Evolve Unit 6
Which action would the nurse encourage a client who has MS in remission and is the parent of 2 active preschoolers to take? A. develop a flexible schedule for completion of routine daily activities B. plan a schedule of specific times each day for playtime w/ the children C. meet w/ a self-help group for people w/ the diagnosis of MS D. provide support to other people w/ MS who also have young children
A
Which client's prescribed meds increases the r/f development of aseptic meningitis? A. muromonab-CD3 B. antithymocyte globulin-rabbit C. rapamycin D. cyclosporine
A
Which clinical finding would the nurse expect when assessing a 4-year-old w/ suspected Kawasaki disease? A. strawberry tongue B. copious discharge from the eyes C. insidious onset of low-grade fever D. maculopapular rash on the extremities
A
Which clinical manifestation would the nurse report immediately to the PCP when providing care for a client w/ HIV? A. blood in the urine B. new or productive cough C. vomiting accompanied by fever D. burning, itching, and discharge from the eyes
A
Which cytokine would the nurse teach a client is tx for MS? A. beta-interferon B. interlukin-2 C. erythropoietin D. colony-stimulating factor
A
Which finding would help confirm the nurse's suspicion that a client may have meningitis after surgery for a brain tumor? A. positive kernig sign B. GCS of 10 C. absence of nuchal rigidity D. negative brudzinski sign
A
Which med reduces the r/f HIV in unaffected individuals? A. truvada B. abacavir C. cromolyn D. methdilazine
A
Which method of delivery is preferred for a pregnant HIV-positive women? A. C-section B. fetal scalp electrode C. vaginal delivery w/ forceps extraction D. vaginal delivery a/ vacuum extraction
A
Which nursing action would be implemented after a client has a lumbar puncture? A. maintaining the client in the supine position for several hours B. encouraging the client to ambulate every hour for at least 6 hours C. keeping the client in the trendelenburg position for at least 2 hours D. placing the client in the high-fowlers position immediately after the procedure
A
Which organism is a common opportunistic infection in a client infected w/ HIV? A. oropharyngeal candidiasis B. cryptosporidiosis C. toxoplasmosis encephalitis D. pneumoncystis jiroveci pneumonia
A
Which potential complication is important for the nurse to include when teaching prevention strategies to clients w/ HIV? A. infection B. depression C. social isolation D. kaposi sarcoma
A
Which response would a nurse give when a client w/ a prosthetic heart valve asks why it is important to take antibiotic before a dental procedure? A. "the antibiotic is taken to prevent infection around your artificial heart valve" B. "valvular heart disease increases the r/f dental caries and gum disease" C. "all clients w/ murmurs need prophylactic antibiotics b4 dental procedures" D. "you only need to take the antibiotics of you have a fever before your dental procedures"
A
Which response would the nurse make to a client recently diagnosed w/ MS who says, "I had planned to get married, but after this diagnosis, I might not be ready."? A. "you don't feel able to make a decision at this time?" B. "have you spoken to your fiance about your feelings?" C. "your fiance loves you and i'm sure still wants to marry you" D. "don't decide now; wait until you feel better and can cope"
A
Which response would the nurse make to a client w/ blurred and double vision and musclar weakness who becomes visibly upset when informed of the diagnosis of MS? A. "that must have shocked you. Tell me what the HCP told you about it" B. "you should see a psychiatrist who will help you cope w/ this overwhelming news" C. don't worry; early tx often alleviates the symptoms of the disease" D. "you should be glad that we caught it early so you can be cured"
A
the nurse is assessing the lab findings of CSF of 4 different clients. Which finding is consistent w/ meningitis? A. increased pressure, WBC >1000, protein >500, decreased glucose, cloudy CSF B. sloughy increased pressure, WBC=500, protein=55, normal glucose, clear CSF C. increased pressure, WBC=250, protein=35, low glucose, clear CSF D. normal pressure, WBC=5, protein=40, normal glucose, clear appearance
A
Which recommendation is essential for the nurse to include when providing counseling to a client w/ SLE? SELECT ALL THAT APPLY A. "wear a large-brimmed hat" B. "take your temp daily" C. "balance periods of rest and activity" D. "use a strong soap when washing the skin" E. "expose the skin to the sun as often as possible"
A, B, C
Which clinical manifestations would the nurse associate w/ a client diagnosed w/ SLE? SELECT ALL THAT APPLY A. joint pain B. facial rash C. pericarditis D. weight gain E. hypotension
A, B, C (HTN)
Which clinical finding would indicate possible meningitis in an infant w/ an infected ventriculopertoneal shunt? SELECT ALL THAT APPLY A. fever B. lethargy C. stiff neck D. poor feeding E. depressed fontanels
A, B, C, D (fontanels bulging)
Which clinical manifestations support the nurse's suspicion that a client w/ AIDS is infected w/ ceyptococcus neoformans (debilitating form of meningitis)? SELECT ALL THAT APPLY A. fever B. seizures C. diarrhea D. confusion E. persistent dry cough
A, B, D
