Burn, HIV/AIDS, Skin Cancer, hypo/hyperthermia

According to the Centers for Disease Control and Prevention (CDC), which stage of the human immunodeficiency virus (HIV) disease is present in the client with a laboratory report revealing a CD4+ T-cell count of 520 cells/mm3? 1 Stage 1 2 Stage 2 3 Stage 3 4 Stage 4

1 (1: >500 2: 200-499 3: less than 200 4: a confirmed HIV infection with no information regarding the CD4+ T-cell counts.)

While providing care for four clients with human immunodeficiency virus (HIV) infections, the nurse notes newly developed clinical manifestations. Which client's condition would the nurse be able to delay reporting to the primary health care provider until unit rounds are made within the next 24 hours? 1 Client A: burning, itching, and discharge from the eyes 2 Client B: blood in the urine 3 Client C: yellow discoloration of the skin 4 Client D: N/V with abd pain

1 (A client with an HIV infection is at risk for multiple diseases. Burning, itching, and discharge from the eyes are not life threatening and can be reported within 24 hours. Client A's condition can be reported within 24 hours. All the other clients' conditions should be reported immediately.)

A client admitted with a burn injury has erythema and mild swelling. Which type of burn would the nurse suspect? 1 First-degree burn 2 Third-degree burn 3 Fourth-degree burn 4 Second-degree burn

1 (A first-degree burn or superficial burn is manifested as erythema and mild swelling on the skin. Third-degree and fourth-degree burns are caused by flame, scald, chemicals, tar, and electric shock and typically involve damage to muscles, tendons, and bones; the client presents with dry, waxy, white, leathery skin. Second-degree burns include contact burns and those associated with third- and fourth-degree burns, but they are much less severe and are characterized by fluid-filled vesicles that are red, shiny, and wet.)

Which statement would the nurse include in the teaching plan of a client anticipating discharge with acquired immunodeficiency syndrome (AIDS)? 1 "Wash used dishes in hot, soapy water." 2 "Let dishes soak in hot water for 24 hours before washing." 3 "You should boil the client's dishes for 30 minutes after use." 4 "Have the client eat from paper plates so they can be discarded."

1 (A person cannot contract human immunodeficiency virus (HIV) by eating from dishes previously used by an individual with AIDS; routine care is adequate. Washing used dishes in hot, soapy water is sufficient care for dishes used by the AIDS client. Dishes do not need to soak for 24 hours before being washed. The client's dishes do not need to be boiled for 30 minutes after use. Paper plates are fine to use but are not indicated to prevent the spread of AIDS.)

Which client's laboratory results indicate the third stage of human immunodeficiency virus (HIV) disease? 1 Client A: CD4 180 2 Client B: 250 3 Client C: 380 4 Client D: 600

1 (According to HIV disease classification, a client with HIV disease is in the third stage of the disease if the CD4+ T cell count is less than 200 cells/mm3. Client A is in third stage of HIV disease. A client is in second stage of HIV disease if the CD4+ T cell count is between 200 and 499 cells/mm3. Client B and client C are in the second stage of HIV disease. A client is in the first stage of HIV disease if the CD4+ T cell count is greater than 500 cells/mm3. Client D is in first stage of HIV disease.)

The wound characteristics of four different clients with burns are mentioned below. Which client most likely suffers skin injury from sunburn? 1 Client 1: pink/red, edema, pain 2 Client 2: red/white, edema, pain, blisters 3 Client 3: black/brown, edema, no pain 4 Client 4: black, no edema/pain

1 (Client 1, with the affected skin color of pink to red, mild edema, and pain, may have sunburn. The healing time for the sunburn is 3 to 6 days. Client 2 has red-to-white-colored skin with pain and moderate edema; however, no eschar is present, so it might have occurred due to scalds or flames. Healing takes about 2 weeks. Client 3 has a black-brown burn wound with severe edema. The hard and inelastic eschar is present. The reason could be electrical burns. This type of burn takes weeks to months for proper healing. The black-colored burn wound with the absence of edema and pain in client 4 may signify burns due to tar or chemicals. This type of burn also takes weeks to months for healing.)

A person on the beach sustains a deep partial-thickness sunburn. Which first-aid measure would the nurse recommend before the client seeks health care? 1 Cool, moist towels 2 Dry, sterile dressings 3 Analgesic sunburn spray 4 Vitamin A and D ointment

1 (Cool, moist towels will decrease edema and minimize pain. Dry dressings, when removed, may further damage the burn site. Although pain is temporarily alleviated, removal of the spray is necessary before further treatment can be instituted; removal may cause injury. Ointments are contraindicated on burns because they have an oil base.)

A client with hypothermia is brought to the emergency department. Which treatment would the nurse anticipate? 1 Core rewarming with warm fluids 2 Ambulation to increase metabolism 3 Frequent oral temperature assessments 4 Gastric tube feedings to increase fluid volume

1 (Core rewarming with heated oxygen and administration of warmed oral or intravenous fluids is the preferred method of treatment. The client will be too weak to ambulate. Oral temperatures are not the most accurate assessment of core temperature because of environmental influences. Warmed oral feedings are advised; gavage feedings are unnecessary.)

A client who experienced extensive burns is receiving intravenous fluids to replace fluid loss. The nurse would monitor for which initial symptom of fluid overload? 1 Crackles in the lungs 2 Decreased heart rate 3 Decreased blood pressure 4 Cyanosis of nailbeds

1 (Crackles, or rales, in the lungs are an early sign of pulmonary congestion and edema caused by fluid overload. Clients with fluid overload will usually demonstrate an increased heart rate and increased blood pressure. A decreased heart rate and decreased blood pressure and cyanosis in a client with fluid overload would be very late and fatal signs.)

The nurse is caring for a client who has a burn in the emergent stage. Which assessment is the highest priority? 1 Extent of burn 2 Cause of burn 3 Where it occurred 4 Type of first aid given

1 (During the emergent stage of a burn, the nurse first assesses the extent and then the cause of the burn, then where it occurred, and then determines first aid measures that were used. For immediate treatment of the burn, the nurse would be concerned with the body location and extent of the burn.)

A client with 35% of total body surface area burned in a fire is now 48 hours postburn. Which finding indicates that the client is moving from the emergent to the acute phase of burn management? 1 Hypokalemia 2 Hypoglycemia 3 Decreased blood pressure 4 Increased urine specific gravity

1 (Fluid remobilization during the acute phase of burn injury results in hypokalemia because of diuresis and the movement of potassium back into the intracellular compartment. Hyperglycemia occurs during the acute phase because of lipolysis, gluconeogenesis, and glycogenolysis and a relative insulin insensitivity. During the acute stage fluid shifts back into the intravascular compartment, resulting in an increased blood pressure and increase in the glomerular filtration rate. When the glomerular filtration rate increases, there is an increase in the urinary output. As the urinary output increases, the urine specific gravity decreases.)

