1. An older adult with no known cognitive impairment residing in a long-term care facility suddenly becomes disoriented and confused. There are no signs of extremity weakness or other neurological changes. Based on these observations, the nurse would focus the assessment in which priority body systems?

a) pulmonary and renal systemsb) reproductive and endocrine systemc) integumentary and neurological systemsd) cardiovascular and gastrointestinal systems

2. A female client arrives at the health care clinic and tells the nurse that she was just bitten by a tick and would like to be tested for Lyme disease. The client tells the nurse that she removed the tick and flushed it down the toilet. Which of the following nursing actions is most appropriate?

a) refer the client for blood test immediatelyb) inform the client that there is no test available for Lyme diseasec) tell the client that testing is not necessary unless arthralgia developsd) instruct the client to return in 4 to 6 weeks to be tested because testing before this time is not reliable

3. Following diagnosis of stage I Lyme disease, the nurse would anticipate that which of the following will be part of the treatment plan for the client?

a) no treatment unless symptoms developb) a 3-week course of oral antibiotic therapyc) daily oatmeal baths for 2 weeksd) treatment with intravenously administered antibiotics

4. A Cub Scout leader, who is a nurse preparing a group of Cub Scouts for an overnight camping trip, instructs the scouts about the methods to prevent Lyme disease. Which statement by one of the Cub Scouts indicates a need for further instructions?

a) I need to bring a hat to wear during the tripb) I should wear long-sleeved tops and long pantsc) I should not use insect repellents because it will attract the ticksd) I need to wear closed shoes and socks that can be pulled up over my pants

5. The client with acquired immunodeficiency syndrome is diagnosed with cutaneous Kaposi's sarcoma. Based on this diagnosis, the nurse understands that this has been confirmed by which of the following?

a) swelling in the genital areab) swelling in the lower extremitiesc) punch biopsy of the cutaneous lesionsd) appearance of reddish-blue lesions noted on the skin

1.a 2.d 3.b.4.c 5.c

6. Which of the following individuals is least likely at risk for the development of Kaposis's sarcoma?

a) A kidney transplant clientb) a male with a history of same-gender partnersc) a client receiving anti-neoplastic medicationsd) an individual working in an environment in which he or she is exposed to asbestos

7. The nurse prepares to give a bath and change the bed linens on a client with cutaneous Kaposi's sarcoma lesions. The lesions are open and draining a scant amount of serous fluid. Which of the following would the nurse incorporate into the plan during the bathing of this client?

a) wearing glovesb) wearing a gown and glovesc) wearing a gown, gloves, and a maskd) wear a gown and gloves to change the bed linens and gloves only for the bath

8. A client is suspected of having systemic lupus erythematosus. The nurse monitors the client, knowing that which of the following is one of the initial characteristic signs of systemic lupus erythematosus?

a) weight gainb) subnormal temperaturec) elevated red blood cell countd) rash on the face across the bridge of the nose and on the cheeks

9. The nurse provides home care instructions to a client with systemic lupus erythematosus and tells the client about methods to manage fatigue. Which statement by the client indicates a need for further instructions?

a) I should take hot baths because they are relaxingb) I should sit whenever possible to conserve my energyc) I should avoid long periods of rest because it causes joint stiffnessd) I should do some exercises, such as walking, when I am not fatigued

10. The client with acquired immunodeficiency syndrome has raised, dark purplish-colored lesions on the trunk of the body. The nurse anticipates that which of the following procedures will be done to confirm whether these lesions are caused by Kaposi's sarcoma?

a) skin biopsyb) lung biopsyc) western blotd) enzyme-linked immunosorbent assay

6.dbdaa

1. The client with acquired immunodeficiency syndrome has a respiratory infection from Pneumocystis jiroveci and a nursing diagnosis of Impaired Gas Exchange written in the plan of care. Which of the following indicates that the expected outcome of care has nor yet been achieved?

a) client limits fluid intakeb) client has clear breath soundsc) client expectorates secretions easilyd) client is free of complaints of shortness of breath

12. A client with pemphigus is being seen in the clinic regularly. The nurse plans care based on which of the following descriptions of this condition?

a) the presence of tiny red vesiclesb) an autoimmune disease that causes blistering in the epidermisc) the presence of skin vesicles found along the nerve caused by a virusd) the presence of red, raised papules and large plaques covered by silvery scales

13. The nurse is providing dietary instructions to the client with systemic lupus erythematosus. Which of the following dietary items would the nurse instruct the client to avoid?

a) steakb) turkeyc) broccolid) cantaloupe

14. A client calls the nurse in the emergency room and tells the nurse that he was just stung by a bee while gardening. The client is afraid of a severe reaction because the client's neighbor experienced such a reaction just 1 week ago. The appropriate nursing action is to:

a) advise the client to soak the site in hydrogen peroxideb) ask the client if ever sustained a bee sting in the pastc) tell the client to call an ambulance for transport to the emergency roomd) tell the client no to worry about the sting unless difficulty with breathing occurs