Which info will the nurse consider when planning for a client w/ HIV who has been diagnosed w/ class 3 TB? SELECT ALL THAT APPLY A. class 3 TB is a clinically active disease, which is contagious B. TB is the leading cause of mortality in clients infected w/ HIV C. HIV positive clients are more likely to have multidrug resistant TB D. individuals w/ HIV usually have high fevers w/ active TB infection E. persons w/ active TB are usually treated on an out-pt basis
A, B, E
Which info would the nurse include when counseling a pregnant client at r/f HIV regarding HIV testing? SELECT ALL THAT APPLY A. the risks of passing the virus to the fetus B. what positive or negative test results indicate C. the risk factors for contracting HIV D. the need for pregnant women to be tested for HIV E. the emotional, legal, and medical implications of test results
A, B, E
The nurse is interviewing a client who was diagnosed w/ SLE. Which clinical findings to this disease would the nurse expect the client to exhibit? SELECT ALL THAT APPLY A. butterfly facial rash B. firm skin fixed to tissue C. inflammation of the joints D. muscle mass degeneration E. inflammation of small arteries
A, C
Which basic strategy would the nurse teach a health class to reduce the incidence of HIV transmission? SELECT ALL THAT APPLY A. using condoms B. using separate toilets C. practicing sexual abstinence D. preventing direct casual contacts E. sterilizing the household utensils
A, C
Which clinical finding would the nurse anticipate for a client who has an exacerbation of MS? SELECT ALL THAT APPLY A. double vision B. resting tremors C. flaccid paralysis D. scanning speech E. intellectual disability
A, D (and nystagmus, spastic paralysis)
Which clinical manifestation would the nurse expect to find in a client who has acute HIV? SELECT ALL THAT APPLY A. malaise B. confusion C. constipation D. swollen lymph glands E. oropharyngeal candidiasis
A, D (flu-like symptoms)
Which clinical manifestation may indicate a client has SLE? SELECT ALL THAT APPLY A. pericarditis B. esophagitis C. fibrotic skin D. discoid lesions E. pleural effusions
A, D, E
A child is prescribed IVIG for Kawasaki disease. B4 administration of IVIG, which actions would the nurse take? SELECT ALL THAT APPLY A. start an IV line B. obtain a cardiac monitor C. ensure NPO status D. check for allergies to antibiotics E. obtain consent for blood product administration
A, E (common side effects include headache and kidney issues, SOB and back pain may be reported) - IVIG is not an antibiotic
An infant is prescribed an antibiotic after cardiac surgery. Which instruction would the nurse emphasize to the parents regarding administration of the medication? A. give the antibiotic between feedings B. ensure that the antibiotic is administered as prescribed C. shake the bottle throughly b4 giving the antibiotic D. keep the antibiotic in the fridge after the bottle has been opened
B
Which CSF lab finding indicates the presence of bacterial meningitis? A. decreased cell count B. increased protein level C. increased glucose level D. low spinal fluid pressure
B
Which action by an uninfected individual would not pose risk of exposure to HIV? A. the uninfected person only has intercourse w/ his spouse B. the person donates a pint of blood to the blood bank C. the person uses a condom each time he has sexual intercourse D. the person limits sexual contact to those individuals w/o HIV antibodies
B
Which action would the nurse be responsible for during a lumbar puncture procedure for an 18 month old toddler? A. coaching the parent to hold the child in their arms B. keeping the child immobilized w/ restraints C. collecting the aspirated drainage in a culture tube D. maintaining the continuous flow of local anesthetic
B
Which client statement indicates a need for more education after the nurse has taught about self-care to a client who has had a mitral valve replacement? A. "i should wear a medical alert band" B. "i will start a vigorous aerobic exercise program" C. "i will take antibiotics when I have my teeth repaired" D. "i should go to the doctor when i get a respiratory infection"
B
Which client statement indicates the need for further teaching regarding safe sex related to their diagnosis of AIDS? A. "i should use a dental dam during oral sex" B. "i can participate in anal sex safely w/o condoms" C. "i should ask my partner to use a female condom while engaging in sex" D. "i should use condoms even while receiving highly active ART"
B
Which complication will the nurse monitor for when caring for a client w/ an infection caused by group A beta-hemolytic streptococci? A. hep A B. rheumatic fever C. spinal meningitis D. RA
B
Which consideration is most important when counseling the family of a child w/ HIV? A. r/f injury B. susceptibility to infection C. inadequate nutritional intake D. altered growth and development
B
Which intervention is the nurse's priority when caring for a child w/ HIV? A. maintaining optimal hydration B. protecting the child from infection C. promoting growth and development D. ensuring adequate and balanced nutrition
B
Which late effect of radiation therapy on the heart would the nurse monitor as a priority on a client? A. trismus B. pericarditis C. lymphedema D. pulmonary fibrosis
B
Which phase described why a lumbar puncture is performed when meningitis is suspected? A. to identify the presence of blood B. to determine the causative agent C. to reduce the ICP D. to measure the spinal fluid glucose level
B
