs and symptoms of what is called red man syndrome or red neck syndrome. This is a response caused by histamine release that occurs with rapid or bolus injection. The client may experience chills, fever, flushing of the face and/or trunk, tachycardia, syncope, tingling, and an unpleasant taste in the mouth. The corrective action is to administer the medication more slowly. An antihistamine, such as diphenhydramine, may be administered as well. The remaining options are incorrect interpretations of the signs/symptoms. Test-Taking Strategy(ies):Focus on the subject, vancomycin. This question may be difficult, and you may want to quickly select option 2. Remember that options that are comparable or alike are not likely to be correct. For this reason, begin to answer this question by eliminating options 2 and 3 first. From the remaining options, recalling the adverse effect of red neck syndrome associated with the use of this medication will direct you to the correct option.Review:Adverse effects of vancomycin.

The nurse is developing a plan of care for the client diagnosed with acquired immunodeficiency syndrome (AIDS) who is experiencing night fever and night sweats. Which nursing intervention should the nurse include in the plan of care to manage this symptom? 1. Administer a sedative at bedtime. 2. Administer an antipyretic at bedtime. 3. Cover the client with only a light blanket. 4. Provide a back rub and comfort measures before bedtime.

2. Administer an antipyretic at bedtime. Rationale:For clients with AIDS who experience night fever and night sweats, it is useful to offer the client an antipyretic before bedtime. It is also helpful to keep a change of bed linens and nightclothes nearby for use. The pillow should have a plastic cover, and a towel may be placed over the pillowcase if there is profuse diaphoresis. The client should have liquids at the bedside to drink. Options 1 and 4 are important interventions, but they are unrelated to fever and night sweats. Option 3 will have little effect on the signs/symptoms. Test-Taking Strategy(ies):Focus on the subject, night fever and night sweats. Although the incorrect options are helpful and important interventions, they do not address the subject of the question. Because night fever and sweats occur serially, it is most helpful to give the antipyretic before sleep as a prophylactic measure.Review:Acquired immunodeficiency syndrome (AIDS).

The nurse is teaching a client about antigens and antibodies when the client asks where antibodies are located in the body. Which is an appropriate response? Select all that apply. 1. Skin 2. Tears 3.Spleen 4.Saliva 5.Blood serum 6.Lymph nodes

2. Tears 3.Spleen 4.Saliva 5.Blood serum 6.Lymph nodes Rationale:Antibodies are found in tears, spleen, saliva, blood, and lymph nodes. Each antibody is able to attach to the kind of antigen it is compatible with. The skin does not form antibodies but rather acts as a barrier to infection. Test-Taking Strategy(ies):Focus on the subject, the location of antibody formation. Think in terms of living systems for the formation of antibodies. Remember that the skin sheds frequently.Review:Antibodies.

The sister of a client with human immunodeficiency virus (HIV) asks the nurse what information she needs in order to take care of her sibling. Which instructions are appropriate for the nurse to recommend? Select all that apply. 1. Disinfect surfaces with 100% bleach. 2. Use gloves when handling body fluids. 3. Encourage a minimum of 12 hours sleep per day. 4. Wash soiled clothes in hot water with 1 cup of bleach. 5. Other members of the household should not share a bathroom. 6. Soak cleaning rags, sponges, and mops in 1:10 bleach solution for 5 minutes.

2. Use gloves when handling body fluids. 4. Wash soiled clothes in hot water with 1 cup of bleach. 6. Soak cleaning rags, sponges, and mops in 1:10 bleach solution for 5 minutes. Rationale:Gloves should be worn when handling HIV-infected persons' body fluids to prevent contracting the infection. Soiled clothes should be washed in hot water with 1 cup of bleach. Sponges, mops, and cleaning rags should be disinfected in the 1:10 bleach solution for 5 minutes. Using 100% bleach on surfaces is unnecessary and may corrode some surfaces. Twelve hours of sleep is unnecessary; recommending 8 hours and naps as needed is more appropriate. The bathroom may be shared as long as proper cleaning methods are done. Test-Taking Strategy(ies):Focus on the subject, caring for a client with HIV. Think about the methods of transmission of the virus and prevention of transmission. Remember that 100% bleach is not necessary and may cause damage to the surfaces being cleaned. Twelve hours of sleep is excessive.Review:Human immunodeficiency virus (HIV).

The nurse is administering tacrolimus to a patient. Which information about this medication would the nurse be sure to include during patient education? 1. Take this medication on an empty stomach. 2. This medication has very few side effects. 3. Avoid eating or drinking products with grapefruits while taking this medication. 4. Flu-like symptoms will develop in the first few days of treatment.

