Unit 5 Exam
Rank the safety of sexual practices with 1 being the safest practice and 6 being the least safe. Mutual masturbation with latex gloves Oral sex without condoms Abstinence Vaginal sex with male condom use Monogamy Unprotected anal sex
1. Abstinence 2. Monogamy 3. Mutual masturbation with latex gloves 4. Vaginal sex with male condom use 5. Oral sex without condoms 6. Unprotected anal sex
Which clinical findings does the nurse anticipate a client with an exacerbation of multiple sclerosis to experience? SATA 1. Double vision 2. Resting tremors 3. Flaccid paralysis 4.Scanning speech 5. Mental retardation
1. Double vision 4.Scanning speech
A client with multiple sclerosis tells the unlicensed assistive personnel (UAP) after physical therapy that she is too tired to take a bath. What is the priority nursing concern at this time? 1. Fatigue 2. Inability to perform activities of daily living (ADLs) 3. decreased mobility 4. muscular weakness
1. Fatigue
Which statement by a client with multiple sclerosis indicates to the nurse that the client needs further teaching? 1. "I use a straw to drink liquids." 2. "I will take a hot bath to help relax my muscles." 3. "I plan to use an incontinence pad when I go out." 4. "I may be having a rough time now, but I hope tomorrow will be better."
2. "I will take a hot bath to help relax my muscles."
A recently hospitalized client with multiple sclerosis is concerned about generalized weakness and fluctuating physical status. What is the priority nursing intervention for this client? 1. Encourage bed rest 2. Space activities throughout the day 3. Teach the limitations imposed by the disease 4. Have one of the client's relatives stay at the beside
2. Space activities throughout the day
A client with multiple sclerosis is in remission. Which diversional activity should the nurse encourage that best meets the client's needs while in remission? 1. Hiking 2. Swimming 3. Computer classes 4. Watching television
2. Swimming
The nurse is reviewing the lab results of a patient with systemic lupus erythematosus. Which lab test is most likely to be a false positive? A. Elevated erythrocyte sedimentation rate B. Positive syphilis test C. Positive TB test D. Increase in components of CBC
B. Positive syphilis test
A nurse is planning to provide discharge teaching to the family of a client with AIDS. Which statement should the nurse include in the teaching plan? A. "Wash used dishes in hot, soapy water" B. "Let dishes soak in hot water for 24 hours before 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. "Wash used dishes in hot, soapy water"
The patient with rheumatoid arthritis suffers a subluxation of the first and second vertebrae. What should the nurse do first, before immediately notifying the health care provider? A. Assess respiratory status and apply oxygen as needed. B. Assess for loss of sensation of loss of movement in the extremities. C. Assess for pain that radiates down the arm and check pulses. D. Assess for change in mental status and orient the patient.
A. Assess respiratory status and apply oxygen as needed
Although eh etiology of rheumatoid arthritis is unknown, it is considered to be what type of disorder? A. Autoimmune disease B. Disease associated with aging C. Genetic disorder D. Trauma disorder
A. Autoimmune disease
Which laboratory results are expected to decrease in a patient who has untreated HIV/AIDS? SATA A. CD4+ B. CD8+ C. White blood cell count D. Lymphocytes E. HIV antibodies F. Viral load
A. CD4+ C. White blood cell count D. Lymphocytes
Patients with ankylosing spondylitis have risk for which condition? A. Compromised respiratory function B. Cardiac arrhythmias C. Hip pain with osteoecrosis D. Dysphagia and decreased gag reflex
A. Compromised respiratory function
Which age-related change increase the likelihood that the older adult will develop the infection after an HIV exposure? A. Decline in the overall efficiency of the immune system B. Belief that HIV is not an issue for older people C. Reluctance to seek treatment for sexual problems D. Mistaking signs/symptoms as normal part of aging
A. Decline in the overall efficiency of the immune system
A patient is diagnosed with Pneumocystis jiroveci pneumonia. Which signs/symptoms does the nurse expect to find when assessing the patient? A. Dyspnea, tachypnea, persistent dry cough, and fever B. Cough with copious thick sputum, fever, and dyspnea C. Substernal chest pain and difficulty swallowing D. Fever, persistent cough, and vomiting blood
A. Dyspnea, tachypnea, persistent dry cough, and fever
The nurse is reviewing the CBC results of a patient wit RA. The results show a low hemoglobin, hematocrit and RBC. Based on these lab results, which interventions is the nurse most likely to implement? A. Encourage rest and ensure rest periods between activities and therapies. B. Instruct the patient to drink extra fluids and to fully consume meals and snacks. C. Instruct UAP to handle the patient carefully to prevent bruising. D. Encourage the patient to ambulate in the hall at least three times during the shift.