15. The nurse is assisting in administering immunizations at a health care clinic. The nurse understands that an immunization will provide:

a) protection from all diseaseb) innate immunity from diseasec) natural immunity from diseased) acquired immunity from disease

15. ababd

16. The nurse is assigned to care for a client with systemic lupus erythematosus. The nurse plans care, knowing that this disorder is a(n):

a) local rash that occurs as a result of allergyb) disease caused by overexposure to sunlightc) inflammatory disease of collagen contained in connective tissued) disease caused by the continuous release of histamine in the body

17. The nurse is assigned to care for a client admitted to the hospital with a diagnosis of systemic lupus erythematosus. The nurse reviews the physician's orders, expecting to note that which type of medication is prescribed?

a) antibioticb) antidiarrhealc) corticosteroidd) opioid analgesic

18. The community health nurse is conducting a research study and is identifying clients in the community at risk for latex allergy. Which client population is at most risk for developing this type of allergy?

a) hairdressersb) the homelessc) children in day care centersd) individuals living in a group home

19. The home care nurse is performing an assessment on a client who has been diagnosed with an allergy to latex. In determining the client's risk factors associated with the allergy, the nurse questions the client about an allergy to which food item?

a) eggsb) milkc) yogurtd) bananas

20. The home care nurse is assigned to visit a client who has returned home from the emergency room following treatment for a sprained ankle. The nurse notes that the client as sent home with crutches that have rubber axillary pads and needs instructions regarding crutch walking. On admission assessment, the nurse discovers that the client has an allergy to latex. Before providing instructions regarding crutch walking, the nurse should:

a) contact the physicianb) cover the crutch pads with clothc) call the local medical supply store and ask for a cane to be deliveredd) tell the client that the crutches must be removed from the house immediately

16. ccadb

21. The home care nurse is ordering dressing supplies for a client who has an allergy to latex. The nurse asks the medical supply personnel to deliver which of the following?

a) elastic bandagesb) adhesive bandagesc) brown ace bandagesd) cotton pads and silk tape

22. The camp nurse prepares to instruct a group of children about Lyme disease. Which of the following information would the nurse include in the instructions?

a) Lyme disease is caused by tick carried by deerb) Lyme disease is caused by contamination from cat fecesc) Lyme disease can be contagious through skin contact with an infected individuald) Lyme disease can be caused by the inhalation of spores from bird droppings

23. The client is diagnosed with stage I Lyme disease. The nurse assesses the client for which characteristic of this stage?

a) arthralgiasb) flu-like symptomsc) enlarged and inflamed jointsd) signs of neurological disorders

24. Select the interventions that would apply in the care of a client at high risk for an allergic response to a latex allergy. Select all that apply

a) use non-latex glovesb) use medications from glass ampulesc) place the client in a private room onlyd) do not puncture rubber stoppers with needlese) keep a latex-safe supply cart available in the client's areaf) use a blood pressure cuff from an electronic device only to measure the blood pressure

25. Amikacin (Amikin) is prescribed for a client with a bacterial infection. The nurse instructs the client to contact the physician immediately if which of the following occurs?

a) nauseab) lethargyc) hearing lossd) muscle aches

21s. dab,abde,c

26. The client who is human immunodeficiency virus seropositive has been taking zalcitabine (ddC, Hivid) as a component of treatment. The nurse plans to monitor which of the following most closely while the client is taking this medication?

a) platelet countb) glucose levelc) red blood cell countd) liver function studies

27. The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving foscarnet (Foscavir), an antiviral. The nurse checks the latest results of which of the following laboratory studies while the client is taking this medication?

a) CD4 cell countb) serum albumin levelc) serum creatinine leveld) lymphocyte count

28. The client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine (Pentam 300). The client develops a temperature of 101F. The nurse does further monitoring of the client, knowing that his sign would most likely indicate that the:

a) dose of the medication is too lowb) client is experiencing toxic effects of the medicationc) client has developed inadequacy of thermoregulationd) result of another infection caused by leukopenic effects of the medication

29. Saquinavir (Invirase) is prescribed for the client who is seropositive for human immunodeficiency virus. The nurse reinforces medication instructions and tells the client to:

a) avoid sun exposureb) eat low-calorie foodsc) eat foods that are low in fatd) take the medication on an empty stomach

30. The client who is human immunodeficiency virus seropositive has been taking Stavudine (d4t, Zerit). The nurse monitors which of the following most closely while the client is taking this medication?

a) gaitb) appetitec) level of consciousnessd) gastrointestinal function

26.dcdaa

1. The client with acquired immunodeficiency syndrome has begun therapy with zidovudine (Retrovir, azidothymidine, AZT, ZDV). The nurse carefully monitors which of the following laboratory results during treatment with this medication?