3. Avoid eating or drinking products with grapefruits while taking this medication. A substance in grapefruit and grapefruit juice prevents metabolism of these drugs. Consuming grapefruit or grapefruit juice while using tacrolimus could increase its toxicity. Tacrolimus can be taken with food or on an empty stomach; there is no specification. The medication does have significant side effects, including nephrotoxicity, that the patient should be taught. A flu-like syndrome occurs during the first few days of treatment when taking monoclonal antibodies, not tacrolimus, because of cytokine release.

A client is diagnosed with human immunodeficiency virus (HIV) infection. The nurse creates a plan of care for the client, knowing what about HIV? 1. Urine is not a medium by which HIV is transferred. 2.Bacterial infections are not likely to occur with this diagnosis. 3.When protozoan infection occurs, the client is generally asymptomatic. 4.Immunosuppression occurs when the T4 lymphocyte count of less than 200/mm3.

4.Immunosuppression occurs when the T4 lymphocyte count of less than 200/mm3. Rationale:HIV infection causes immunosuppression and is indicated by a T4 lymphocyte count of less than 200/mm3. Bacterial and protozoan infections can occur, and these infections occur as opportunistic ones as a result of the immunosuppression. Urine is a body fluid that can transfer the HIV virus. Test-Taking Strategy(ies):Focus on the subject, HIV. The correct option is the umbrella option. Remember that although bacterial, fungal, and protozoan infection can occur, these infections occur as opportunistic ones as a result of the immunosuppression.Review:Human immunodeficiency virus (HIV).

An instructor is teaching about wheal-and-flare reactions. Which statement made by the student nurse indicates that further education is required? 1. "A wheal-and-flare reaction is very dangerous." 2. "A wheal-and-flare reaction can serve a diagnostic purpose." 3. "A mosquito bite is an example of a wheal-and-flare reaction." 4. "A wheal-and-flare reaction is characterized by a pale wheal containing edematous fluid."

1. "A wheal-and-flare reaction is very dangerous." A wheal-and-flare reaction is a reaction that occurs in response to an allergen. The reaction occurs in minutes or hours and is usually not dangerous. This reaction serves a diagnostic purpose as a means of demonstrating allergic reactions to specific allergens during skin tests. The classic example of a wheal-and-flare reaction is a mosquito bite. Wheal-and-flare reactions are characterized by a pale wheal containing edematous fluid.

An adult calls the emergency department seeking advice on managing the pain caused by a bee sting to the arm. The client states that previous bee stings did not result in any allergic reactions. What should the nurse tell the client to do first? 1. Apply ice and elevate the arm. 2. Place a heating pad to the sting site. 3. Place the arm in a dependent position. 4. Cleanse the sting site with warm soapy water.

1. Apply ice and elevate the arm. Test-Taking Strategy(ies):Note the strategic word, first. Focus on the subject, treatment of a bee sting and that the site of the bee sting is painful. Eliminate options 2 and 3 because these measures will not directly assist in alleviating the pain at the site of injury. From the remaining options, recalling that cleansing the site has little effect on minimizing the pain will assist in eliminating option 4 and direct you to option 1. Test-Taking Strategy(ies):Note the strategic word, first. Focus on the subject, treatment of a bee sting and that the site of the bee sting is painful. Eliminate options 2 and 3 because these measures will not directly assist in alleviating the pain at the site of injury. From the remaining options, recalling that cleansing the site has little effect on minimizing the pain will assist in eliminating option 4 and direct you to option 1.Review:Bee sting.

Which are the most potential modes of human immunodeficiency virus (HIV) transmission? Select all that apply. 1. Breast milk 2. Needlestick injury 3. Using latex condoms 4. Monogamous relationships 5. Transfusion of HIV infected blood 6. Inconsistent use of protective equipment

1. Breast milk 2. Needlestick injury 5. Transfusion of HIV infected blood 6. Inconsistent use of protective equipment Rationale:A needlestick injury is a potential source of HIV infection, and the person from whom the used needle came from should be tested for the infection. HIV can be transmitted through breast milk and HIV-infected mothers should not breast-feed. Infected blood transfusions are a potential source; however, blood products do receive screening. Inconsistent use of protective equipment and universal precautions can lead to HIV transmission. Latex condoms prevent transmission of HIV. A monogamous relationship between two noninfected partners is considered safe. Test-Taking Strategy(ies):Note the strategic word, most. Focus on the subject, potential modes of transmission of HIV. Specific knowledge of the HIV virus and its transmission is necessary to answer correctly. The use of a latex condom and a monogamous relationship are considered to be safe.Review:Human immunodeficiency virus (HIV) transmission.