A toddler w/ a hx of enlarged lymph nodes, prolonged fever, eryhthema of the extremities, and a rash is admitted to the peds unit w/ a diagnosis of Kawasaki disease. Which criteria would the nurse recognize as essential to confirm this diagnosis? A. an increased antistreptolysin (ASO) titer B. a combination of signs C. a low-grade temp D. an increased sedimentation rate
B (5 of the 6 specific signs: fever, trunk rash, enlarged cervical lymph nodes, bilateral congestion of the conjunctiva, edema, and redness of extremities)
Which early clinical manifestation of meningeal irritation would the nurse assess in a client w/ head trauma? A. sunset eyes B. kernig sign C. planter reflex D. homans sign
B (inability to completely extend the legs)
Which finding by the nurse is most important to communicate to the HCP when assessing a client who has aortic stenosis and is scheduled for aortic valve replacement? A. loud systolic murmur B. multiple dental caries C. heartburn when lying down D. paroxysmal nocturnal dypnea
B (increase r/f endocarditis)
the nurse is reviewing the CSF lab findings of 4 clients. Which client would the nurse suspect has had a previous meningeal hemorrhage? A. yellow CSF B. brown CSF C. unclear or hazy CSF D. pink-red to orange CSF
B (red = current bleed)
The child who is HIV positive has CD4 count that shows severe immunosuppression. Which immunizations can the child be given safely at this time? SELECT ALL THAT APPLY A. varicella B. hepatitis A C. polio vaccine D. measles, mumps, rubella (MMR) E. diphtheria, tetanus, pertussis (DTaP)
B, C, E
A child w/ Kawasaki disease is in pain caused by the desquamating rash. Which would the nurse identify as the best short-term goal for this child? A. the rash will diminish after lotion is applied B. analgesics will be administered as prescribed C. pain will be maintained at a level of 3/10 D. diversional activities will help distract the child from the discomfort
C
A client asks the nurse, "should i tell my partner that i just found out I'm HIV positive?" Which is the nurse's most appropriate response? A. "do not tell our partner unless asked" B. "this is a decision you alone can make" C. "you are having difficulty deciding what to say" D. "tell your partner that you don't know how you became sick"
C
During a lumbar puncture for confirmation of bacterial meningities, the nurse notes that the infant's spinal fluid is cloudy. The nurse recalls this info indicates which result? A. healthy spinal fluid B. increased glucose level C. increased WBC count D. rising number of RBCs
C
For a client diagnosed w/ AIDS, the nurse identifies white patchy plaques on the mucosa of the client's oral cavity. The nurse recognizes this finding most likely represents w/ opportunistic infection? A. cytomegalovirus B. histoplasmosis C. candida albicans D. human papillomavirus
C
The RN notices reddish linear streaks in the nail bed of the client. Which systemic condition would teh RN suspect in the client? A. syphilis B. iron-deficieny anemia C. subacute bacterial endocarditis D. COPD
C
When a client develops bacterial meningitis, which action is the nurse's priority? A. monitoring for signs of ICP B. adding pads to the sides of the bed C. administering prescribed antibiotics D. administering glucocorticoids
C
Which assessment finding is a common integumentary manifestation in clients w/ AIDS? A. Kawasaki disease B. plaque psoriasis C. poor wound healing D. seborrheic eczema
C
Which autoimmune disease affect the CNS? A. uveitis B. celiac disease C. MS D. goodpasture syndrome
C
Which client has AIDS? A. CD4 count 750 B. CD4 count 550 C. CD4 count 175 D. CD4 count 450
C
Which complication would the nurse recognize as the most serious in an infant w/ meningitis? A. epilepsy B. blindness C. peripheral circulatory collapse D. communicating hydrocephalus
C
Which education would the nurse provide the family of an infant who is HIV positive about the best long-term care environment? A. pediatric unit B. critical care unit C. home environment D. extended -care facility
C
Which finding would the nurse conclude is r/t a child's diagnosis of rheumatic heart disease? A. negative C-reative protein B. increased reticulocyte count C. positive antistreptolysin titer D. low ESR
C
Which guidance would the nurse to provide a sexually active 16-year-old client when she inquires as to how she can protect herself from contracting HIV? A. ask her partners to withdraw before ejaculating B. make certain their relationship is monogamous C. insist that her partner use a condom when having sex D. seek counseling about various contraceptive methods
C
Which lab test would the nurse review for a client suspected of RA? A. pancreatic lipase B. Bence Jones protein C. ANA D. alkaline phosphatase
C
Which nursing statement about providing care for clients w/ HIV indicates the need for further teaching? A. "i will ask the client to avoid exposure to new infectious agents" B. "i will ask the client about intake of supplemental vitamins and micronutrients" C. "i will ask the client to avoid involvement in community activities" D. "i will ask the client if he/she is up to date w/ recommended vaccines"
C
Which response would the nurse make to a client who has MS and asks the nurse, "Will I experience unbearable pain?"? A. "tell me about your fears regarding pain" B. "analgesics will be prescribed to control the pain" C. "some clients report tingling or burning but not unbearable pain" D. "let's make a list of the things you need to ask your HCP"