A. Encourage rest and ensure rest periods between activities and therapies.
A patient is an IV drug user who regularly shares needles and syringes with friends. What information does the nurse provide to decrease the patient's risk of HIV through shared needles and syringes after each use? A. Fill and flush needle and syringes with water, then fill syringe with bleach, shake approximately 30-60 seconds, and rinse with water B. Fill and flush needle and syringe with water, then fill syringe with soap and hot water, shake 2 minutes, and rinse with cold water C. Soak needles and syringes after each use in a bleach and hot water solution overnight, and then allow to air dry D. Never reuse needles; rinse syringes after each use with rubbing alcohol or bleach solution, and then rinse them with hot water
A. Fill and flush needle and syringes with water, then fill syringe with bleach, shake approximately 30-60 seconds, and rinse with water
Which patient reported symptoms would typify early rheumatoid arthritis? A. I feel tired and weak. B. I fell like my hands are burning. C. I have severe stiffness in the morning. D. I have gained a lot of weight.
A. I feel tired and weak.
Which treatment modalities might the nurse expect for a patient who is undergoing nonsurgical management of chronic joint pain? SATA A. Immobilization to promote rest B. Weight control C. Exercise balanced with rest D. Thermal modalities E. Limit foods and liquids that contain calcium F. Home traction
A. Immobilization to promote rest B. Weight control C. Exercise balanced with rest D. Thermal modalities
A nurse is caring for a client who is HIV positive. For which complication associated with this diagnosis is it most important for the nurse to teach prevention strategies? A. Infection B. Depression C. Social isolation D. Kaposi sarcoma
A. Infection
The HIV-positive patient is receiving combination antiretroviral therapy drugs. Why is it essential that the drugs be taken every day at the same time? A. Missing or delaying doses decreases the blood concentration needed to inhibit viral replication B. Missing or delaying doses decreases the risk of developing opportunistic mutations C. Missing or delaying doses decreases the effectiveness of the viral replication D. Missing or delaying doses decreases the risk of developing HIV resistant mutations
A. Missing or delaying doses decreases the blood concentration needed to inhibit viral replication
Which nursing actions can the nurse delegate to unlicensed assistive personnel who will be giving mouth care to a patient with HIV/AIDS? SATA A. Offer the patient mouth rinses with sodium bicarbonate and sterile water several times a day B. Assess the patient's mouth for increased presence of sores or white plaques C. Encourage the patient to drink plenty of fluids D. Assist the patient to brush teeth with a soft toothbrush E. Apply an oral analgesic gel to gums as needed F. Offer an alcohol-based mouthwash if patient reports "funny" taste in mouth
A. Offer the patient mouth rinses with sodium bicarbonate and sterile water several times a day C. Encourage the patient to drink plenty of fluids D. Assist the patient to brush teeth with a soft toothbrush
Which patient is manifesting signs/symptoms that are likely to be associated with connective tissue disease? A. Patient has chronic pain, decreased function, and joint deterioration. B. Patient has cardiac dysthymias and occasional chest pain. C. Patient has acute back pain after exercise and exertion. D. Patient has poor skin turgor and sluggish capillary refill.
A. Patient has chronic pain, decreased function, and joint deterioration.
The nurse hears in shift report that the patient has toxoplasmosis encephalitis. The nurse is most likely to perform which types of focused assessments? A. Perform a mental status examination and assess for headache B. Auscultate heart sounds and monitor for cardiac arrhythmias C. Palpate the abdomen for tenderness and listen for bowel sounds D. Monitor intake and urine output and palpate the bladder
A. Perform a mental status examination and assess for headache
The home health nurse is assisting a family who lives with and cares for a member who is HIV positive. Which item would the nurse instruct the family not to share in order to decrease the risk of accidental exposure to HIV? A. Safety razor B. Household utensils C. Towels D. Toilets
A. Safety razor
Which practices are generally recommended to prevent sexual transmission of HIV? SATA A. Use of latex or polyurethane condoms for genital and anal intercourse B. Use of natural-membrane condoms for genital and anal intercourse C. Use of an appropriate water-based lubricant with a latex condom D. Use of antiviral medications taken on a precise schedule E. Use of a latex barrier for genital and anal intercourse F. Use of latex gloves for finger or hand contact with the vagina or rectum
A. Use of latex or polyurethane condoms for genital and anal intercourse C. Use of an appropriate water-based lubricant with a latex condom E. Use of a latex barrier for genital and anal intercourse F. Use of latex gloves for finger or hand contact with the vagina or rectum
Which conditions may be the first signs of HIV in women? SATA A. Vaginal candidiasis B. Bladder infection C. Spontaneous abortion D. Pelvic inflammatory disease E. Mononucleosis F. Genital herpes
A. Vaginal candidiasis D. Pelvic inflammatory disease F. Genital herpes
The nurse is orienting a newly graduated RN to the medical unit. Which point should be included about protecting self from HIV exposure when caring for patients? A. Wear gloves when in contact with patient's mucous membranes or non-intact skin B. Wear full protective gear when providing nay care to HIV-positive patients C. Always wear a mask when entering an HIV-positive patient's room D. Talk to the employee health nurse about starting preexposure prophylaxis
A. Wear gloves when in contact with patient's mucous membranes or non-intact skin
HIV is most commonly transmitted by which routes? SATA A. Oral B. Sexual C. Parenteral D. Airborne E. Perinatal F. Enteral
B. Sexual C. Parenteral E. Perinatal
The patient with HIV has pain and burning along sensory nerve tracts, and the nurse observes fluid-filled blisters and crusts. Which question is the nurse most likely to ask to assist the healthcare provider in making the diagnosis of shingles caused by the varicella zoster virus? A. "Are you allergic to any types of antibiotics?" B. "Did you have chickenpox during childhood?" C. "Are you having trouble with your vision?" D. "Did you notice any pruritus or perineal irritation?"