Which opportunistic infections are classified as fungal diseases? Select all that apply. 1. Candidiasis 2. Histoplasmosis 3. Cytomegalovirus 4. Herpes simplex 1 5. Cryptococcal meningitis 6. Mycobacterium tuberculosis

1. Candidiasis 2. Histoplasmosis 5. Cryptococcal meningitis Rationale:Candidiasis is a fungal infection that causes thrush, and vaginal yeast infections. Histoplasmosis is a fungal disease that causes pneumonia-like symptoms. Cryptococcal meningitis is a fungal infection causing fever, headache, and confusion, and it may cause blindness or deafness. Cytomegalovirus and herpes simplex 1 are viral diseases. Mycobacterium tuberculosis is classified in the bacterial/mycobacterial category. Test-Taking Strategy(ies):Note the subject, opportunistic infections that are fungal diseases. Specific knowledge of fungal, viral, and bacterial diseases is necessary to answer correctly. Remember that candidiasis, histoplasmosis, and cryptococcal meningitis are fungal infections.Review:Opportunistic infections and fungal infections.

The nurse preparing to administer an intravenous dose of immune globulin (IGIV) should first ensure the availability of which medication? 1. Epinephrine 2. Acetylcysteine 3. Phytonadione 4. Protamine sulfate

1. Epinephrine Rationale:IGIV is an immune serum that increases antibody titer and antigen-antibody reaction, providing passive immunity against infection. Anaphylactic reactions, although rare, can occur, and so the nurse ensures that epinephrine is readily available when administering this medication. Protamine sulfate is the antidote for heparin. Vitamin K is the antidote for oral anticoagulants. Acetylcysteine is used to treat acetaminophen overdose. Test-Taking Strategy(ies):Focus on the subject, IGIV adverse effects. Note the word availability in the question. Recalling that an anaphylactic reaction can occur will direct you to option 1. Also, specific knowledge of the common antidotes is needed to answer correctly.Review:Immune globulin (IGIV).

The nurse is performing an assessment on a client with a diagnosis of systemic lupus erythematosus (SLE). Which finding should the nurse expect to note? Select all that apply. 1. Fever 2. Bradycardia 3. Lymphadenopathy 4. Butterfly rash on the face 5. Muscular aches and pains

1. Fever 3. Lymphadenopathy 4. Butterfly rash on the face 5. Muscular aches and pains Rationale:Manifestations of SLE may include fever, musculoskeletal aches and pains, butterfly rash on the face, pleural effusion, basilar pneumonia, generalized lymphadenopathy, pericarditis, tachycardia, hepatosplenomegaly, nephritis, delirium, seizures, psychosis, and coma. Test-Taking Strategy(ies):Focus on the subject, manifestations of SLE. Knowledge about the manifestations of SLE is needed to answer this question. Think about the pathophysiology associated with this disorder to assist in eliminating option 2.Review:the clinical manifestations of systemic lupus erythematosus (SLE).

The nurse assesses the client diagnosed with acquired immunodeficiency syndrome (AIDS) for early signs of Kaposi's sarcoma. What characteristics would be consistent with that lesion? Select all that apply. 1. Flat 2. Raised 3. Resembling a blister 4. Light blue in color 5. Brownish and scaly in appearance 6.Color varies from pink to dark violet or black

1. Flat 6.Color varies from pink to dark violet or black Rationale:Kaposi's sarcoma generally starts with an area that is flat and pink that changes to a dark violet or black color. The lesions are usually present bilaterally. They may appear in many areas of the body and are treated with radiation, chemotherapy, and cryotherapy. None of the other options are associated with this type of lesion. Test-Taking Strategy(ies):Note the strategic word, early. Focus on the subject, Kaposi's sarcoma. Recalling that Kaposi's sarcoma lesions are flat and have a variety of colors from pink to dark violet or black eliminates the remaining options.Review:the characteristics of Kaposi's sarcoma. Tip for the Nursing Student:Kaposi's sarcoma is characterized by skin lesions that occur in individ

The nurse is caring for a client who recently had a kidney transplant. The nurse plans care knowing that the client is at risk for which complications associated with transplantation? Select all that apply. 1. Infection 2. Organ rejection 3. Cardiovascular disease 4. Recurrence of original disease 5. Loss of temperature regulation functions

1. Infection 2. Organ rejection 3. Cardiovascular disease 4. Recurrence of original disease Rationale:Complications associated with kidney transplantation include the following: infection; organ rejection; cardiovascular disease; recurrence of original disease; corticosteroid-related complications; and malignancies. Loss of temperature regulation functions is not a complication associated with kidney transplantation. Test-Taking Strategy(ies):Focus on the subject, complications associated with kidney transplantation. Thinking about the functions of the kidney and this surgical procedure will assist in answering correctly.Review:Kidney transplantation.