C
Which role does shark cartilage play in the management of HIV and AIDS? A. enhances immunity B. reduces oral thrush C. is a complementary therapy D. is a nutritional supplement
C
Which statement by a client w/ HIV w/ a low viral load who has been asymptomatic for years indicates the need for additional education on the disease process? A. "i inform all my partners of my HIV-positive status" B. "I should not skip any does of ART meds" C. "I occasionally have oral sex w/o the use of protection" D. "i have never shared or reused any of my diabetic supplies"
C
Which test is used in the diagnosis of SLE? A. patch test B. photo patch test C. direct immunofluorescence test D. indirect immunofluorescence test
C
Which intervention would reduce the risk of perinatal transmission via vaginal birth in an adolescent who is diagnosed w/ HIV? A. using forceps during delivery B. using a fetal scalp electrode during delivery C. using ART during the intrapartum period D. administering zidovudine an hour before labor
C (zidovudine during birth not 1 hour b4)
Which client would benefit from the administration of prophylactic antibiotics? SELECT ALL THAT APPLY A. chickenpox infection B. fever of unknown origin C. pre-op hip replacement D. congenital bicuspid aortic valve E. current chemo tx
C, D, E
A 25 year old female pt w/ SLE who has a facial rash and alopecia tells the nurse, I never leave my house because I hate the way I look. An appropriate nursing diagnosis for the pt is A. activity intolerance r/t fatigue and inactivity B. impaired social interaction r/t lack of social skills C. impaired skin integrity r/t itching and skin sloughing D. social isolation r/t embarrassment about the effects of SLE
D
A client reports neck stiffness, severe headache, and a decreased LOC. Which condition would the nurse suspect? A. encephalitis B. brain abscess C. viral meningitis D. bacterial meningitis
D
A client w/ SLE is at 39 weeks gestation. Which would the nurse anticipate regarding this client? A. a newborn large for gestational age B. the possible need for postpartum dialysis C. greater prominence of the butterfly-shaped rash D. a need to discontinue the client's salicylate therapy
D
After completing physical assessments and review of lab data, which client could the nurse identify as having findings consistence w/ RA? A. uric acid= 8.5 B. CRP= 800 (normal= 6.8- 820) C. anti-deoxyribonuclic acid (DNA) antibody= 90 D. ESR= 65 (normal <30)
D
For which condition is antibiotic prophylaxis prescribed for a 2 year old child w/ a cardiac malformation who us awaiting corrective surgery? A. bacterial pneumonia B. laryngotracheobronchitis C. URI D. subacute bacterial endocarditis
D
How would the nurse document the high-pitched, scratchy heart sounds that aare associated w/ pericarditis and occur as the heart contracts and relaxes within the inflamed pericardial sac? A. diastolic murmur B. S1 C. S4 D. pericardial friction rub
D
The nurse is caring for an infant w/ bacterial meningitis. Which etiology would the nurse consider as the most likely route of transmission to the CNS? A. GU tract B. GI tract C. skin or mucous membranes D. cranial apertures or sinuses
D
Upon assessment of a client w/ HIV, the nurse discovers red to purpule skin lesions on the client's neck, arms, and chest (kaposi sarcoma). Which virus presents these skin lesions? A. parvovirus B. papillomavirus C. varicella-zoster virus D. herpesvirus 8 (HHV-8)
D
Which action would the circulating nurse in the OR, who recently tested positive for HIV, implement regarding participation in exposure-prone procedures? A. adhere to standard precautions at all times B. avoid handling equipment used in direct pt care C. disinfect all equipment used for non-invasive procedures D. seek approval circumstances and procedures from a review panel
D
Which assessment finding supports the diagnosis of HIV infection in a male newborn? A. delay in temp regulation B. continued bleeding after circumcision C. hypoglycemia within the first day of birth D. oral candidiasis (thrush) that does not respond readily to tx
D
Which position would the nurse use for an infant who will have a lumbar puncture? A. sitting w/ the buttocks at the table's edge and the head flexed B. prone with the head extended over the table's edge and the extremities swaddled C. lateral recumbent w/ the back at the table's edge and the head and legs extended D. side-lying w/ the back at the table's edge and the head flexed w/ the knees brought to the chin
D
Which sign would the nurse expect the provider to document in the client's medical record when, after performing a lumbar puncture, the provider applied pressure on the jugular vein and saw an increase in spinal fluid pressure? A. homans sign B. romberg sign C. chvostek sign D. queckenstedt sign
D
Which tx would the nurse anticipate when caring for a preschooler w/ Kawasaki disease? A. restricting fluids, especially fruit juices B. ensuring bright lighting in the room during assessments C. administering penicillin G benzathine (bicillin) as prescribed) D. administering IVIG as prescribed
D
Which type of infection is potentially prevented by antibiotics administered b4 any dental work is performed on a child who has had open heart surgery to repair a cardiac defect? A. gingivitis B. pericarditis C. myocarditis D. endocarditis