B. "Did you have chickenpox during childhood?"
A young male has just be diagnosed as HIV positive. He tells the nurse that he suspects contracting the virus from a female several weeks ago and that he had sex with his girlfriend several says ago. What is the nurse's best response? A. "The virus needs time to replicate, so your girlfriend is probably okay, but she should get tested" B. "Even in the early phases, it is possible to pass the HIV virus; both women should be notified" C. "HIV always progresses to AIDS. You and your girlfriend need to start medication right away" D. "You should tell your girlfriend about being HIV positive, the health department will contact the other woman"
B. "Even in the early phases, it is possible to pass the HIV virus; both women should be notified"
The nurse is teaching a group of college students about preventing HIV infection through sexual contact. Which statement made by one of the students indicates effective teaching? A. "A latex condom with spermicide provides the best protection against getting infection with HIV" B. "Mutually monogamous sex with a non-infected partner is the best method to prevent HIV infection" C. "Contraceptive methods like implants and injections are recommended to prevent HIV transmission" D. "If my same sex partner and I are both HIV positive, then there is no point in using a condom"
B. "Mutually monogamous sex with a non-infected partner is the best method to prevent HIV infection"
The unlicensed assistive personnel comes to the nurse crying and upset because "Some of the patient's spit got on my arm when I was helping him with oral hygiene, and he is HIV positive." What is the nurse's best response? A. "You'll be okay; don't worry about it. A little bit of saliva is no big deal" B. "Wash your arm; saliva is not infectious with HIV unless it is bloody" C. "Let's use chlorohexidine to wash your arm and send you for HIV testing" D. "Did you wash your arm? Next time, stand back during the swish and spit"
B. "Wash your arm; saliva is not infectious with HIV unless it is bloody"
The patient with HIV/AIDS appears emaciated and has diarrhea, anorexia, mouth lesions, and persistent weight loss. What conditions does the nurse suspect this patient is developing? A. AIDS dementia complex B. AIDS wasting syndrome C. AIDS gastrointestinal opportunistic infection D. AIDS candidiasis opportunistic infection
B. AIDS wasting syndrome
The patient with HIV/AIDS develops manifestations of tuberculosis. What type of precautions does the nurse institute at this time? A. Standard precautions B. Airborne precautions C. Enteric precautions D. Neutropenic precautions
B. Airborne precautions
For a patient with Reiter's syndrome, besides asking about joint pain, which additional question would the nurse ask? A. Is there any chance that you were bitten by an insect? B. Are you having pain or burning with urination? C. Do you have family history of arthritis? D. Do you get short of breath after minor exertion?