The nurse has given the client with human immunodeficiency virus (HIV) suggestions to minimize dysphagia. The nurse determines that the client has understood the instructions if the client states that she or he should increase intake of which food? 1. Puddings 2. Hot soup 3.Peanut butter 4.Raw vegetables

1. Puddings Rationale:Dysphagia is the difficult swallowing. The client is instructed to avoid spicy, sticky, or excessively hot or cold foods. The client is also instructed to avoid foods that are rough, such as uncooked fruits or vegetables. The client is encouraged to take in foods that are mild, nonabrasive, and easy to swallow. Examples of these include baked fish, noodle dishes, well-cooked eggs, and desserts such as ice cream or pudding. Dry grain foods such as crackers, bread, or cookies may be softened in milk or another beverage before eating. Test-Taking Strategy(ies):Focus on the subject, nutritional considerations in the client demonstrating difficulty swallowing. Evaluate each of the foods listed in terms of how easily they are swallowed. The hot, sticky, and rough foods in options 2, 3, and 4, respectively, help you choose the correct option.Review:Acquired immunodeficiency syndrome (AIDS).

The nurse is teaching a client diagnosed with acquired immunodeficiency syndrome (AIDS) how to avoid foodborne illnesses. The nurse instructs the client to prevent acquiring infection from food by avoiding which item? 1. Raw oysters 2. Bottled water 3. Pasteurized milk 4. Products with sorbitol

1. Raw oysters Rationale:The client who is at risk for immunosuppression is taught to avoid raw or undercooked seafood, meat, poultry, and eggs. The client should also avoid unpasteurized milk and dairy products. Fruits that can be peeled, as well as bottled beverages, are safe. The client may be taught to avoid sorbitol, but this is to diminish diarrhea and has nothing to do with foodborne infections. Test-Taking Strategy(ies):Focus on the subject, foodborne illness. Sorbitol can cause diarrhea, but it is unrelated to foodborne illness, so option 4 is eliminated first. Eliminate option 3 next because products that are pasteurized are free of microbes. From the remaining options, noting the word raw in option 1 will direct you to this option.Review:foodborne illnesses and dietary teaching for the client with acquired immunodeficiency syndrome (AIDS).

The nurse assesses the client for the hallmark characteristic of stage I Lyme disease. Which assessment finding should the nurse most likely expect to note? 1. Skin rash 2. Arthralgias 3. Dizziness and headaches 4.Enlarged and inflamed joints

1. Skin rash Rationale:The hallmark of stage I of Lyme disease is the development of a skin rash within 2 to 30 days of infection, generally at the site of the tick bite. The rash develops into a concentric ring, giving it a "bull's-eye" appearance. The lesion enlarges up to 50 to 60 cm, and smaller lesions develop farther away from the original tick bite. In stage I, most infected persons also develop flulike symptoms that last 7 to 10 days, and these symptoms may recur later. Test-Taking Strategy(ies):Focus on the subject, stage I of Lyme disease. Note the strategic words, most likely. Eliminate options that are comparable or alike because of the connection with joints. Next, note that the question asks for the characteristic of stage I. From the remaining options, select the least serious manifestation because the subject of the question relates to the earliest stage. Expect neurological disorders to occur with progression of the disease.Review:Stage I of Lyme disease

A client began receiving an intravenous (IV) infusion of packed red blood cells 30 minutes ago. What is the initial nursing action when the client reports itching and a tight sensation in the chest? 1. Stop the transfusion. 2. Check the client's temperature. 3. Call the primary health care provider. 4. Recheck the unit of blood for compatibility.

1. Stop the transfusion Rationale:The symptoms reported by the client indicate that the client is experiencing a transfusion reaction. The first action of the nurse when a transfusion reaction is observed is to discontinue the transfusion. The IV of normal saline with new IV tubing is started and the primary health care provider is notified. The nurse then checks the client's vital signs: temperature, pulse, and respirations and then rechecks the unit of blood as appropriate for infusion into the client. Depending on agency protocol, the nurse may also obtain a urinalysis, draw a sample of blood, and return the unit of blood and tubing to the blood bank. The nurse also institutes supportive care for the client, which may include administration of antihistamines, crystalloids, epinephrine steroids, or vasopressors as prescribed. Test-Taking Strategy(ies):Focus on the subject, the action to take if a transfusion reaction occurs. Noting the strategic word, initial, will direct you to the correct option. Remember that the first action of the nurse when a transfusion reaction is observed is to discontinue the transfusion.Review:transfusion reaction.