D
Which would the nurse conclude about isolation for the child admitted to the peds unit w/ a diagnosis of meningococcal meningitis? A. it is unnecessary during the incubation period B. it is required for 7-10 days until the fever dubsides C. it is unnecessary after the diagnosis is confirmed D. it will be necessary for 24-72 hours after the initiation of antibiotic therapy
D
For which reason would a lumbar puncture be performed on a client? SELECT ALL THAT APPLY A. confirming spinal cord injuries B. assessing sensory nerve problems C. measuring blood flow in many areas D. reading CSF pressure E. injecting contrast medium for diagnostic study
D, E
Which service provided by the public health nurse thru the local health department would support primary prevention of HIV? SELECT ALL THAT APPLY A. ensure access to confidential screening for HIV B. assist clients w/ gaining access to ART C. increase awareness of voluntary counseling and testing for HIV D. provide info about safe-sex practices thru local venues E. support community level initiatives to impact traditions, norms, and beliefs regarding sexuality
D, E
Which intervention is best when an adolescent has been admitted w/ a hx of symptoms of fatigue, intermittent fever, weight loss, and arthralgia, and the diagnosis is SLE? A. implementation of corticosteroids B. education about diet, rest, and exercise C. sun avoidance and calcium supplements D. avoidance of destructive coping mechanisms
B
Which nursing intervention would the nurse implement for a hospitalized client w/ MS who voices a concern about generalized weakness and fluctuating physical status? A. encourage bed rest for this client B. space activities throughout the day C. teach the limitations imposed by the disease D. have one of the client's relatives stay at the bedside
B
Which result for a 30 year old pt w/ SLE is most important for the nurse to communicate to the HCP? A. decreased CRP B. elevated BUN C. positive ANA D. positive LE cell prep
B
Which stage of HIV is a client who CD4 count of 350? A. stage 1 B. stage 2 C. stage 3 d. Stage 4
B
Which stage of HIV would a pt w/ a CD4 count of 325 be classified? A. stage 1 B. stage 2 C. stage 3 D. stage 4
B
Which statement by a pt w/ SLE indicates that the pt has understood the nurses teaching about the condition? A. i will exercise even if I am tired B. I will use sunscreen when I am outside C. i should take birth control to keep from getting pregnant D. i should avoid aspirin or NSAIDs
B
Which statement by the client who has MS indicates a need for further teaching? A. "i avoid using a straw to drink liquids" B. "i will take a hot bath to help relax my muscles" C. "i plan to use an incontinence pad when I go out" D. "i may be having a rough time now, but tomorrow may be better"
B
Which statement when the nurse is counseling an HIV positive woman on precautions to be followed indicates the need for further counseling? A. "i will avoid smoking and have nutritious food" B. "i will go for pelvic examination every 12 months" C. "i will use female condoms if my partner refuses to use condoms" D. "i will undergo regular screenings for syphilis, gonorrhea, and other vaginal infections"
B (every 6 months)
A client who is positive for HIV is admitted to a surgical unit after an orthopedic procedure. The nurse recalls that HIV is transmissible thru which means? SELECT ALL THAT APPLY A. feces B. blood C. semen D. urine E. sweat F. tears
B, C
Which action transmits HIV? SELECT ALL THAT APPLY A. multiple mosquito bites B. sharing syringe needles C. breast-feeding newborns D. dry kissing an infected person E. anal intercourse F. sharing drinking glasses
B, C, E
Which statement by the nurse regarding the prevention of HIV transmission by healthcare workers is correct? SELECT ALL THAT APPLY A. " i should never reuse equipment used in invasive procedures" B. "if i perform exposure-prone procedures, I should know my HIV antibody status" C. "i should identify exposure-prone procedure by institutions where they are performed" D. "if I am infected w/ HIV, I am restricted from practice of non-exposure-prone procedures" E. "if I have exudative lesions or weepi
B, C, E
Which finding would the nurse expect when assessing a client who is in the early stage of MS? SELECT ALL THAT APPLY A. headache B. nystagmus C. skin infection D. scanning speech E. intention tremors
B, D, E
Which lab report enables the nurse to conclude a client has stage 3 HIV? SELECT ALL THAT APPLY A. CD4 count 800 or 32% B. CD4 count 100 or 11% C. CD4 count of an unknown percentage and kaposi sarcoma D. CD4 count of an unknown percentage and burkitt lymphoma E. CH4 count of 150 or 12% and kaposi sarcoma
B, E -stage 4 = no CD4 count but has kaposi sarcoma or burkitt lymphoma
A new clinic pt w/ joint swelling and pain is being tested for SLE. Which test will provide the most specific findings for the nurse to review? A. rheumatoid factor (RF) B. ANA C. Anti-Smith antibody (Anti-Sm) D. Lupus eryematosus (LE) cell prep
C
Which response would the nurse make to an obviously upset client, newly diagnosed w/ MS, who asks, "Am I going to die?"? A. "most individuals w/ your disease live a normal life span" B. "is your family here? I would like to explain your disease to all of you" C. "the prognosis varies, as most individuals have remissions and exacerbations" D. "why don't you speak w/ your HCP to get more details?"