B. Are you having pain or burning with urination?
A pregnant woman who is HIV-positive arrives at the labor and delivery unit and in active labor. The patient tells the nurse that she has been consistently taking her antiretroviral therapy but did not have access to prenatal care. Which situation is the labor and delivery nurse most likely to prepare for? A. Birth of a distressed infant who is likely to manifest opportunistic infections B. Birth of a premature infant who is likely to have a low birth weight C. Excessive bleeding and high risk for septicemia in the mother D. A vaginal delivery with isolation precautions for the infant
B. Birth of a premature infant who is likely to have a low birth weight
The patient tells the nurse that he has been taking glucosamine for joint pain. Which physical finding is cause for greatest concern? A. Patient is 15 lbs overweight B. Blood pressure is 150/80 C. Resting pulse is 90/min D. Patient has a light red rash
B. Blood pressure is 150/80
Based on the nurse's knowledge of the most common cause of death for patients with systemic lupus erythematosus which lab rests will the nurse closely monitor when caring for these patients? A. Cardiac enzymes and sedimentation rate B. Blood urea nitrogen and creatinine C. Complete blood count and platelet count D. Liver enzymes and cholesterol levels
B. Blood urea nitrogen and creatinine
What is the most important means of preventing HIV spread or transmission? A. Genetic research B. Education C. Medication therapy D. Standard precaution
B. Education
The nurse sees an increased number of periungual lesions on a patient with RA and reports this vascular change to the HCP. What is the best rationale for reporting this finding? A. The nurse should always report any unusual findings to the health care provider. B. If arterial involvement is occurring major organs can become ischemic. C. The brownish spots affect body image but will readily resolve with treatment. D. The lesions will eventually ulcerate and become infected.
B. If arterial involvement is occurring major organs can become ischemic.
A mother with the diagnosis of AIDS states that she has been caring her baby even though she has not been felling well. What important information should the nurse determine? A. If she has kissed the baby B. If the baby is breastfeeding C. When the baby last received antibiotics D. How long she has been caring for the baby
B. If the baby is breastfeeding
A patient with systemic lupus erythematosus is prescribed a relatively new drug, belimumab. Which concept will the nurse use to emphasize important teaching points about this medication? A. Comfort B. Immunity C. Mobility D. Oxygenation
B. Immunity
The patient with AIDS come to the emergency department and reports a cough, dyspnea, chest pain, fever, chills, night sweats, weight loss, and anorexia. He tells the nurse that he recently had a tuberculosis (TB) skin test (purified protein derivative [PPD]), which was negative. What should the nurse do first? A. Complete the assessment and notify the health care provider B. Initiate airborne precautions and assess respiratory status C. Seek out validation of the patient's negative PPD test results D. Obtain order for automated nuclei acid amplification test for TB
B. Initiate airborne precautions and assess respiratory status
Which assessment finding indicates to the nurse that the patient is experiencing early rheumatoid arthritis? A. Joint deformities B. Joint inflammation C. Weight loss D. Subcutaneous nodules
B. Joint inflammation
The healthcare provider tells the nurse that the patient is considered Stage I according to the Center for Disease Control and Prevention case definition for HIV disease. What would the nurse expect to find when assessing the patient? A. Signs/symptoms associated with Kaposi's sarcoma B. No signs/symptoms of AIDS-defining illness C. Respiratory symptoms due to pneumonia D. Symptoms of AIDS wasting syndrome
B. No signs/symptoms of AIDS-defining illness
Based on the concept of Treatment as Prevention, which outcome statement indicates that the goal of combination antiretroviral therapy is being met? A. Patient states understanding of medication regimen B. Patient's viral load is at an undetectable level C. Patient is classified as Stage Unknown D. Patient has no signs of opportunistic infection
B. Patient's viral load is at an undetectable level
What can be expected for a patient with recently diagnosed systemic lupus erythematosus? A. Frequent acute inflammatory episodes B. Spontaneous remissions and exacerbations C. Symptoms similar to OA D. Frequent infections and reduced immune response
B. Spontaneous remissions and exacerbations
Which statements about the transmission of HIV are true? SATA A. HIV may be transmitted only during the end stages of the disease B. Those with recent HIV infection and high viral load are very infectious C. Those with end-stage HIV and no drug therapy are very infectious D. HIV is transmitted through touching an infected person E. All people infected with HIV can easily infect others F. An undetectable viral load requires greater multiple exposures
B. Those with recent HIV infection and high viral load are very infectious C. Those with end-stage HIV and no drug therapy are very infectious F. An undetectable viral load requires greater multiple exposures
The health care provider informs the nurse that the patient has a joint effusion of the right knee. What is the nurse most likely to find during physical assessment of the knee? A. Hard bony protrusion palpated at the joint space B. Tightness during flexion and extension of knee C. Inability to independently stand or walk D. Dry, red, scaly skin over the knee that itches and flakes
B. Tightness during flexion and extension of knee
A patient is diagnosed with HIV is receiving combination antiretroviral therapy. Which laboratory test is the best for determining the effectiveness of the therapy? A. Western blot analysis B. Viral load testing C. Enzyme-linked immunosorbent assay D. 4th generation testing
B. Viral load testing