A nurse has just been asked by a friend to administer allergy shots at home to save money by avoiding office visits. Which response by the nurse is most appropriate? 1. "I would, but it is illegal for nurses to administer injections outside of a medical setting." 2. "These injections should only be administered in a setting where emergency equipment and drugs are available." 3. "Just make sure you have epinephrine in an injectable syringe provided along with the allergy injections." 4. "Allergy shots are not usually effective; it is safer and more effective to control allergies by avoiding allergens."

2. "These injections should only be administered in a setting where emergency equipment and drugs are available." Anaphylactic reactions occur suddenly in hypersensitive patients after exposure to the offending allergen. They may occur after parenteral injection of drugs (especially antibiotics) or blood products, and after insect stings. The cardinal principle in management is speed in recognition of signs and symptoms of an anaphylactic reaction, maintenance of a patent airway, prevention of spread of the allergen by using a tourniquet, administration of drugs, and treatment for shock. The reasoning isn't because it is illegal or because the allergy shots are not effective and the patient needs more than just epinephrine available.

A client who is immunosuppressed is being admitted to the hospital on neutropenic precautions. Which nursing interventions should be implemented to protect the client from infection? Select all that apply. 1. Restrict all visitors. 2. Admit the client to a private room. 3. Place a mask on the client if the client leaves the room. 4. Use strict aseptic technique for all invasive procedures. 5. Place a "See the Nurse Before Entering" sign on the door to the room. 6. Remove a vase with fresh flowers in the room that was left by a previous client.

2. Admit the client to a private room. 3. Place a mask on the client if the client leaves the room. 4. Use strict aseptic technique for all invasive procedures. 5. Place a "See the Nurse Before Entering" sign on the door to the room. 6. Remove a vase with fresh flowers in the room that was left by a previous client. Rationale:The client should wear a mask for protection from exposure to microorganisms whenever he or she leaves the room. The client who is on neutropenic precautions is immunosuppressed and therefore is admitted to a private room on the nursing unit. The use of strict aseptic technique is necessary with all invasive procedures to prevent infection. A sign indicating "See the Nurse Before Entering" should be placed on the door to the client's room, so the nurse can ensure that neutropenic precautions are implemented by anyone entering the room. Sources of standing water and fresh flowers should be removed to decrease the microorganism count. Not all visitors must be restricted; however, visitors need to be restricted to healthy adults and must perform strict hand-washing procedures and don a mask before entering the client's room. Test-Taking Strategy(ies):Focus on the subject, an immunosuppressed client and neutropenic precautions. Read each option carefully and recall that the client is at risk for contracting infection. Select the options that protect the client from infection.Review:neutropenic precautions

Which instructions should the nurse provide to the client about the prevention and early detection of Lyme disease? Select all that apply. 1. Wear dark clothing when walking in wooded areas. 2. Avoid heavily wooded areas and areas with thick underbrush. 3. Wear long-sleeved tops and long pants with closed shoes and a hat or cap. 4.Bathe after being in an infested area, and inspect the body carefully for ticks. 5.Avoid the use of insect repellent on the skin and clothing because of its toxicity. 6.If a tick is found, report to the health care provider immediately for a blood test to detect the presence of Lyme disease.

2. Avoid heavily wooded areas and areas with thick underbrush. 3. Wear long-sleeved tops and long pants with closed shoes and a hat or cap. 4.Bathe after being in an infested area, and inspect the body carefully for ticks. Rationale:Lyme disease is a systemic infectious disease caused by the spirochete Borrelia burgdorferi and results from the bite of an infected deer tick. Client instructions for the prevention and early detection of Lyme disease include avoiding heavily wooded areas and areas with thick underbrush, wearing long-sleeved tops and long pants with closed shoes and a hat or cap, bathing immediately after being in an infested area and inspecting the body carefully for ticks, walking in the center of trails in wooded areas, avoiding wearing dark clothing because lighter-colored clothing makes spotting ticks easier, using insect repellent on the skin and clothing when in an area where ticks are likely to be found, gently removing a tick from the skin with tweezers and flushing it down the toilet, and reporting flulike symptoms to the health care provider. Lyme disease blood testing is not reliable until 4 to 6 weeks after being bitten by the tick. Test-Taking Strategy(ies):Focus on the subject, prevention and early detection of Lyme disease. Note the strategic word, early. Recalling that Lyme disease results from the bite of an infected deer tick will assist in selecting the correct options. Also, eliminate option 1 because of the words dark clothing, and option 6 because of the word immediately. Also remember that Lyme disease blood testing is not reliable until 4 to 6 weeks after being bitten by the tick.Review:Measures to prevent Lyme disease. Tip for the Nursing Student:The typical ring-shaped rash of Lyme disease does not occur with all clients.