A client is recovering from full-thickness burns, and the nurse provides counseling on how to best meet nutritional needs. Which client food selections indicate to the nurse that the client understands the teaching? 1 Cheeseburger and a milkshake 2 Beef barley soup and orange juice 3 Bacon and tomato sandwich and tea 4 Chicken salad sandwich and soft drink

1 (Of the selections offered, a cheeseburger and a milkshake have the highest calories and protein, which are needed for the increased basal metabolic rate associated with burns and for tissue repair. Although orange juice provides vitamin C, beef barley soup does not provide adequate protein or calories. A bacon and tomato sandwich and tea do not provide an adequate amount of calories and protein; nor do a chicken salad sandwich and a soft drink.)

Which organism is a common opportunistic infection in a client infected with human immunodeficiency virus (HIV)? 1 Oropharyngeal candidiasis 2 Cryptosporidiosis 3 Toxoplasmosis encephalitis 4 Pneumocystis jiroveci pneumonia

1 (Oropharyngeal candidiasis is the most common infection associated with HIV because the immune system can no longer control Candida fungal growth. Pneumocystis jiroveci pneumonia (PCP) is more common in a client infected with acquired immunodeficiency syndrome (AIDS). It causes tachypnea and persistent dry cough. Cryptosporidiosis, an intestinal infection caused by Cryptosporidium organisms, presents in clients with AIDS as does toxoplasmosis encephalitis, which is caused by Toxoplasma gondii and is acquired through contact with contaminated cat feces or by ingesting infected undercooked meat.)

Which risk would the nurse consider when providing care to a client in the acute phase of treatment for a full-thickness burn? 1 The risk of septicemia and its potential complications from treatment 2 The risk of psychosocial adjustments and resuming previous roles 3 The risk of oral mucous membrane injury and its associated risks 4 The risk of insufficient community resources and emotional support

1 (Skin is the first line of defense against infection. When much of it is destroyed, the client is vulnerable to infection. Complications, such as infection and contractures, still may occur during the acute phase and as the client is healing. Psychosocial adjustments, previous roles, and insufficient community resources are priorities in the rehabilitative phase. Risk of oral mucous membrane injury is in the emergent (resuscitation) stage. Emotional support is provided in all three phases.)

The nurse is caring for a client with burns and reviews the client's laboratory results: blood urea nitrogen (BUN), 30 mg/dL (10.2 mmol/L); creatinine, 2.4 mg/dL (184 mcmol/L); serum potassium, 6.3 mEq/L (6.3 mmol/L); pH, 7.1; PO2, 90 mm Hg; and hemoglobin (Hgb), 7.4 g/dL (74 mmol/L). Which condition would the nurse suspect the client has based on these findings? 1 Azotemia 2 Hypokalemia 3 Metabolic alkalosis 4 Respiratory alkalosis

1 (The BUN is greater than the expected value of 10 to 20 mg/dL (3.6-7.1 mmol/L). Urea nitrogen is the major nitrogenous end product of protein and amino acid catabolism; azotemia is the accumulation of excessive nitrogenous compounds, such as BUN and creatinine, in the blood. The client has hyperkalemia; the expected value for potassium is 3.5 to 5.5 mEq/L (3.5-5.5 mmol/L). Although the client does have a metabolic acid-base imbalance, it is acidosis, not alkalosis, because the pH is less than the expected range of 7.35 to 7.45. The PO2 is within the expected range of 80 to 100 mm Hg, which indicates that the problem is metabolic, not respiratory.)

Which action would the nurse implement when providing care for a client with acquired immunodeficiency syndrome (AIDS)? 1 Use standard precautions. 2 Employ airborne precautions. 3 Plan interventions to limit direct contact. 4 Discourage long visits from family members.

1 (The Centers for Disease Control and Prevention (Canada: Public Health Agency of Canada) states that standard precautions should be used for all clients; these precautions include wearing of gloves, gown, mask, and goggles when there is risk for exposure to blood or body secretions. There is no indication that airborne precautions are necessary. Planning interventions to limit direct contact or discouraging long visits from family members will unnecessarily isolate the client.)

A client is admitted to the hospital with severe burns. Which clinical finding would the nurse anticipate during the acute phase of burn recovery? 1 Unstable vital signs 2 Decreased urinary output 3 High serum potassium levels 4 Reduced intravascular fluid volume

1 (The beginning of the acute phase of burn recovery (36-48 hours after the injury) is evident by hemodynamic instability, which is reflected in unstable vital signs. As fluid returns to the intravascular compartment, increased renal blood flow and diuresis occur. During the acute phase of burn recovery, potassium moves back into cells, decreasing, not increasing, serum potassium levels. Fluid returns to the intravascular compartment during the acute phase of burn recovery, and intravascular deficits do not occur.)

Which gastrointestinal (GI) change may be found in the client with burn injuries? 1 Abdominal distention 2 Increased peristalsis 3 Activation of GI motility 4 Increased blood flow to the GI area

1 (The client with burn injuries may have abdominal distention due to loss of peristalsis. Gastrointestinal motility may be inhibited with burn injuries. Blood flow may be reduced and mucosal damage might have occurred.)

Which action would be the nurse's first priority when receiving a client with major burns? 1 Assessing airway patency 2 Checking the client from head to toe 3 Administering oxygen as needed 4 Elevating the extremities if no fractures are noticed

1 (The first action of the nurse for a client with major burns should be assessing airway patency because airway obstruction will lead to the death of the client. Other subsequently important actions of the nurse for the client should be assessment of the client from head to toe. The client should be administered oxygen according to need. The extremities should be elevated if there are no fractures.)

Which result would the nurse expect to find when reviewing the serum screening tests of a client with acquired immunodeficiency syndrome (AIDS)? 1 A decrease in CD4 T cells 2 An increase in thymic hormones 3 An increase in immunoglobulin E 4 A decrease in the serum level of glucose-6-phosphate dehydrogenase

1 (The human immunodeficiency virus (HIV) infects helper T-cell lymphocytes; therefore 300 or fewer CD4 T cells per cubic millimeter of blood or CD4 cells accounting for less than 20% of lymphocytes is suggestive of AIDS. The thymic hormones necessary for T-cell growth are decreased. An increase in immunoglobulin E is associated with allergies and parasitic infections. A decrease in the serum level of glucose-6-phosphate dehydrogenase is associated with drug-induced hemolytic anemia and hemolytic disease of the newborn.)