The healthcare provider prescribed an integrase inhibitor drug for the patient with HIV. The patient asks the nurse how this drug works. What is the nurse's best response? A. "It reduces efficiency of converting human genetic material into HIV genetic material" B. "It reinforces your immune system's ability to fight off an HIV infection" C. "It prevents viral deoxyribonucleic acid (DNA) from integrating into your DNA" D. "It will prevent your HIV infection from progressing to AIDS"
C. "It prevents viral deoxyribonucleic acid (DNA) from integrating into your DNA"
The HIV-positive patient tells the nurse that his HIV-negative partner will be using preexposure prophylaxis (PrPE) emtricitab. Which statement indicates to the nurse the need for additional teaching about this drug? A. "My partner will need to be tested for HIV every 3 months" B. "This drug will decrease the chances of my partner becoming HIV-positive" C. "Once we start using emtricitab I will no longer need to use a condom" D. "My partner will need to be monitored for any side effects of this drug"
C. "Once we start using emtricitab I will no longer need to use a condom"
A client asks the nurse, "Should I tell my partner that I just found out I'm HIV positive?" What is the nurse's most appropriate response? A. "This is a decision you alone can make" B. "Do not tell your partner unless asked" C. "You are having difficulty deciding what to say" D. "Tell your partner that you don't know how you became sick"
C. "You are having difficulty deciding what to say"
Although there is a wide range of time from beginning of HIV infection to the development of AIDS, which patient is most likely to develop AIDS very quickly? A. Adult female who has one-time sex with an HIV-positive partner B. Older male who has vaginal sex with an HIV-positive female C. Adult male who is transfused with HIV-contaminated blood D. Older nurse who is stuck by HIV-contaminated needle at work
C. Adult male who is transfused with HIV-contaminated blood
The UAP tells the nurse that the patient with RA is increasingly manipulative and demanding and trying to meet the patient's requests in interfering with the care of other patients. What is he best action of the nurse to take? A. tell the UAP to ignore the demands, complete assigned tasks, and go on to other patients. B. Inform the patient that the UAP has additional duties and has a fixed amount of time per patient. C. Assess patient behaviors and help the patient to focus on realistic goals and coping strategies. D. Temporarily perform the UAP duties until boundaries and expectations are established.
C. Assess patient behaviors and help the patient to focus on realistic goals and coping strategies.
What is the most common area of involvement of rheumatoid arthritis in the spine? A. Lumbar spine B. Sacral spine C. Cervical spine D. Thoracic spine
C. Cervical spine
The nurse reads in the chart that the patient has Candida stomatitis. Which concept is the nurse most likely to consider in planning interventions for this patient? A. Gas exchange B. Cellular regulation C. Comfort D. Elimination
C. Comfort
A patient who has HIV/AIDS and tuberculosis (TB) was recently started on the combination antiretroviral therapy (cART) regimen. The TB symptoms worsen and the nurse informs the healthcare provider, who makes the diagnosis of immune reconstitution inflammatory syndrome (IRIS). Which therapy is the provider most likely to order to treat IRIS? A. Bronchodilators B. Adjustment of cART C. Corticosteroids D. Anti-tubercular drugs
C. Corticosteroids
A patient comes to the clinic because he thinks he may have lyme disease. What is the most important question to ask to assist the health care provider in determining if Lyme disease is the correct diagnosis? A. Have you had flu like symptoms? B. Do you notice stiffness in your joints? C. Did you notice a bull's-eye-shaped lesion? D. Have you had any facial drooping?
C. Did you notice a bull's-eye-shaped lesion?
The nurse is assessing the skin of a patient with systemic lupus erythematosus. What is the nurse most likely to notice about the skin? A. Small, brownish spots around the nail bed B. Generalized hardening of the skin C. Dry, scaly, raised rash on the face D. Raynaud's phenomenon
C. Dry, scaly, raised rash on the face
The patient with HIV/AIDS tells the nurse that food tastes funny and it is difficult to swallow. What is the nurse's priority action at this time? A. Instruct the unlicensed assistive personnel to assist patient with oral hygiene B. Place the patient in a high Fowler's and restrict oral intake C. Examine mouth and throat for white plaques or inflammation D. Collaborate with the dietitian to provide a soft diet
C. Examine mouth and throat for white plaques or inflammation
The nurse is teaching a patient about the common side effects of long term salicylate and non steroidal anti inflammatory therapy. Which body system side effects does the nurse focus on in the teaching plan? A. Central nervous system B. Skin C. Gastrointestinal D. Cardiovascular
C. Gastrointestinal
A nurse is caring for a client with a diagnosis of AIDS. The IV infiltrates and needs to be restarted. What is necessary to protect the nurse when restarting the IV? SATA A. Mask B. Gown C. Gloves D. Face shield E. Hand hygiene
C. Gloves E. Hand hygiene
During an AIDS education class a client states, "Vaseline works great when I use condoms." Which conclusion about the client's knowledge of condom use can the nurse draw from this statement? A. An understanding of safer sex B. An ability to assume self-responsibility C. Ignorance related to correct condom use D. Ignorance concerning the transmission of HIV
C. Ignorance related to correct condom use
The nurse is caring for a patient with systemic lupus erythematosus who is having a flare-up of the condition. Which abnormal vital sign is a classic sign for an exacerbation. A. Increased BP B. Decreased pulse C. Increased temperature D. Decreased respirations
C. Increased temperature
The nurse reads in the documentation that the patient with rheumatoid arthritis may have Sjogren's syndrome. Which assessment is the nurse most likely to perform to validate this documentation? A. Weigh the patient and compare weight to baseline. B. Take the temperature and assess for signs of infection. C. Inspect mouth for dry sticky membranes and eyes for redness. D. Observe for joint contractures and loss of range of motion.