C
Which instruction would the nurse include when teaching a client w/ HIV about self- management? A. "limit your daily intake to 2 L daily" B. "eat more roughage daily w/ your meals" C. "rinse your mouth w/ normal saline after every meal" D. "maintain a 4 to 5 hour gap between each meal"
C (proper oral care)
Which action of a client w/ HIV who reports genital discharge associated w/ irritation, pain, and itching might have lead to this condition? SELECT ALL THAT APPLY A. taking diethylstilbestrol B. taking iron supplements C. wearing tight jean pants D. performing kegel exercises E. using antibiotic meds
C, E
A client asks the nurse what causes the sudden loss of vision in pts w/ MS. Which factor would the nurse include in the explanation? A. virus-induced iritis B. ICP C. closed-angle glaucoma D. optic nerve inflammation
D
A client has a hx of a persistent cough, hemoptysis, unexplained weight loss, fatigue, night sweats, and fever. Which risk would be assessed? A. lung cancer B. cerebrovascular disease C. cardiopulmonary alterations D. HIV
D
A client who has MS is admitted to the hospital w/ increasingly frequent and severe exacerbations. The client's partner confides to the nurse, "Life is getting very hard and depressing, and I am upset w/ myself for thinking about a nursing home." Which response would the nurse make? A. " you may be able to decrease you feelings of guilt by seeking counseling" B. "it would be helpful if you became involves in volunteer work at this time" C. "i recognize it's hard to deal with, but try to remembe
D
Which client w/ HIV exhibits the clinical manifestations associated w/ histoplasma capslatum infection? A. bloody diarrhea, gastric pain, and weight loss B. whitish-yellow patches in mouth, esophagus, and vagina C. jaundice, fatigue, abd pain, loss of appetite, and dark urine D. nonproductive cough, hypoxemia, elevated body temp, and weight loss
D
Which diagnostic criterion would the nurse use to explain AIDS to a client w/ HIV? A. contracts HIV-specific antibodies B. develops an acute retroviral syndrome C. is capable of transmitting the virus to others D. has a CD4 count of less than 200
D
Which info will the nurse include when a client asks to be screened for HIV? A. identifies the number of CD4 cells that are in the blood B. shows how much of the HIV virus is present in the blood C. takes several days for results to be complete and reported D. detects antibodies to HIV and may not detect acute infection
D
Which info would the nurse expect the client who has MS w/ hand tremors to report? A. the tremors increase when I fall asleep B. the tremors increase when I feel fatigued C. the tremors increase when I become nervous D. the tremors increase when I perform activities
D
Which info would the nurse use to explain a positive diagnosis for HIV infection? A. performance of high-risk sexual behaviors B. evidence of extreme weight loss and high fever C. identification of an associated opportunistic infections D. positive ELISA and western blot tests
D
Which organism would the nurse suspect is responsible when a client w/ HIV reports dyspnea on excretion, increased HR, a persistent dry cough, and a persistent low-grade fever w/ bilateral crackles auscultated in the lower lung lobes? A. cryptosporidium B. candida albicans C. toxoplasma gondii D. pneumocystis jiroveci
D
Which precaution would the nurse identify as a prevention for transmission of HIV and other blood borne illnesses? A. barrier B. droplet C. contact D. standard
D
Which response would the nurse give to a client who expresses fear that AIDS may be acquired as a result of a blood transfusion? A. "the blood is treated w/ radiation to kill the virus" B. "the ability to directly identify HIV has eliminated this concern" C. "consideration should be given to donating your own blood for transfusion" D. "screening for HIV antibodies has minimized this risk"
D
Which statement by an adolescent during an annual physical exam indicates the need for HIV testing? A. "i only have sex w/ 1 partner" B. "i always use barrier contraception" C. "i occasionally smoke pot w/ friends" D. "i have shared needles when using drugs"
D
Which statement by the client of combination ART for the management of HIV indicates the need for further teaching? A. "i must take all doses of the meds as scheduled' B. "i will notify the HCP of any fever" C. "all three meds must be taken to prevent med resistance" D. "these ART meds will cure my HIV"
D
Which statement by the nursing student indicates understanding of the precautions needed in the provision of care to a child who is HIV positive? A. "i'll put on a mask" B. "i'll put on an N95 mask" C. "i'll put on a gown and gloves" D. "i'll put on gloves if i'm going to be in contact w/ body fluids"
D
Why are children w/ HIV more prone to infection than adults w/ HIV? A. the immune system of children produce insufficient antibodies B. children are exposed to more pathogens each day than are adults C. the AIDS virus attacks children's immune systems thru different mechanisms D. adults have had more exposure to pathogens over time and produce more antibodies
D
Which body system would the nurse assess in a client w/ HIV when inquiring about papilledema and the presence of exudates? A. ocular B. respiratory C. neurologic D. cardiovascular
A