Which medication reduces the risk for human immunodeficiency virus (HIV) infection in unaffected individuals? 1 Truvada 2 Abacavir 3 Cromolyn 4 Methdilazine

1 (Truvada is the first medication approved to reduce the risk for HIV infection in unaffected individuals who are at a high risk of HIV infection. Abacavir treats HIV infection and is a reverse transcriptase inhibitor. Cromolyn manages allergic rhinitis and asthma. Methdilazine, an antihistamine, treat the skin and provides relief from itching.)

Which specific emergency burn management would be appropriate for a client hospitalized with burns caused by flames? 1 Removing all metal objects 2 Helping the client bathe or shower 3 Initiating cardiopulmonary resuscitation 4 Administering tetanus toxoid for prophylaxis

1 (When a client with flame burn injuries is hospitalized, the primary health care provider should first remove all smoldering clothing and metal objects. In case of radiation burns, the client is helped bathe or shower. Cardiopulmonary resuscitation would be appropriate in the emergency management of an electrical burn injury. The administration of tetanus toxoid for prophylaxis would be considered as the general management for all types of burns.)

While caring for a client with a burn injury and in the resuscitation phase, the nurse notices that the client is hoarse and produces audible breath sounds on exhalation. Which immediate action would be appropriate for the safe care of the client? Select all that apply. One, some, or all responses may be correct. 1 Providing oxygen immediately 2 Notifying the rapid response team 3 Considering it a normal observation 4 Initiating an intravenous (IV) line and beginning fluid replacement 5 Obtaining an electrocardiogram (ECG) of the client

1, 2 (Hoarseness of voice, difficulty in swallowing, or an audible breath sound on exhalation after a burn injury indicates an impaired airway. The client should be given oxygen immediately. The rapid response team should also be notified for further management. This occurrence should not be considered a normal observation. An IV line should be initiated for fluid replacement only once the client's airway is patent. An ECG is obtained when the client suffers from electrical burns.)

Which intervention would the nurse use for a client with full-thickness burns to the chest and anterior right arm? Select all that apply. One, some, or all responses may be correct. 1 Monitoring vital signs 2 Cutting off the clothing 3 Inserting a urinary catheter 4 Removing the client's jewelry 5 Establishing an intravenous line

1, 2, 3, 4, 5 (According to the Rule of Nines, the client has full-thickness burns to 22.5% of the body (18% chest and 4.5% right arm). The nurse would monitor vital signs (including oxygen saturation), remove the client's clothing and jewelry, insert a urinary catheter to maintain intake and output, and insert an intravenous line to administer fluids.)

The nurse provides discharge teaching to a client with acquired immunodeficiency syndrome (AIDS) and a low white blood cell (WBC) count. Which client statements indicate understanding of the content? Select all that apply. One, some, or all responses may be correct. 1 "My roommate will take care of our cat's litter box." 2 "I will rinse my toothbrush in bleach once a week." 3 "I will use a different cup every time I have a drink." 4 "I will eat at least one piece of fresh fruit every day." 5 "I will walk at the mall twice a week to keep up my strength." 6 "I will wash my hands thoroughly after shaking hands with anyone."

1, 2, 3, 6 (When a client with AIDS has a low WBC, it is necessary to avoid possible sources of infection. Raw fruit and vegetables should be avoided, as should large gatherings of people who might be ill. When the WBC is low, the client should avoid changing the litter box, and cups and glasses should not be reused. The client should rinse the toothbrush in bleach weekly and then rinse out the bleach with hot water. Hands should be washed with an antimicrobial soap before eating and drinking, after touching a pet, after using the toilet, and after shaking hands with anyone.)

Which would the nurse's immediate interventions be for the client with moderate hypothermia? Select all that apply. One, some, or all responses may be correct. 1 Administering heated oxygen (O2) gas 2 Positioning the client in supine position 3 Administering high-carbohydrate liquids 4 Applying external heat with heating blankets 5 Performing cardiopulmonary bypass technique

1, 2, 4 (Clients with moderate hypothermia should be administered heated O2 or inspired gas to prevent heat loss via the respiratory tract. Positioning the client in the supine position prevents orthostatic changes in blood pressure from cardiovascular instability. Applying external heat with heating blankets can promote the core temperature by producing peripheral vasodilation. High-carbohydrate liquids without alcohol or caffeine should be administered in clients with mild hypothermia. Cardiopulmonary bypass technique should be performed in a client with severe hypothermia.)

The nurse assesses for which client symptoms that indicate hyperthermia? Select all that apply. One, some, or all responses may be correct. 1 Vasodilation 2 Dry and flushed skin 3 Pale and cyanotic skin 4 Decreased capillary refill 5 Decreased urinary output

1, 2, 5 (During hyperthermia, vasodilation occurs that causes the flushed appearance of the skin; as a result, the skin may be warm to the touch. Hyperthermia causes loss of water from the body and results in dry skin and mucous membranes, decreased urinary output, and other signs of dehydration and electrolyte imbalance. Clients with hyperthermia may not have pale and cyanotic skin; instead, they have dry, flushed skin. Clients with hyperthermia may not have decreased capillary refill; instead, they have increased capillary refill.)

To reduce the incidence of human immunodeficiency virus (HIV) transmission, which basic strategies would the nurse teach a health class? Select all that apply. One, some, or all responses may be correct. 1 Using condoms 2 Using separate toilets 3 Practicing sexual abstinence 4 Preventing direct casual contacts 5 Sterilizing the household utensils

1, 3 (HIV is found in body fluids such as blood, semen, vaginal secretions, breast milk, amniotic fluid, urine, feces, saliva, tears, and cerebrospinal fluid. A client should use condoms to prevent contact between the vaginal mucous membranes and semen. Practicing sexual abstinence is the best method to prevent transmission of the virus. The HIV virus is not transmitted by sharing the same toilet facilities, casual contacts such as shaking hands and kissing, or by sharing the same household utensils.)

Which would the nurse identify as increasing the risk of human immunodeficiency virus (HIV) transmission? Select all that apply. One, some, or all responses may be correct. 1 Childbirth 2 Monogamy 3 Breast-feeding 4 Needle sharing 5 Shared plates and cups

1, 3, 4 (HIV can be spread through breast-feeding and childbirth, sharing needles, and unprotected sexual contact. Having multiple sexual partners, not monogamy, increases the risk of HIV transmission. HIV cannot be transmitted through sharing plates and cups.)