C. Inspect mouth for dry sticky membranes and eyes for redness.
The nurse is caring for a patient with rheumatoid arthritis who just had arthrocentesis. What is the priority intervention? A. Assess frequently for post procedural pain and ensure optimal pain relief. B. Place the patient in a prone position and elevate the extremity. C. Monitor the inception site for bleeding or leakage of synovial fluid. D. Teach and encourage leg, gluteal, and quadriceps setting exercises.
C. Monitor the inception site for bleeding or leakage of synovial fluid.
When a patient has rheumatoid arthritis of the temporomandibular joint, what is the major complain? A. Toothache on the affected side B. headache in the temple area C. Pain on chewing and opening the mouth D. Earache on the affected side
C. Pain on chewing and opening the mouth
A patient with RA may need to undergo vernal anesthesia for a hip replacement. Which information needs to be brought to the immediate attention of the surgeon before the procedure is scheduled? A. Patient has a previous history of joint surgery on the affected side. B. Patient has been taking vitamin C and nonsteroidal anti-inflammatory drugs for years. C. Patient has cervical spine disease and has not had any recent spinal x rays. D. Patient fears that the procedure will cause complications because of the RA.
C. Patient has cervical spine disease and has not had any recent spinal x rays.
A patient who is HIV positive has been taking combination antiretroviral therapy (cART) for several years. Today the nurse sees that the test results show a CD4+ T-cell count of less than 200 cells/mm. Which intervention is the nurse most likely to perform? A. Reinforce patient's successful compliance with medication regimen B. Assess patient's understanding of the importance of medication schedule C. Provide emotional support when patient is informed about AIDS diagnosis D. Emphasize need to practice safe sex because risk of transmission is high
C. Provide emotional support when patient is informed about AIDS diagnosis
The nurse is assessing a patient whose lifestyle creates a high risk for HIV/AIDS. Which assessment is the nurse most likely to perform to differentiate HIV from AIDS? A. History of substance or alcohol abuse B. History of any occupational exposure to HIV C. Signs/symptoms of opportunistic infections D. Practice of safe versus risk sexual behaviors
C. Signs/symptoms of opportunistic infections
The patient with rheumatoid arthritis expresses uncertainty about the disease process and fear of becoming dependent. What is the nurse's best response? A. You'll be okay. very few people with RA actually become wheelchair bound. B. Do you have anyone to help you when you can't take care of yourself? C. Tell me what you know about living with RA and the treatment options. D. So, you are feeling afraid and uncertain. That seems normal to me.
C. Tell me what you know about living with RA and the treatment options
What is a clinically significant feature for patients who are identified as non-progressive? A. They rarely ever convert to full-blown AIDS B. They do not transmit virus to sexual partners C. Viral load is either undetectable or very low D. Opportunistic infections never manifest
C. Viral load is either undetectable or very low
A client who abused intravenous drugs was diagnosed with the human immunodeficiency virus (HIV) several years ago. The nurse explains that the diagnostic criterion for acquired immunodeficiency syndrome (AIDS) has been met when the client: A. contracts HIV-specific antibodies B. develops acute retroviral syndrome C. is capable of transmitting the virus to others D. has a CD4+ T lymphocyte level of less than 200 cells/ul
D. has a CD4+ T lymphocyte level of less than 200 cells/ul
Which person should be advised to have periodic screening for HIV? A. An 18-year-old college student who recently starting dating a new person B. A 65-year-old widower who may be moving in with a homosexual friend C. A 28-year-old woman who plans to get pregnant in a few years D. A 23-year-old man who plans to enjoy serial monogamy for a few years
D. A 23-year-old man who plans to enjoy serial monogamy for a few years
What is the best laboratory test to detect early rheumatoid arthritis? A. Rheumatoid factor B. Erythrocyte sedimentation rate C. Complete blood cell count D. Anti-cyclic citrullinated peptide
D. Anti-cyclic citrullinated peptide
The nurse is caring for a patient with AIDS who has been admitted for treatment of exacerbation of cryptosporidosis. What is the priority assessment for this patient? A. Assess breath sounds and monitor respiratory status B. Assess neurologic status and monitor for headaches C. Assess for difficulty in swallowing and pain behind the sternum D. Assess for signs of dehydration and monitor electrolytes
D. Assess for signs of dehydration and monitor electrolytes
The nurse is providing teaching for a patient with RA who is receiving methotrexate. Which teaching point must the nurse include? A. medication is taken every morning on an empty stomach. B. Avoid driving or operating heavy machinery. C. Expect some increase in swelling while taking this medication. D. Avoid crowds of people and people who are ill.