A nurse is caring for a patient who is undergoing plasmapheresis for glomerulonephritis. The nurse should be observant for which symptoms indicating citrate toxicity? 1. Sneezing 2. Headache 3. Hypertension 4. Conjunctivitis

2. Headache When caring for a patient undergoing plasmapheresis, the nurse should be observant for headache. Citrate toxicity is a common complication of plasmapheresis because citrate is used as an anticoagulant and may cause hypocalcemia, which in turn manifests as headache, paresthesias, and dizziness. Another common complication of plasmapheresis is hypotension caused by a vasovagal reaction or transient volume changes. Sneezing and conjunctivitis are not manifestations of citrate toxicity but are common symptoms of allergy.

A client is diagnosed with Goodpasture's syndrome. Which clinical manifestations should the nurse expect to note on assessment of the client? Select all that apply. 1. Weight loss 2. Hemoptysis 3. Hypertension 4. Shortness of breath 5.Increased urinary output 6. Generalized nondependent edema

2. Hemoptysis 3. Hypertension 4. Shortness of breath 6. Generalized nondependent edema Rationale:Goodpasture's syndrome is an autoimmune disorder in which autoantibodies are made against the glomerular basement membrane and neutrophils. The two organs primarily affected are the lungs and kidneys. Lung damage manifests as pulmonary hemorrhage. Kidney damage manifests as glomerulonephritis that may rapidly progress to complete kidney failure. Manifestations include hemoptysis, hypertension, shortness of breath, generalized nondependent edema, decreased urinary output, weight gain, and tachycardia. Test-Taking Strategy(ies):Focus on the subject, Goodpasture's syndrome. Focus on the client's diagnosis, and recall that the two organs primarily affected in this disorder are the lungs and kidneys. This will assist in eliminating options 1 and 5, because weight gain and decreased urinary output are more likely to occur in a kidney disorder.Review:Manifestations of Goodpasture's syndrome.

Which action should the nurse implement when a client receiving quinupristin/dalfopristin by intravenous intermittent infusion develops diarrhea? 1. Discontinue the medication. 2. Notify the health care provider. 3.Monitor the client's temperature. 4.Administer an antidiarrheal agent.

2. Notify the health care provider. Rationale:Quinupristin/dalfopristin is a combination of two antibiotics used to treat infections caused by staphylococci and by vancomycin-resistant Enterococcus. One adverse effect of the medication is superinfection, including antibiotic-associated colitis, which may result from bacterial imbalance. If the client develops diarrhea, the medication should be withheld, and the health care provider is notified. The nurse would not discontinue the medication. The nurse would not administer an antidiarrheal, unless specifically prescribed by the health care provider. Test-Taking Strategy(ies):Focus on the subject, nursing considerations for quinupristin/ dalfopristin. Recall the effects of antibiotics. Eliminate option 1, using general pharmacology guidelines and principles. Remember that the nurse never discontinues a medication. From the remaining options, recalling that antibiotic-associated colitis is an adverse effect will direct you to the correct option.Review:Quinupristin/dalfopristin

The nurse reviews the record of a client diagnosed with pemphigus and notes that the primary health care provider has documented the presence of Nikolsky's sign. Based on this documentation, which should the nurse expect to note? 1. Carpal spasm is elicited by compressing the upper arm. 2. The epidermis of the client's skin can be rubbed off by slight friction or injury. 3. The client complains of discomfort behind the knee on forced dorsiflexion of the foot. 4. A spasm of the facial muscles is elicited by tapping the facial nerve in the region of the parotid gland.

2. The epidermis of the client's skin can be rubbed off by slight friction or injury. Rationale:A hallmark sign of pemphigus is Nikolsky's sign, which occurs when the epidermis can be rubbed off by slight friction or injury. Other characteristics of pemphigus include flaccid bullae that rupture easily and emit a foul-smelling drainage, leaving crusted, denuded skin. The lesions are common on the face, back, chest, groin, and umbilicus. Even slight pressure on an intact blister may cause spread to adjacent skin. Trousseau's sign is a sign for tetany, in which carpal spasm can be elicited by compressing the upper arm and causing ischemia to the nerves distally. A possible sign of thrombosis in the leg is discomfort behind the knee on forced dorsiflexion of the foot. Chvostek's sign seen in tetany is a spasm of the facial muscles elicited by tapping the facial nerve in the region of the parotid gland. Test-Taking Strategy(ies):Focus on the subject, Nikolsky's sign. Eliminate carpal spasms and facial muscle spasms first because they are comparable or alike. From the remaining options, recalling that discomfort behind the knee on forced dorsiflexion of the foot may indicate the presence of thrombophlebitis will assist in eliminating that client finding.Review:Characteristic findings in pemphigus.