Which clinical manifestations support the nurse's suspicion of a cryptococcosis infection in a client with acquired immunodeficiency syndrome (AIDS)? Select all that apply. One, some, or all responses may be correct. 1 Generalized seizures 2 Dyspnea with audible wheezing 3 Blurred vision and photophobia 4 Neurological deficits and somnolence 5 Unilaterally enlarged lymph nodes

1, 3, 4 (Seizures, neurological problems/deficits, and blurred vision are the manifestations of cryptococcosis. Cryptococcosis is a debilitating meningitis and can be a widely spread infection in clients who have AIDS. It is caused by Cryptococcus neoformans. Histoplasmosis is a respiratory infection caused by Histoplasma capsulatum, which progresses to widespread infection in a client with AIDS. The symptoms of histoplasmosis are dyspnea and enlarged lymph nodes.)

The shaded areas (head and chest) in the illustration indicate the parts of the body where a client sustained burns. Calculate the percentage of the body that was burned using the rule of nines. Record your answer using one decimal place. _______%

13.5% (The front of the head is 4.5%, and the anterior torso is 9%, for a total of 13.5%.)

A person sustains severe burns of the arms and is waiting for emergency services to arrive. The nurse bystander responds to the scene. Another bystander is getting ready to apply butter to the burns, stating that it will provide soothing relief. Which response by the nurse is best? 1 "Let's focus on sitting quietly with the victim while waiting for the ambulance." 2 "Let's cover up the victim with one of those tablecloths instead." 3 "Let's apply first aid cream to the burns rather than the butter." 4 "Let's get that butter on quickly."

2 (A tablecloth is typically not fuzzy and nonadhering and will keep the burned person warm. Doing nothing is inappropriate; body heat should be conserved with a nonadhering covering. Cream is difficult to remove and may result in additional damage. Butter is contraindicated for the treatment of burns.)

Which clinical parameter will be most important for the nurse to assess when administering warmed intravenous fluids to a client with hypothermia? 1 Hematocrit 2 Cardiac rhythm 3 Intake and output 4 Blood urea nitrogen

2 (Because dysrhythmias can occur during rewarming and may need treatment, ongoing cardiac monitoring is essential. Hematocrit may increase with hypothermia and would be expected to improve with administration of warm fluids, but changes in hematocrit during rewarming are expected. Intake and output would be monitored during intravenous infusion, but are not as important to monitor as cardiac rhythm. Renal failure may occur as a complication of hypothermia and blood urea nitrogen would be monitored, but is not as important to monitor as cardiac rhythm.)

Which consideration is most important when counseling the family of a child with human immunodeficiency virus (HIV)? 1 Risk for injury 2 Susceptibility to infection 3 Inadequate nutritional intake 4 Altered growth and development

2 (Children with HIV have a dysfunction of the immune system (depressed or ineffective T lymphocytes, B lymphocytes, and immunoglobulins) and are susceptible to opportunistic infections. All children are subject to injury because of their curiosity, inexperience, and lack of judgment. Although inadequate nutrition can be a problem for children with HIV, the prevention of infection is the priority. Although children with HIV are usually small for their age, altered growth and development is not as life threatening as an infection.)

Which action by an uninfected individual would not pose a risk of exposure to human immunodeficiency virus (HIV)? 1 The uninfected individual only has intercourse with his or her spouse. 2 The individual donates a pint of blood to the blood bank. 3 The individual uses a condom each time he or she has sexual intercourse. 4 The individual limits sexual contact to those individuals without HIV antibodies.

2 (Equipment used in blood donation is disposable; the donor does not yet come into contact with anyone else's blood. Risk of exposure within a monogamous marriage depends on the spouse's previous behavior. Although condoms do offer protection, they can rupture or be improperly used; risks of infection are present with any sexual contact. Finally, individuals may be infected before testing positive for the antibodies; therefore individuals can transmit the virus long before they know they are infected.)

A client was admitted with full-thickness burns 2 weeks ago. Since admission, the client has lost an average of 1 lb (0.5 kg) of weight each day. Which dietary adjustment would the nurse recommend? 1 Increase low-sodium milk intake. 2 Provide high-protein drinks. 3 Increase foods that are low in potassium. 4 Provide 10% more calories in the form of fats.

2 (High-protein drinks have twice the calories per volume of other fluids and provide protein for wound healing. Low-sodium milk does not contain adequate calories to help meet the high metabolic rate associated with burns. Potassium is restricted during the first 48 to 72 hours after a burn injury, not 2 weeks after the injury. Increased calories in the form of protein and carbohydrates, not fats, are needed.)

The nurse is evaluating the condition of a client with burns of the upper body. Which finding will alert the nurse of a potential respiratory obstruction? 1 Deep breathing 2 Hoarse quality to the voice 3 Pink-tinged, frothy sputum 4 Rapid abdominal breathing

2 (Hoarseness is a sign of potential respiratory insufficiency as a result of inhalation injury, which causes edema in the surrounding tissues, including the vocal cords. Sputum will be sooty, not frothy; pink-tinged, frothy sputum is associated with pulmonary edema. Deep breathing and rapid abdominal breathing indicate metabolic acidosis, not respiratory insufficiency.)

Which client condition would the nurse keep in mind while performing a rewarming procedure in a client with severe hypothermia? 1 The client is at risk for hypertension from rewarming shock. 2 The client should be monitored for after drop during rewarming. 3 The cold myocardium should be stimulated in a hypothermic client. 4 The core of the client with severe hypothermia should be warmed after the extremities.

2 (Rewarming places the client at risk for after drop, a further drop in core temperature. This occurs when cold peripheral blood returns to the central circulation. So, the core temperature of the client should be monitored carefully during rewarming. Rewarming shock can produce hypotension, not hypertension. The cold myocardium is extremely irritable, making it vulnerable to dysrhythmias. Gentle handling is essential to prevent the myocardium from being stimulated. Clients with moderate to severe hypothermia should have the core warmed before the extremities to prevent rewarming shock.)

Which stage of the human immunodeficiency virus (HIV) would a client with a CD4+ T cell count of 325 cells/mm3 be classified? 1 Stage 1 2 Stage 2 3 Stage 3 4 Stage 4

2 (Stage 2 describes a client with a CD4+ T cell count between 200 and 499 cells/mm3. Stage 1 describes a client with a CD4+ T cell count of greater than 500 cells/mm3. Stage 3 describes a client with a CD4+ T cell count of less than 200 cells/mm3. Stage 4 describes a client with a confirmed HIV infection but no information regarding CD4+ T cell counts is available.)