D. Avoid crowds of people and people who are ill
What is the most common route for healthcare providers to be exposed to the HIV virus? A. Getting blood on exposed skin of hands or arms B. Touching infected body fluids with bare hands C. Having body fluid splashed on mucous membranes D. Getting stuck with a contaminated needle
D. Getting stuck with a contaminated needle
The patient is taking hydroxychloroquine for RA. Which patient statement is cause for greatest concern? A. I seem to have a mild stomach discomfort when I take this medication. B. I get kind of light headed. I suppose I should stand up a little slowly. C. Could you give me a Tylenol or something mild? I have some muscle pain. D. I think I must need new glasses. Lately, my vision is really blurry.
D. I think I must need new glasses. Lately, my vision is really blurry.
In RA, autoantibodies are formed that attack healthy tissue, especially synovium, causing which condition? A. Nerve pain B. Bone porosity C. Ischemia D. Inflammation
D. Inflammation
The patient reports numbness or tingling on the lips that occurred 24 hours ago, and now there is a painful lesion. Which action is the nurse most likely to take? A. Ask the patient if he ate undercooked meat because of the potential exposure to Toxoplasma gondii B. Obtain an order for ketoconazole because patient is developing candidal esophagitis C. Check for fever and palpate lymph nodes because the patient may have histoplasmosis D. Instruct caregiver to wear gloves during oral hygiene because of suspected herpes simplex virus
D. Instruct caregiver to wear gloves during oral hygiene because of suspected herpes simplex virus
Which malignancy is most common in patients with HIV/AIDS? A. Non-Hodgkin's B-cell lymphoma B. Anal cancer C. Primary brain cancer D. Kaposi's sarcoma
D. Kaposi's sarcoma
A rheumatic disease is any condition of disease of which body systems? A. Cardiovascular B. Hematopoietic C. Integumentary D. Musculoskeletal
D. Musculoskeletal
What musculoskeletal health problem is often associated with rheumatoid arthritis? A. Paget's disease B. Lyme disease C. Marfan Syndrome D. Osteoporosis
D. Osteoporosis
Which groups are experiencing increased numbers of new HIV infections in the United States and Canada? A. White homosexual men and women B. Older heterosexual men and women C. Asian women who have sex with men D. Persons of color; African and Hispanic
D. Persons of color; African and Hispanic
Which lab test is the only significant test for diagnosing a patient with discord lupus? A. Antinuclear antibody B. Serum complement C. CBC D. Skin Biopsy
D. Skin Biopsy
A nursing student sustains a needle-stick from a hollow-bore needle while attempting to establish a peripheral intravenous (IV) catheter. What should the student do first? A. Finish the procedure and establish the IV B. Go to the employee clinic for postexposure prophylaxis C. Inform the nursing instructor or charge nurse D. Thoroughly scrub and flush the puncture site
D. Thoroughly scrub and flush the puncture site
What is the best rationale for the nurse to be familiar with the HIV infectious viral particle process? A. To help patients to identify the timeframe of greatest risk for infection B. To teach HIV positive patients about how they became infection with the virus C. To assist in identifying nonprogressors from those who will progress to AIDS D. To educate HIV patients about the importance of adhering to a medication schedule
D. To educate HIV patients about the importance of adhering to a medication schedule
Which person is the most likely candidate for combination antiretroviral therapy as postexposure prophylaxis? A. Person who routinely injects recreational drugs with friends B. Nursing student who was stuck with a needle from a known HIV-negative source C. College student who had consensual sex with an HIV-negative partner D. Woman who was raped by an assailant with unknown HIV status
D. Woman who was raped by an assailant with unknown HIV status
Which disorder could have a similar clinical presentation to multiple sclerosis? a. amyotrophic lateral sclerosis b. spinal cord tumor c. Guillain-barre' d. quadriplegia
a. amyotrophic lateral sclerosis
The nurse is caring for a patient who has a shunt for plasmapheresis. Which intervention related to the shunt does the nurse perform? a. assess for bruit or thrill every 2-4 hours b. flush the shunt with sterile normal saline c. wrap the shunt with a protective gauze dressing d. ensure that IV fluid is infusing at prescribed rate
a. assess for bruit or thrill every 2-4 hours
The nurse is teaching a patient with multiple sclerosis and her family about her exercise program. Which points must the nurse include? SATA a. range of motion exercises are an important component b. stretching should precede rigorous activity c. increased body temperature can lead to increased fatigue d. steadily increasing walking distances can lead to jogging e. stretching and strengthening exercises will be part of your program f. take your pain medication at least 30 minutes prior to exercise
a. range of motion exercises are an important component c. increased body temperature can lead to increased fatigue e. stretching and strengthening exercises will be part of your program
The home health nurse sees in the patient's record that he takes riluzole. Which question is the nurse most likely to ask? a. when were you first diagnosed with amyotrophic lateral sclerosis? b. has the mediation relieved any of the symptoms caused by multiple sclerosis? c. has your acute back pain returned to the more familiar chronic pain? d. have you always had neurogenic bladder problems since your spinal cord injury?