Which action would be the priority for the nurse to take in preparation for a lumbar puncture for an infant w/ a tentative diagnosis of bacterial meningitis? A. ask the parents what they were told about the test B. use a doll to demonstrate the procedure to the infant C. obtain a pacifier for the infant to suck on during the procedure D. tell the parents that they may stay w/ their infant during the test
A (informed consent)
Which factor would the nurse identify as increasing risk of HIV transmission? SELECT ALL THAT APPLY A. childbirth B. monogamy C. breast-feeding D. needle sharing E. shared plates and cups
A, C, D
A client receiving tx via intrathecal therapy reports a headache and neck stiffness. Upon assessment, the client's body temp is 103. Which infection would the nurse suspect? A. giardiasis B. meningitis C. pneumonia D. furunculosis
B
After the nurse has finished teaching methods of reducing fatigue to the client w/ MS, which statement made by the client indicates that the client has understood the nurse's instruction? A. take a hot bath on a daily basis B. rest in an air-conditioned room C. increase the dose of muscle relaxants D. avoid naps during the day
B
Which autoimmune disease can result in damage to the heart? A. uveitis B. rheumatic fever C. myasthenia gravis D. graves disease
B
Which dietary changes would the nurse suggest to the client w/ diarrhea associated w/ HIV? SELECT ALL THAT APPLY A. "eat more fatty foods" B. "eat much less roughage" C. "drink 2 cups of coffee daily" D. "eat more spicy and week food" E. "drink plenty of fluids between meals"
B, E
A client has thin, dark red vertical lines about 1-3 mm long in the nails. Which disease is associated w/ this physiologic alteration in the client? SELECT ALL THAT APPLY A. psoriasis B. trichinosis C. cardiac failure D. DM E. bacterial endocarditis
B, E (trichinosis is a parasitic disease)
Which intervention is the appropriate initial nursing action when a client reports urinary urgency and frequency during a exacerbation of MS? A. begin teaching self-cath B. develop a plan to ensure high fluid intake C. palpate the supra public area of the abd D. initiate a regimen to monitor urinary output
C (assess first)
Which action by the new employee indicates effective learning after the RN gives instructions about providing care for a hospitalized client w/ HIV? A. keeping fresh flowers in the pt's room B. encourage the client to eat fresh fruits and veggies C. keeping a dedicated disposable glove box in the pt's room D. changing gauze-containing wound dressings every other day
C (change gauze every day)_
An infant is being admitted to a peds unit w/ bacterial meningitis. Which action would the nurse take first? A. assess the infant's neuro status B. begin IV fluids and antibiotics C. implement respiratory isolation precautions D. teach the parents the importance of maintaining a quiet environment
C (contagious)
Which finding would the nurse expect when completing a physical assessment of an infant w/ meningococcal meningitis? A. severe glossitis B. low-grade fever C. purpuric skin rash D. tremors of the extremities
C (high fever)
Which client has a higher r/f contracting HIV? A. a client who is involved in mutual masturbation B. a client who undergoes voluntary prenatal HIV testing C. a client who shares equipment to snort or smoke drugs D. a client who engages in insertive sex w/ a non-infected partner
C (impaired judgement regarding high-risk behaviors)
Which conclusion about the client's knowledge of condom use would the nurse draw during a AIDS education class when a client states, "petroleum jelly works great when i use condoms"? A. an understanding of safer sex thru proper condom use B. an ability to assume self-responsibility and protection of others C. lack of knowledge r/t correct condom application and use D. ignorance regarding transmission of HIV
C (petroleum jelly breaks condoms)
Whihc disorder would the nurse suspect in a cleint who reports hair loss, joint pain, and a facial rash and has a medical record showing the presence of a butterfly rash? A. scleroderma B. angioedema C. RA D. SLE
D
While performing a neck assessment, the nurse finds the client has enlarged lymph nodes, a hx of IV drug use, and bisexual activity. Which possible activity would the nurse suspect? A. cancer B. thyroid disease C. tracheal displacement D. HIV
D
Which adverse effect would the nurse explain to an ambulatory client w/ relapsing-remitting MS while receiving every-other-day injections of interferon beta-1a? SELECT ALL THAT APPLY A. depression B. polycythemia C. flu-like symptoms D. increased r/f infection E. decreased perspiration
A, C, D (will cause sweating)
Which client's lab results indicate the 3rd stage of HIV? A. CD4 cell count is 180 B. CD4 count is 250 C. CD4 count is 380 D. CD4 count is 600
A
Which response is therapeutic for a client who says, "the world is filled w. terrible people. Why couldn't one of them get HIV instead of me"? A. "it seems unfair that you should have this disease" B. "i'm sure you really don't wish this on someone else" C. "maybe you should speak w/ your religious leader" D. "you can get tx; HIV is considered a chronic illness"
A
Which result would the nurse expect to find when reviewing the serum screening tests of a client w/ AIDS? A. a decrease in CD4 count B. an increase in thymic hormones C. an increase in IgE D. a decrease in the serum level of glucose-6-phosphate dehydrogenase