The nurse is caring for a client with severe burns 36 hours after the client's admission and identifies the client's potassium level of 6.0 mEq/L (6.0 mmol/L). Which drink will the nurse recommend be included in the client's diet? 1 Milk 2 Tea 3 Orange juice 4 Tomato juice

2 (The client is hyperkalemic, and potassium intake should be limited; tea is very low in potassium. Milk, orange juice, and tomato juice are all high-potassium foods and should be avoided.)

The nurse is teaching a student nurse about the ongoing monitoring of a client with electrical burns. Which statement made by the student nurse indicates the need for further teaching? 1 "I should monitor the airway." 2 "I should monitor the eye pH." 3 "I should monitor vital signs." 4 "I should monitor urine output."

2 (The pH of the eye is monitored when chemical burns occur to the eye. The nurse should monitor the client's airway for breathing, vital signs, heart rhythm, neurovascular status of injured limbs, level of consciousness, and urine output.)

While assessing the mouth of a client with acquired immunodeficiency syndrome (AIDS), the nurse finds the condition illustrated in the image. Which pathogen is responsible for the client's condition? 1 Cryptosporidium 2 Candida albicans 3 Toxoplasma gondii 4 Histoplasma capsulatum

2 (This infection is caused by the fungus Candida albicans. The image shows oral candidiasis or yeast. The cottage cheese-like, yellowish-white plaques and inflammation are the manifestations that indicate oral candidiasis. Cryptosporidium is responsible for cryptosporidiosis, which is an intestinal infection. Toxoplasmosis encephalitis is caused by Toxoplasma gondii. Histoplasmosis is caused by Histoplasma capsulatum, which is a respiratory infection.)

Which diagnostic test result indicates if a client will develop acquired immunodeficiency syndrome (AIDS) from the human immunodeficiency virus (HIV)? 1 Level of immunoglobulin M (IgM) in the client's blood 2 The number of CD4+ T cells available 3 Presence of antigen-antibody complexes 4 Speed with which the virus invades the ribonucleic acid (RNA)

2 (Whether HIV becomes AIDS depends on the number of CD4+ T cells. IgM and the presence of antigen-antibody complexes have no effect on HIV. The speed with which HIV invades the RNA has no effect on the future development of AIDS.)

A client who is positive for human immunodeficiency virus (HIV) is admitted to a surgical unit after an orthopedic procedure. The nurse realizes that HIV is transmissible through which means? Select all that apply. One, some, or all responses may be correct. 1 Feces 2 Blood 3 Semen 4 Urine 5 Sweat 6 Tears

2, 3 (HIV, which is the virus that causes acquired immunodeficiency syndrome (AIDS), is transmitted through infected blood, semen, and bloody bodily fluids. HIV is not spread casually. Although HIV may be found in other bodily secretions, including feces, urine, sweat, tears, saliva, sputum, and emesis, the amount of virus is likely not sufficient enough to be transmitted.)

A client has burn injuries from an electrical current. Which interventions would be used as first aid until the client is transferred to a health care facility? Select all that apply. One, some, or all responses may be correct. 1 Cover the burns with ice. 2 Leave the adherent clothing in place. 3 Wrap the client in a dry, clean sheet. 4 Remove as much burned clothing as possible. 5 Immerse the burned body part in cool water.

2, 3, 4 (When a client is injured by an electrical current, the adherent clothing should be left in place until the client is transferred to a primary health care center. Wrapping the client in a clean, dry sheet may prevent further contamination of the wound and also provide warmth. Removing as much burned clothing as possible prevents further tissue damage. The burns should not be covered with ice because this may cause hypothermia and vasoconstriction of blood vessels. Do not immerse the burned body part in cool water because it may cause extensive heat loss.)

Which actions transmit the human immunodeficiency virus (HIV)? Select all that apply. One, some, or all responses may be correct. 1 Multiple mosquito bites 2 Sharing syringe needles 3 Breast-feeding a newborn 4 Dry kissing an infected individual 5 Anal intercourse 6 Sharing drinking glasses

2, 3, 5 (Fluids such as blood and semen are highly concentrated with HIV. HIV may be transmitted parenterally by sharing needles and postnatally through breast milk. HIV may also be transmitted through anal intercourse. HIV is not transmitted by mosquito bites, sharing of drinking glasses, or dry kissing. Deep kissing involving a large amount of salvia does transmit HIV.)

According to the Centers for Disease Control and Prevention (CDC) classification, which laboratory report enables the nurse to conclude a client has a stage 3 human immunodeficiency virus (HIV) infection? Select all that apply. One, some, or all responses may be correct. 1 CD4+ T-cell count 800 cells/mm3 or a percentage of 32% 2 CD4+ T-cell count 100 cells/mm3 or a percentage of 11% 3 CD4+ T-cell count of an unknown percentage and Kaposi sarcoma 4 CD4+ T-cell count of an unknown percentage and Burkitt lymphoma 5 CD4+ T-cell count 150 cells/mm3 or a percentage of 12% and Kaposi sarcoma

2, 5 (The CDC has classified four stages of HIV infection. Stage 3 is characterized by a CD4+ T-cell count less than 200 cells/mm3 or a percentage less than 14%. A T-cell count of greater than 500 cells/mm3 or a percentage of 29% or greater is regarded as stage 1 HIV. A client whose HIV infection is confirmed with no information on the CD4+ T-cell count but who has an acquired immunodeficiency syndrome-defining illness such as Kaposi sarcoma or Burkitt lymphoma is considered to be in stage 4 HIV.)

A client is admitted for treatment of partial- and full-thickness burns of the entire right lower leg extremity and the anterior portion of the right upper arm. The nurse performs an immediate appraisal of the percentage of body surface area burned using the rule of nines. What percentage of body surface area does the nurse determine is affected? Record the answer to one decimal place. _______%

22.5 (The entire right lower extremity is 18%; the anterior portion of the right upper extremity is 4.5%. 18 + 4.5 = 22.5)

Which instruction would the nurse include when teaching a client with human immunodeficiency virus (HIV) about self-management? 1 "Limit your daily fluid intake to 2 liters daily." 2 "Eat more roughage daily with your meals." 3 "Rinse your mouth with normal saline after every meal." 4 "Maintain a 4- to 5-hour gap between each meal."

3 (A client infected with HIV should maintain proper oral care to improve his or her appetite. The client should rinse his or her mouth with sterile water or normal saline several times a day, especially after meals, to maintain proper oral hygiene. The client should drink plenty of fluids to maintain proper body fluid balance. Roughage should be limited in a client's diet because it is not easily digestible and may lead to severe diarrhea and contains microorganisms that can lead to infection. The client should consume small, frequent meals to maintain adequate caloric intake.)