a. when were you first diagnosed with amyotrophic lateral sclerosis?
A patient reports increased fatigue and stiffness of the extremities. These symptoms have occurred in the past, but they resoled and no medical attention was sought. Which questions does the nurse ask to assess whether the symptoms may be associated with multiple sclerosis? SATA a. "are you having persistent headaches that occur with stress?" b. "do you have persistent sensitivity to temperature?" c. "do you ever have slurred speech or trouble swallowing?" d. "are you having trouble breathing with minor exertion?" e. "has anyone in your family been diagnosed with multiple sclerosis?" f. "do you have spasms at night that wake you from your sleep?"
b. "do you have persistent sensitivity to temperature?" c. "do you ever have slurred speech or trouble swallowing?" e. "has anyone in your family been diagnosed with multiple sclerosis?" f. "do you have spasms at night that wake you from your sleep?"
A patient with multiple sclerosis is prescribed oral fingolimod. Which key point must the nurse teach the patient about this drug? a. "you must be carefully monitored for allergic reactions because the drug tends to build up in the body." b. "we need to teach you how to monitor your pulse rate because this drug can cause a slow heart rate." c. "this drug will decrease the frequency of clinical relapses, but there is an increased risk for stroke." d. "the medication will improve your ability to walk, but it also increases the risk for seizure activity."
b. "we need to teach you how to monitor your pulse rate because this drug can cause a slow heart rate."
The patient with multiple sclerosis has dysarthria. What assessment would the nurse perform to monitor for a likely coexisting complication? a. watch the patient walk and note smoothness of movement b. check the patient's gag reflex and ability to swallow c. ask the patient to use a pencil to write a sentence d. have the patient stand and close eyes, and observe the patient for sway
b. check the patient's gag reflex and ability to swallow
The patient with multiple sclerosis states she is bothered by diplopia. Which intervention does the nurse expect to implement? a. obtain an order for consultation or referral for corrective lenses b. teach the patient scanning techniques, moving her head from side to side c. application of an eye patch alternating from eye to eye every few hours d. prophylactic bilateral patches to both eyes at night
c. application of an eye patch alternating from eye to eye every few hours
A patient tells the nurse, "I have the symptoms of multiple sclerosis (MS), and I have been dealing with them for so long! Why won't anyone help me?" Which intervention should the nurse employe first? a. help the patient to locate and make an appointment with a specialist b. ask the patient to describe the symptoms and past treatments c. encourage the patient to verbalize feelings and frustrations d. give the patient a brochure about the diagnosis and treatment of MS
c. encourage the patient to verbalize feelings and frustrations
The nurse has provided teaching to the husband of a 33 year old woman who was recently diagnosed with multiple sclerosis. Which statement by the patient's husband indicates he needs additional teaching on the course of the illness? a. "she could fall because she may lose her balance and have poor coordination." b. "eventually she will not be able tot drive because of vision problems." c. "she will probably have decreased libido and diminished orgasm." d. "as the disease progresses, she could have intermittent short-term memory loss."
d. "as the disease progresses, she could have intermittent short-term memory loss."
To assess the hypoglossal nerve (cranial nerve XII), what will the nurse ask the patient to do? a. blink eyelids and raise eyebrows b. read an eye chart or newspaper c. demonstrate a deep cough d. stick the tongue straight out
d. stick the tongue straight out