a) blood cultureb) blood glucose levelc) blood urea nitrogen leveld) complete blood count

32. The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine (Videx). The nurse interprets that he client may have the medication discontinued by the physician if which of the following significantly elevated results is noted?

a) serum protein levelb) blood glucose levelc) serum amylase leveld) serum creatinine level

33. The nurse is caring for a post-renal transplantation client taking cyclosporin (Sandimmune, Gengraf, Neoral). Th nurse notes an increase in one of he client's vital signs and the client is complaining of a headache. What is the vital sign that is most likely increased?

a) pulseb) respirationc) blood pressured) pulse oximetry

34. Ketoconazole (Nizoral) is prescribed for a client with a diagnosis of candidiasis. Select the interventions that the nurse includes when administering this medication. Select all that apply

a) restrict fluid intakeb) instruct the client to avoid alcoholc) monitor liver function studiesd) administer the medication with a antacide) instruct the client to avoid exposure to the sunf) administer the medication on an empty stomach

35. The nurse has an order to begin administering foscarnet (Foscavir) to the client with cytomegalovirus retinitis and acquired immunodeficiency syndrome (AIDS). The nurse assesses the latest results of which laboratory study prior to administering the dose?

a) serum albumin levelb) serum creatinine levelc) CD4 countd) lymphocyte count

31.dcc,bce, 35.b

36. A home care nurse provides instructions to a client with systemic lupus erythematosus (SLE) about measures to manage fatigue. Which statement by the client indicates the need for further instruction?

a) I need to avoid long periods of restb) I need to sit whenever possiblec) I should take a hot bath every eveningd) I should engage in moderate low-impact exercise when I am not tired

37. A nurse is reviewing the results of serum laboratory studies for a client with acquired immunodeficiency syndrome (AIDS) who is receiving didanosine (Videx). The nurse interprets that the client may have the medication discontinued by the physician if which of the following laboratory test results is significantly elevated?

a) serum cholesterol levelb) serum amylase levelc) blood glucose concentrationd) serum protein concentration

38. A client with acquired immunodeficiency syndrome (AIDS) who is taking zidovudine (Retrovir) 200 mg orally three times daily has severe neutropenia noted on the follow-up laboratory studies. The nurse interprets that which of the following is likely to occur at this point?

a) prednisone (Deltasone) probably will be added to the medication regimenb) epoetin (Epogen) probably will be added to the medication regimenc) the medication dose probably will be reducedd) the medication probably will be discontinued until laboratory results indicated bone marrow recovery

39. A client with human immunodeficiency virus (HIV) infection is taking indinavir (Crixivan). The nurse plans to tell the client which of the following when providing instructions about the use of this medication?

a) take the medication with water on an empty stomachb) take the medication with a high-fat snackc) take the medication with the large meal of the dayd) store the medication in the refrigerator

40. A client is receiving acyclovir (Zovirax) by the intravenous (IV) route for treatment of cytomegalovirus (CMV) infection. After reconstituting the powder dispensed by the pharmacy, the nurse administers this medication by:

a) continuous IV infusion over 12 hoursb) continuous IV infusion over 24 hoursc) rapid IV bolus over 5 minutesd) slow IV infusion over 1 hour

36. cbbad

41. A nurse is monitoring a client with herpes simplex virus who is receiving intravenous (IV) acyclovir (Zovorax). Which of the following laboratory results would be of concern as a possible adverse effect of this medication?

a) blood urea nitrogen (BUN) of 36 mg/dLb) platelet count of 300,000 cells/mm3c) white blood cell count of 6000 cells/mm3d) red blood cell count of 5.2 million cells/mm3

42. A client with acquired immunodeficiency syndrome (AIDS) is receiving ganciclovor (Cytovene). The nurse takes which priority nursing action in caring for this client?

a) ensuring that the client uses an electric razor for shavingb) administering the medication with an antacidc) monitoring for signs of hyperglycemiad) administering the medication without food

43. A client with acquired immunodeficiency syndrome (AIDS) has been started on therapy with zidovudine also called azidothymidine (AZT)(Retrovir). The nurse monitors the results of which laboratory blood study for adverse effects of therapy?

a) complete blood count (CBC)b) blood urea nitrogen (BUN) levelc) creatinine leveld) potassium concentration

44. A client with acquired immunodeficiency syndrome (AIDS) is receiving didanosine (Videx). The nurse reviewing the client's laboratory results should most closely monitor serum levels of:

a) cholesterolb) amylasec) glucosed) protein

45. A client is receiving zalcitabine (Hivid). The nurse plans to monitor the results of which study to determine the effectiveness of this medication?

a) enzyme-linked immunosorbent assay (ELISA)b) western blotc) CD4+ cell countd) complete blood cell (CBC) count with differential

41.aaabc