The registered nurse instructs a new employee about providing care for a hospitalized client with a human immunodeficiency (HIV) infection. Which action made by the new employee indicates effective learning? 1 Keeping fresh flowers in the client's room 2 Encouraging the client to eat fresh fruits and vegetables 3 Keeping a dedicated disposable glove box in the client's room 4 Changing gauze-containing wound dressings every other day

3 (A client with an HIV infection is at a high risk of contracting infections. The nurse would keep a dedicated disposable glove box in the client's room and avoid using supplies from a common area. The nurse would refrain from keeping potted plants and flowers in the client's room because they act as sources of potentially infectious bacteria and fungi. A client with an HIV infection would be discouraged from consuming raw fruits and vegetables and would instead be provided with well-cooked food to reduce risk of food borne pathogens. To reduce the risk of infections, the nurse would change gauze-containing wound dressings every day.)

Which client has second-degree burns? 1 Client A: waxy white, dark brown appearance 2 Client B: redness, pain, minimal edema 3 Client C: moist blebs, blisters, severe pain 4 Client D: dry, leathery eschar, absence of pain

3 (Client C has second-degree burns. The client is experiencing severe pain and the skin shows moist blebs and blisters. Client A may have third- and fourth-degree burns, in which the skin is waxy white, dark brown in appearance. Client B may have first-degree burns, in which the skin is red in color with minimal edema and pain. Client D may have third- and fourth-degree burns as the skin is dry, leathery eschar and there is absence of pain.)

Which type of burn injury should be followed up by scheduling the client for an electrocardiogram (ECG)? 1 Flame burn 2 Chemical burn 3 Electrical burn 4 Radiation burn

3 (In an electrical burn injury, changes in the ECG may indicate damage to the heart. In flame burn injuries, the smoldering clothing and all metal objects are removed. If a client suffers from chemical burns, the dried chemicals present on skin should not be made wet but should be brushed off. If the client has radiation burn injuries, then the source should be removed using tongs or lead protective gloves.)

Which key feature indicates malignancy in a client with acute immunodeficiency syndrome (AIDS)? 1 Dry skin 2 Weight loss 3 Kaposi sarcoma 4 Opportunistic infections

3 (Kaposi sarcoma is a key feature that indicates malignancy in an AIDS client. Dry skin is an integumentary manifestation in a client suffering from AIDS. Weight loss is a gastrointestinal manifestation in a client with AIDS. Opportunistic infection is an immunological manifestation in a client with AIDS.)

A client is admitted to the hospital with partial- and full-thickness burns of the chest and face sustained while trying to extinguish a brush fire. Which concern is the nurse's priority? 1 Loss of skin integrity caused by the burns 2 Potential infection as a result of the burn injury 3 Inadequate gas exchange caused by smoke inhalation 4 Decreased fluid volume because of the depth of the burns

3 (Maintaining a patent airway is the priority; because of the proximity of the chest and face to the nose and mouth, inhalation burns also may have occurred. Although loss of skin integrity caused by the burns is important, it is not the priority at this time. Although potential for infection as a result of the burn injury is important, it is not the priority. Although fluid needs are important, the gas exchange is priority.)

A client develops sepsis after severe burn injuries. For which complication is the client at high risk? 1 Diarrhea 2 Constipation 3 Paralytic ileus 4 Malabsorption syndrome

3 (Paralytic ileus, or hypoactive bowel, is a complication caused by sepsis in clients with burns. Diarrhea can be caused by the use of enteral feedings or antibiotics. Constipation can occur as a side effect of opioid analgesics, decreased mobility, and a low-fiber diet. In malabsorption syndrome, the small intestine cannot absorb nutrients from foods. Burns do not cause malabsorption syndrome. Causes of malabsorption syndromes include disorders such as celiac disease and short bowel syndrome.)

Which nursing intervention indicates misinformation when providing care for clients with the human immunodeficiency virus (HIV) infection? 1 "I will ask the client to avoid exposure to new infectious agents." 2 "I will ask the client about intake of supplemental vitamins and micronutrients." 3 "I will ask the client to avoid involvement in community activities." 4 "I will ask the client if he or she is up to date with recommended vaccines."

3 (The HIV infection decreases the client's immunity, making the client prone to infection. HIV-infected clients should avoid exposure to new infectious agents. They should consume nutritional support to maintain lean body mass and ensure appropriate levels of vitamins and micronutrients. They need to remain or become compliant with recommended vaccines to prevent vaccine-preventable diseases. HIV-infected clients may feel isolated and lonely; therefore they should be involved in support groups and community activities.)

A client recovering from deep partial-thickness burns develops chills, fever, flank pain, and malaise. The primary health care provider makes a tentative diagnosis of urinary tract infection. Which diagnostic tests would the nurse expect the primary health care provider to prescribe to confirm this diagnosis? 1 Cystoscopy and bilirubin level 2 Specific gravity and pH of the urine 3 Urinalysis with a urine culture and sensitivity 4 Creatinine clearance and albumin/globulin (A/G) ratio

3 (The client's manifestations may indicate a urinary tract infection; a culture of the urine will identify the microorganism, and sensitivity will identify the most appropriate antibiotic. A cystoscopy is too invasive as a screening procedure; altered bilirubin results indicate liver or biliary problems, not urinary signs and symptoms. Creatinine clearance reflects renal function; A/G ratio reflects liver function. Although an increased urine specific gravity may indicate red blood cells, white blood cells, or casts in the urine, which are associated with urinary tract infection, it will not identify the causative organism.)

Upon review of morning laboratory reports, which client's report indicates acquired immunodeficiency syndrome (AIDS)? 1 Client 1: CD4 750 2 Client 2: 550 3 Client 3: 175 4 Client 4: 450

3 (The diagnosis of AIDS requires that the person should be HIV positive and have either a CD4+ T-cell count of less than 200 cells/mm3 (200 cells/(L) or less than 14% or an opportunistic infection. Client 3, with a CD4+ T-cell count of less than 200 cells/mm3 (200 cells/(L) and is HIV positive, is having AIDS-defining illness. A healthy client usually has at least 800 to 1000 CD4+ T-cells/mm3 of blood. The CD4+ T-cells are reduced in the client with HIV disease. Client 1, with a CD4+ T-cell count of 750 cells/mm3 and HIV positive, does not have AIDS. Client 2, with a CD4+ T-cell count of 550 cells/mm3 and HIV positive, does not have AIDS. Client 4, having a CD4+ T-cell count of 450 cells/mm3 and HIV positive does not have AIDS.)