A
While caring for an HIV-positive pregnant adolescent, which finding would indicate to the nurse an increased risk of perinatal transmission via vaginal birth? A. a viral load of 1200 B. a postive gram beta-strep culture C. ruptured membranes and rapidly progressing labor D. hx of receiving combination ART therapy and having a viral load less than 200
A
While providing care for 4 clients w/ HIV, the nurse notes newly developed clinical manifestations. Which client's condition would the nurse be able to delay reporting to teh PCP until unit rounds are made within the next 24 hours? A. burning, itching, and discharge from the eyes B. blood in the urine C. yellow discoloration of the skin D. N/V accompanied by abd pain
A
Which stage of HIV is present in the client w/ CD4 count of 520? A. stage 1 B. stage 2 C. stage 3 D. stage 4
A (greater than 500) - stage 2 = 200-499 - stage 3 = less than 200
Which statement would the nurse include in the teaching plan of a client anticipating discharge w/ AIDS? A. "wash used dishes in hot, soapy water" B. "let dishes soak in hot watch for 24 hours b4 washing" C. "you should boil the client's dishes for 30 minutes after use" D. "have the client eat from paper plates so they can be discarded"
A (normal)
Which educational topic is a high priority for the nurse providing education to a client w/ SLE? A. instructing about ways to protect the skin B. helping the client identify coping strategies C. discussing methods to monitor body temp D. teaching about the effects of the disease on lifestyle
A (prevent infections)
Which event indicates a need to suggest testing of a client for HIV? SELECT ALL THAT APPLY A. diagnosed w/ TB in 1985 B. travelled to italy and greece in the late 1990s C. received blood transfusions in 1980 during total hip replacement surgery D. engaged in sexual relations w/ someone of the same sex for several years E. spent several nights in jail for a DUI charge
A, C, D
Which statement indicates a client understands transmission of HIV? SELECT ALL THAT APPLY A. "i can contract HIV by participating in oral sex" B. "i can contract HIV by eating from used utensils" C. "HIV is contracted by using contaminated needles" D. "I can contract HIV by using the bathroom of a person who us HIV positive" E. "babies can contract HIV b/c of contact w/ maternal blood during birth"
A, C, E
Which instruction would the nurse take when teaching a client w/ MS about managing urinary retention? SELECT ALL THAT APPLY A. using the crede maneuver B. using an indwelling catheter C. using anticholinergic meds D. monitoring and restricting fluid intake to 800 ml daily E. monitoring for an reporting signs of UTI
A, E
Which comment made by health-department staff during evaluation of training for HIV requires clarification by the nurse? A. if the HIV antibody is positive, it will be followed w/ a western blot test to check for false positive, correct? B. the HIV antibody test helps us identify people w/ symptomatic AIDS so that we can get them early tx C. it seems odd that voluntary screening for HIV can either be anonymous or confidential, but I guess maybe more people will come for screening if its anonymo
B
Which diagnostic test result indicates if a client will develop AIDS from HIV? A. level of IgM in the client's blood B. the number of CD4 cells C. presence of antigen-antibody complexes D. speed w/ which the virus invades the RNA
B
Which diversion activity would the nurse encourage to meet the client's needs during the remission phase of his MS? A. hiking B. swimming C. sewing class D. watching TV
B
Which important info would the nurse determine regarding the care provided by a mother diagnosed w/ AIDS who has been caring for her baby despite not feeling well? A. if she has ever kissed the baby and how B. if the mother is breast-feeding her baby C. when the baby last received antibiotics D. how long she has been caring for the baby
B
Which info would be important for the nurse to include in the teaching plan of a client w/ SLE to reduce the frequency of exacerbations? A. basic principles of hygiene B. techniques to reduce stress C. measures to improve nutrition D. signs of an impending exacerbation
B
Which vaccine is required to comply w/ the immunization schedule of a 26 year old pt recently diagnosed w/ HIV who has a CD4 count of 150 and needs an immunization update? A. flu; measles, mumps, rubella (MMR); varicella; hepatitis A B. pneumococcal, MMR, flu, varicella C. diphtheria, tetanus, hepatitis A, hepatitis C D. tetanus, hepatitis B, flu, pneumococcal
D (MMR and varicella are contraindicated b/c they are live pathogen vaccines)
Which instruction indicates a lack of understanding of a nurse teaching a HIV-positive client about strategies to prevent opportunistic infections? A. "reuse cups after washing them w/ warm soapy water" B. "rinse your toothbrush in liquid laundry bleach each week" C. "wash your armpits, groin, and genitals w/ antimicrobial soap twice a day" D. "purchase organic, unpasteurized apple cider for your vitamin C requirement"
D (bacteria)
Which symptom would the nurse expect to decrease in response to corticosteroid therapy prescribed for a client w/ MS? A. emotional lability B. muscular contractions C. pain in the extremities D. visual impairment
D (decrease inflammation)