Which medication does the nurse expect to be beneficial for a patient who smokes one pack of cigarettes each day and has a history of cough, crackles, and hematuria? 1. Colestipol 2.Floxuridine 3. Azathioprine 4. Acetohydroxamic acid

3. Azathioprine Cough, crackles, and hematuria are clinical manifestations of Goodpasture syndrome, which is found in smokers. Azathioprine is used in the management of Goodpasture syndrome. Colestipol is used in the treatment of hyperlipidemia, which is a clinical manifestation of nephrotic syndrome. FUDR is used for treating renal cancers. Acetohydroxamic acid is used in the treatment of renal calculi.

A patient has taken amoxicillin once as a child for an ear infection. When given an injection of Penicillin V, the patient develops a systemic anaphylactic reaction. What manifestations would be seen first? 1. Dyspnea 2. Dilated pupils 3. Itching and edema 4. Wheal-and-flare reaction

3. Itching and edema A systemic anaphylactic reaction starts with edema and itching at the site of exposure to the antigen. Shock can develop rapidly with rapid, weak pulse, hypotension, dilated pupils, dyspnea, and possible cyanosis. The wheal-and-flare reaction occurs with a localized anaphylactic reaction, such as a mosquito bite.

The nurse was stuck accidently with a needle used on a patient with human immunodeficiency virus (HIV). After reporting this, what is a priority action by the nurse? 1. A negative evaluation by the manager 2. Applying personal protective equipment 3. Start on combination antiretroviral therapy 4. Begin counseling to report blood exposures

3. Start on combination antiretroviral therapy Postexposure prophylaxis with combination antiretroviral therapy can decrease significantly the risk of infection. Personal protective equipment should be available, although it may not have stopped this needle stick. The needle stick has been reported. The negative evaluation may or may not be needed, but would not occur first.

The nurse is orienting a new RN in the care of a client with acquired immunodeficiency syndrome (AIDS). Which statement by the new RN indicates that the teaching has been effective? 1. "The client should be assessed frequently for bradypnea." 2."Jaundiced skin is often seen a late sign in clients with AIDS." 3."An assessment should always include a thorough exam of their oral cavity." 4."I should monitor for a low-specific-gravity urine, which indicates dehydration."

3."An assessment should always include a thorough exam of their oral cavity." Rationale:Clients with acquired immunodeficiency syndrome (AIDS) often have opportunistic infections. Candida albicans, the causative organism of thrush, is a common opportunistic infection. Thrush presents as white patches in the oral cavity. Clients with AIDS often develop pneumonia and, therefore, may experience tachypnea, not bradypnea. Jaundice is a symptom of hepatic disease. Clients with AIDS often have inadequate nutrition and hydration and, therefore, may suffer from dehydration, resulting in a high urine specific gravity rather than a low specific gravity of urine. Test-Taking Strategy(ies):Focus on the strategic word, effective, and the subject, acquired immunodeficiency syndrome (AIDS). Recalling the pathophysiology associated with AIDS will assist in eliminating options 2 and 4, because these are not hallmark manifestations of the disease. Clients with AIDS do have respiratory problems; however, the problem is an increased rather than a decreased respiratory rate. Also, recalling that the client with AIDS is at risk for infection will direct you to option 3.Review:Acquired immunodeficiency syndrome (AIDS).

The nurse assesses a patient with recently diagnosed acquired immunodeficiency syndrome (AIDS). When obtaining a health history from the patient, what statement does the nurse determine most correlates with this diagnosis? 1."I am feeling fatigue in the evening." 2."I am sleeping six to eight hours per night." 3."I have had a steady weight loss over the past several months." 4."I have been having feelings of helplessness and hopelessness."

3."I have had a steady weight loss over the past several months." A very common complaint of patients with acquired immunodeficiency syndrome (AIDS) is steady weight loss regardless of attempts to maintain or gain weight. Other common findings include anorexia, decreased sleep, constipation, and anxiety. Sleeping six to eight hours per night, fatigue in the evening, and feelings of helplessness and hopelessness may be seen with human immunodeficiency virus/AIDS, but they are not as diagnostic as unexplained steady weight loss.

The nurse is caring for a client who is receiving corticosteroids after a renal transplant. The nurse should plan to carefully monitor which laboratory result for this client? 1. Potassium 2.Magnesium 3.Blood glucose 4.Serum albumin

3.Blood glucose Rationale:Corticosteroid therapy can result in glucose intolerance, leading to elevated blood glucose levels. The nurse monitors blood glucose levels to detect this side effect of therapy. With successful transplant, the client's serum electrolyte levels should be better regulated, although corticosteroids could also cause sodium retention. Test-Taking Strategy(ies):Focus on the subject, the effects of corticosteroids. Think about the side effects and adverse effects of corticosteroids. Remembering that corticosteroids affect blood glucose will assist in directing you to the correct option.Review:The effects of corticosteroids.