Indicate the first step involved in the disposal of sharp wastes after use on a client with acquired immunodeficiency syndrome (AIDS). 1 Place tape over the container. 2 Place the container in a paper bag. 3 Place the waste in a puncture-resistant container. 4 Pour a 1:10 bleach solution in the container.

3 (The sharp wastes of a client with AIDS should first be placed in a puncture-resistant container and labeled. Then a 1:10 bleach solution should be poured into the container for disinfection. Next the container should be taped to prevent leakage. The container should be then placed into a paper bag and subsequently disposed of in the regular trash.)

Arrange the order of airway management in a client with burns. 1. Place the client on ventilatory support. 2. Escharotomies of the chest wall, if necessary. 3. Intubate the client within 1 to 2 hours after injury. 4. Extubation is indicated when edema resolves.

3, 1, 2, 4 (Airway management often involves endotracheal intubation. In general, the client with burns to the face and neck may require intubation within 1 to 2 hours after injury. After intubation, the client is placed on ventilatory support, providing oxygen concentration based on arterial blood gas values. Escharotomies of the chest wall may be necessary to relieve respiratory distress. Extubation may be indicated when edema resolves, usually 3 to 6 days after initial injury, unless severe inhalation injury is involved.)

Which changes that occur with aging increase the risk for hypothermia in older adults? Select all that apply. One, some, or all responses may be correct. 1 Increased metabolic rate 2 Increased shivering response 3 Decreased amount of body fat 4 Diminished energy reserves 5 Chronic medical conditions

3, 4, 5 (Many older adults have decreases in body fat, diminshed energy reserves, and chronic medical conditions that increase the risk for hypothermia when exposed to cold. Metabolic rate slows with aging, which increases hypothermia risk. The shivering response to cold decreases with age, and this increases hypothermia risk.)

Which diagnostic criterion should the nurse use to explain acquired immunodeficiency syndrome (AIDS) to a client with immunodeficiency virus (HIV)? 1 Contracts HIV-specific antibodies 2 Develops an acute retroviral syndrome 3 Is capable of transmitting the virus to others 4 Has a CD4+T-cell lymphocyte level of less than 200 cells/µL (60%)

4 (AIDS is diagnosed when an individual with human immunodeficiency virus (HIV) develops one of the following: a CD4+ T-cell lymphocyte level of less than 200 cells/µL (60%), wasting syndrome, dementia, one of the listed opportunistic cancers (e.g., Kaposi sarcoma [KS], Burkitt lymphoma), or one of the listed opportunistic infections (e.g., Pneumocystis jiroveci pneumonia, Mycobacterium tuberculosis). The development of HIV-specific antibodies (seroconversion), accompanied by acute retroviral syndrome (flulike syndrome with fever, swollen lymph glands, headache, malaise, nausea, diarrhea, diffuse rash, joint and muscle pain) 1 to 3 weeks after exposure to HIV reflects acquisition of the virus, not the development of AIDS. A client who is HIV positive is capable of transmitting the virus with or without the diagnosis of AIDS.)

A 26-year-old client recently diagnosed with human immunodeficiency virus (HIV) has a CD4 count of 150 cells/mm3 and needs an immunization update. Which vaccines are required for this client to comply with the recommended immunization schedule? 1 Influenza; measles, mumps, rubella (MMR); varicella; and hepatitis A vaccines 2 Pneumococcal, MMR, influenza, and varicella vaccines 3 Diphtheria, tetanus, hepatitis A, and hepatitis C vaccines 4 Tetanus, hepatitis B, influenza, and pneumococcal vaccines

4 (According to recent recommendations, adults with HIV should receive tetanus, influenza, hepatitis B, and pneumococcal vaccines. Live pathogen vaccines (MMR, varicella) are contraindicated for individuals whose CD4 count is less than 200 cells/mm3. Currently, there is no immunization for hepatitis C, and the diphtheria vaccine is not recommended.)

When a client asks to be screened for human immunodeficiency virus (HIV) infection, which information will the nurse include in client teaching about the test? 1 Identifies the number of CD4 cells that are in the blood 2 Shows how much of the HIV virus is present in the blood 3 Takes several days for results to be complete and reported 4 Detects antibodies to HIV and may not detect acute infection

4 (Because initial screening for HIV detects antibodies to HIV, which take several weeks to months to develop, the common screening tests may not detect early acute HIV infection. CD4 cell count is monitored to determine progression of HIV and effectiveness of treatment, but it is not used for screening. Viral load testing shows the amount of HIV virus in the blood and is used to detect disease progression and effectiveness of treatment. The screening test results are typically available in about 30 minutes, not several days)

For which medication would the nurse monitor the serum creatinine and blood urea nitrogen (BUN) levels, when administered to a client receiving therapy for extensive burn wounds? 1 Nitrofurantoin 2 Mafenide acetate 3 Silver sulfadiazine 4 Gentamicin sulfate

4 (Gentamicin sulfate may cause nephrotoxicity in the client; therefore the nurse would monitor the client prescribed this medication for serum creatinine and BUN changes. The nurse monitors the client on nitrofurantoin for signs of allergic reactions. Mafenide acetate requires monitoring of blood gases and serum electrolyte levels. In clients who are on silver sulfadiazine, the nurse monitors the wounds for infections.)

Which action would be the nurse's priority of care for a client with hypothermia? 1 Administering electrolytes 2 Monitoring body temperature 3 Increasing the temperature of the room 4 Removing the client from the cold environment

4 (Hypothermia is associated with a decrease in core body temperature, which requires interventions that lead to an increase in the client's internal body temperature. The client should be first removed from the cold environment. Electrolytes should be administered once the client's temperature is controlled. Monitoring the client's temperature is performed during ongoing assessments after providing initial treatment. Increasing the room temperature should be done after the client is removed from the cold environment.)

Which statement regarding interventions for clients with inhalation burns shows a nurse needs further education? 1 "I would administer intravenous analgesia." 2 "I would prepare for an endotracheal intubation." 3 "I would anticipate the need for a fiberoptic bronchoscopy." 4 "I would immediately calculate the burned surface area with the rule of nines."

4 (Inhalation injury burns occur in the nose, mouth, throat, and airway. The nurse would administer intravenous analgesia and anticipate both endotracheal intubation and a need for fiberoptic bronchoscopy. Inhalation burns are not visible or limited to the nose, mouth, throat, and airway; there are not any calculations, because the surface area is internal.)

