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The ELISA test can be falsely negative if testing occurs after the client has become infected but prior to
making antibodies to HIV. This period of time is known as the window period and can last up to 36 months.
The nurse needs to assess the clients sexual behavior further to determine the proper response. The other
actions are not the most important, but discussing safer sex practices is always appropriate.
ANS: D
All of the actions are important, but due to the infectious nature of this illness, ensuring proper disposal of
soiled dressings is vital.
ANS: A
Truvada is a new drug used for pre-exposure prophylaxis and appears to reduce transmission of human
immune deficiency virus (HIV) from known HIV-positive people to HIV-negative people. The drug does not
reduce the need for practicing safe sex. Since the drug can lead to drug resistance if used, clients will still need
HIV testing every 3 months. This drug has not been taken off the market and is not used for postexposure
prophylaxis.
A,B, D A diagnosis of AIDS requires that the person be HIV positive and have either a CD4+ T-cell count of less than
200 cells/mm3 or less than 14% (even if the total CD4+ count is above 200 cells/mm3) or an opportunistic
infection such as Pneumocystis jiroveci and HIV wasting syndrome. Having a positive ELISA test and taking
antiretroviral medications are not AIDS-defining characteristics
A.
Fatigue is a common problem for clients with leukemia. This client is managing his or her own ADLs using
rest periods, which indicates an understanding of fatigue and how to control it. Helping to plan an activity
schedule is a lesser indicator. Requesting a sleeping pill does not help control fatigue during the day. Asking
visitors to leave when tired is another lesser indicator. Managing ADLs using rest periods demonstrates the
most comprehensive management strategy.
A
This client has possible multiple myeloma. A positive Bence-Jones protein finding would correlate with this
condition. The Epstein-Barr virus is a herpesvirus that causes infectious mononucleosis and some cancers. A
hemoglobin of 18 mg/dL is slightly high for a male and somewhat high for a female; this can be caused by
several conditions, and further information would be needed to correlate this value with a specific medical
condition. A red blood cell count of 8.2/mm3 is also high, but again, more information would be needed to
correlate this finding with a specific medical condition.
D
All the options are drugs used to treat multiple myeloma, but the drug used specifically for bone manifestations
is zoledronic acid (Zometa), which is a bisphosphonate. This drug class inhibits bone resorption and is used to
treat osteoporosis as well.
D
Although individuals with SCD often have elevated white blood cell (WBC) counts, this extreme elevation
could indicate leukemia, a complication of taking hydroxyurea. The nurse should report this finding
immediately. Alternatively, it could indicate infection, a serious problem for clients with SCD. Hematocrit and
hemoglobin levels are normally low in people with SCD. The potassium level, while slightly low, is not as
worrisome as the WBCs
C
During a sickle cell crisis, the tissue distal to the occlusion has decreased blood flow and ischemia, leading to
pain. Due to decreased blood flow, the clients legs will be cool or cold. The UAP can attempt to keep the
clients legs warm. Ice and elevation will further decrease perfusion. Elastic bandage wraps are not indicated
and may constrict perfusion in the legs.
A
The client who had two bloody diarrhea stools that morning may be hemorrhaging in the gastrointestinal (GI)
tract and should be assessed first. The client with the change in respiratory rate may have an infection or
worsening anemia and should be seen next. The other two clients are not a priority at this time.
Chemical and ionizing radiation exposure and viral infections are known risk factors for developing leukemia.
Eating genetically modified food and receiving vaccinations are not known risk factors.
C
Superior vena cava syndrome is often a late-stage manifestation. After the client is stabilized and comfortable,
the nurse should initiate a conversation about advance directives. Allopurinol is used for tumor lysis syndrome.
Potassium levels are important in tumor lysis syndrome, in which cell destruction leads to large quantities of
potassium being released into the bloodstream. Surgery is rarely done for superior vena cava syndrome.
Test your knowledge about the 5 seeing habits discussed in the text 'UPS 5 seeing habits'.