A client has an initial positive result of an enzyme-linked immunosorbent assay (ELISA) test for human immunodeficiency virus (HIV). The client begins to cry and asks the nurse what this means. Which knowledge should the nurse use to provide support to the client? 1. The client is HIV positive, but the client's CD4 cell count is high. 2. The client is HIV positive, but the disease has been detected early. 3. There are occasional false-positive readings with this test; results can be verified by repeating it one more time. 4. False-positive results can occur, and more testing is needed before diagnosing the client as being HIV positive.

4. False-positive results can occur, and more testing is needed before diagnosing the client as being HIV positive. Rationale:If the client tests positive for HIV with the ELISA test, the test is repeated because of the potential for a false-positive result (e.g., from a recent influenza or hepatitis B vaccine) or a false-negative result if drawn too early after infection. If the test is positive a second time, the Western blot (a more specific test) is done to confirm the finding. The client is not diagnosed as HIV positive unless the Western blot is positive. Some laboratories also run the Western blot a second time with a new specimen before making a final determination Test-Taking Strategy(ies):Focus on the subject, the procedure for HIV testing and an affirmative diagnosis. Use knowledge about these procedures and recall that if the client tests positive for HIV with the ELISA test, the test is repeated because of the potential for a false-positive result.Review:human immunodeficiency virus (HIV) and enzyme-linked immunosorbent assay (ELISA).

The nurse instructs a client diagnosed with oral candidiasis (thrush) about caring for the disorder. Which statement by the client indicates a need for additional teaching? 1. "I can eat foods that are liquid or pureed." 2. "I should eliminate spicy foods from my diet." 3."It's best if I don't drink citrus juices or hot liquids." 4."I need to rinse my mouth four times daily with commercial mouthwash."

4."I need to rinse my mouth four times daily with commercial mouthwash." Rationale:Clients with thrush cannot tolerate commercial mouthwashes because the high alcohol concentration in these products can cause pain and discomfort of the lesions. A solution of warm water or mouthwash formulas without alcohol are better tolerated and may promote healing. A change in diet to liquid or pureed food often eases the discomfort of eating. The client should avoid spicy foods, citrus juices, and hot liquids. Test-Taking Strategy(ies):Note the strategic words, need for additional teaching. These words indicate a negative event query and ask you to select an option that is an incorrect statement. In addition, noting the words commercial mouthwash in the correct option will direct you to this option.Review:the client teaching points related to candidiasis (thrush).

The nurse has given a prescribed subcutaneous injection to a client with acquired immunodeficiency syndrome (AIDS). Which action should the nurse implement to best dispose of the used needle and syringe? 1. Break the needle before discarding it. 2.Recap the needle before discarding the syringe in a disposal unit. 3.Place the uncapped needle and syringe in a labeled cardboard box. 4.Place the uncapped needle and syringe in a labeled, rigid plastic container.

4.Place the uncapped needle and syringe in a labeled, rigid plastic container. Rationale:Standard precautions include specific guidelines for handling of needles. Needles should not be recapped, bent, broken, or cut after use. They should be disposed of in a labeled, impermeable container specific for this purpose. Needles should not be discarded in cardboard boxes, because these types of boxes are not impervious. Needles should never be left lying around after use. Test-Taking Strategy(ies):Note the strategic word, best. Focus on the subject, disposing of a used needle. Focus on the guidelines related to standard precautions. Recalling that a needle should never be recapped or broken will eliminate options 1 and 2. From the remaining options, noting the words rigid plastic container in option 4 will direct you to this option.Review:Needle disposal.

The nurse is providing medication education to the client prescribed cyclosporine after a renal transplant. The nurse should stress the importance of alerting the primary health care provider of which occurrence? 1. Hair loss 2. Weight loss 3. Hypotension 4.Signs of infection

4.Signs of infection Rationale:Cyclosporine is an immunosuppressant medication that is used to prevent transplant rejection. The client should be especially alert for signs and symptoms of infection while taking this medication and report them to the health care provider, if they occur. The client is also taught about other side effects of the medication, including hypertension, increased facial hair, tremors, gingival hyperplasia, and gastrointestinal complaints. Test-Taking Strategy(ies):Focus on the subject, the occurrence that should be reported to the primary health care provider. Recalling that cyclosporine is an immunosuppressant will assist in determining that the client is at risk for infection while taking this medication.Review:Client teaching points related to cyclosporine.