A client with human immunodeficiency virus (HIV) reports dyspnea on exertion, increased heart rate, a persistent dry cough, and a persistent low-grade fever. The nurse auscultates bilateral crackles in the lower lung lobes. Which organism would the nurse suspect is responsible for this condition? 1 Cryptosporidium 2 Candida albicans 3 Toxoplasma gondii 4 Pneumocystis jiroveci

4 (Pneumocystis jiroveci causes pneumonia, which is the most common opportunistic infection in clients infected with the human immunodeficiency virus (HIV). Symptoms of Pneumocystis jiroveci pneumonia include dyspnea on exertion, tachypnea, a persistent dry cough, and a persistent low-grade fever. An auscultation of the breath sounds indicates crackles. Cryptosporidium causes diarrhea and weight loss. Candida albicans causes mouth pain and difficulty swallowing. Toxoplasma gondii causes speech and vision difficulty.)

A client who sustained burn injuries due to a fire and an explosion has a carbon monoxide level of 14%. Which pathophysiological risk is increased in the client? 1 Stupor 2 Vertigo 3 Convulsions 4 Slight breathlessness

4 (Slight breathlessness may occur when the carbon monoxide level is 14%. Stupor and vertigo may result when the carbon monoxide level is in between 21% and 40%. When the level of carbon monoxide reaches between 41% and 60%, coma or convulsions may occur.)

Upon assessment of a client with human immunodeficiency virus (HIV), the nurse discovers red to purple skin lesions on the client's neck, arms, and chest (see image). Which virus presents skin lesions as pictured? 1 Parvovirus 2 Papillomavirus 3 Varicella-zoster virus 4 Herpesvirus 8 (HHV-8)

4 (The image represents Kaposi sarcoma (KS). Human herpesvirus 8 (HHV-8) is associated with KS in immunosuppressed clients. Parvovirus causes gastroenteritis. Papillomavirus causes warts. Varicella-zoster causes chickenpox and shingles.)

The nurse is educating a client on combination antiretroviral (cART) in the management of human immunodeficiency virus (HIV). Which statement by the client indicates the need for further teaching? 1 "I must take all doses of the medications as scheduled." 2 "I will notify the health care provider of any fever." 3 "All three medications must be taken to prevent medication resistance." 4 "These antiretroviral medications will cure my HIV infection."

4 (The use of cART inhibits viral replication but does not kill the virus. Clients will be instructed to take all scheduled doses, notify the health care provider of any fever, and take all three medications in the regimen to prevent resistance and worsening infection.)

The nurse is caring for a client during the first few hours after admission to the burn unit with full-thickness burns of the trunk and head. Which nursing goal is the priority during the emergent phase of this injury? 1 Preventing pain 2 Managing leukopenia 3 Preventing infection 4 Managing fluid loss

4 (There are massive fluid shifts during the emergent (resuscitation) phase of burns; fluid balance is the priority. A full-thickness burn will not feel pain during the emergent phase. The leukocyte count is not affected in the first few hours. Although infection is a possibility, its prevention is not the priority goal; fluid balance is the priority.)

The nurse teaches a client with acquired immunodeficiency syndrome (AIDS) to avoid consuming undercooked meat as a means of preventing which infection? 1 Tuberculosis (TB) 2 Cryptococcosis 3 Cryptosporidiosis 4 Toxoplasmosis encephalitis

4 (Toxoplasma gondii causes toxoplasmosis encephalitis, which may occur due to the ingestion of infected undercooked meat or contact with contaminated cat feces. Mycobacterium tuberculosis causes TB and spreads by airborne routes. Cryptococcosis is caused by Cryptococcus neoformans located in the soil or bird feces; inhalation of the dust causes a debilitating meningitis and can be a widely spread infection in AIDS. Cryptosporidiosis is an intestinal infection caused by Cryptosporidium (parasite) organisms and spread through human or animal feces.)

Which organism is consistent with a protozoal infection in clients with acquired immunodeficiency syndrome (AIDS)? 1 Candidiasis 2 Tuberculosis 3 Cryptococcosis 4 Toxoplasmosis

4 (Toxoplasmosis is a protozoal infection in the AIDS client and an AIDS-defining condition in adults. Candidiasis is an indication of fungal infection. Tuberculosis is a bacterial infection. Cryptococcosis is a fungal infection.)

Which instruction indicates a lack of understanding of a nurse teaching a human immunodeficiency virus (HIV)-positive client about strategies to prevent opportunistic infections? 1 "Reuse cups after washing them with warm soapy water." 2 "Rinse your toothbrush in liquid laundry bleach every week." 3 "Wash your armpits, groin, and genitals with antimicrobial soap twice a day." 4 "Purchase organic, unpasteurized apple cider for your vitamin C requirements."

4 (Unpasteurized fruit juices or milk may harbor bacteria harmful to a weakened immune system. The client should refrain from reusing cups without washing them. Weekly rinsing of a toothbrush in liquid laundry bleach helps prevent infectious pathogens from accumulating on the brush. The armpits, groin, and genitals tend to house higher amounts of microorganisms and should be cleaned twice a day with antimicrobial soap.)

Which nursing action would be included in the plan of care to promote the nutritional status of a client during the acute phase of treatment after extensive burns? 1 Provide a diet high in sodium. 2 Limit caloric intake to decrease the work of the body. 3 Reduce protein intake to avoid overtaxing the kidneys. 4 Administer the prescribed intravenous fluid with the added vitamin C

4 (Vitamin C is essential for wound healing. It provides a component of intercellular ground substance that develops into collagen and is necessary to build supportive tissue. To prevent excessive fluid retention, which will increase the cardiovascular workload, sodium intake should be regulated. Decreasing calories will promote catabolism of body tissue; caloric need is increased. Protein intake should be increased to help repair damaged tissue.)

Which client with human immunodeficiency virus (HIV) exhibits the clinical manifestations associated with a Histoplasma capsulatum infection? 1 Client A: bloody diarrhea, gastric pain, weight loss 2 Client B: white/yellow patches in mouth, esophagus, & vagina 3 Client C: jaundice, fatigue, abd pain, loss of appetite, dark urine 4 Client D: nonproductive cough, hypoxemia, elevated temp, weight loss

D (The client with a nonproductive cough, hypoxemia, weight loss, and elevated body temperature may have pneumonia resulting from an opportunistic Histoplasma capsulatum infection. The client with bloody diarrhea, gastric pain, and weight loss, may have Cytomegalovirus-induced gastritis. The client with whitish-yellow patches in the mouth, esophagus, and vagina may have a Candida albicans infection. The client with jaundice, fatigue, abdominal pain, loss of appetite, and dark urine may have hepatitis C.)