Nursing Elites

1. The LPN is caring for a client newly diagnosed with HIV. Which statement made by the client regarding antiretroviral therapy (ART) would require correction from the nurse?

• A. "If I start ART and use condoms, I'm less likely to transmit HIV to my partner."?
• B. "I can still use ART even though I am Hepatitis C positive."?
• C. "I will need to be on ART indefinitely."?
• D. "I know I will need to come back for blood draws so that I can begin ART when my CD4 count is over 1,000 cells/mm3."?

Correct answer: D

Rationale: The correct answer is the statement, "I know I will need to come back for blood draws so that I can begin ART when my CD4 count is over 1,000 cells/mm3."? This statement would require correction from the nurse because initiating ART when the CD4 count is over 1,000 cells/mm3 is not supported by guidelines. The World Health Organization (WHO) recommends making treatment a priority for those with a CD4 count of ?350 cells/mm3, as early intervention can help delay disease progression. Therefore, waiting for a CD4 count of over 1,000 cells/mm3 is not in line with current recommendations. Choice A is correct, as studies have shown that using condoms along with ART can significantly reduce the risk of HIV transmission to sexual partners. Choice B is also correct because being Hepatitis C positive does not contraindicate the use of ART. Choice C is correct as well, as ART is typically needed indefinitely to maintain viral suppression and manage HIV. Therefore, the only statement that would require correction is Choice D.

2. A client is taught about healthy dietary measures and the MyPlate food plan. How many of his grains should be whole grains according to the MyPlate food plan?

• A. One-quarter
• B. One-third
• C. One-half
• D. Two-thirds

Correct answer: C

Rationale: The correct answer is 'One-half.' According to the MyPlate food plan, at least half of the grains consumed daily should be whole grains. This ensures a well-balanced and healthy diet. Choices A, B, and D are incorrect because they do not align with the dietary recommendation provided by the MyPlate food plan. One-quarter, one-third, and two-thirds do not represent the appropriate proportion of whole grains as advised by the plan, which emphasizes the importance of including a significant portion of whole grains in one's diet.

3. During the examination of a client's throat, a nurse touches the posterior wall with a tongue blade and elicits the gag reflex. The nurse documents normal function of which cranial nerves?

• A. Cranial nerves V and VI
• B. Cranial nerves XII and VIII
• C. Cranial nerves XII and VIII
• D. Cranial nerves IX and X

Correct answer: D

Rationale: The correct answer is cranial nerves IX (glossopharyngeal nerve) and X (vagus nerve). When the nurse touches the posterior pharyngeal wall with a tongue blade and elicits the gag reflex, it indicates normal function of these nerves. Cranial nerves V (trigeminal nerve) and VI (abducens nerve) are not directly responsible for the gag reflex. Cranial nerves XII (hypoglossal nerve) and VIII (vestibulocochlear nerve) are not directly involved in eliciting the gag reflex. Testing cranial nerve I involves smell function, and cranial nerve II is related to eye examinations, making them irrelevant in this scenario.

4. A nurse assisting with data collection for a client with kidney failure notes that the client has the appearance of generalized edema over the entire body. The nurse documents this finding using which terminology?

• A. Anasarca
• B. Ecchymosis
• C. Unilateral edema
• D. Increased vascularity of the skin tissue

Correct answer: A

Rationale: The correct term for generalized edema over the entire body is 'Anasarca.' Anasarca is indicative of a systemic issue such as congestive heart failure or kidney failure. It does not refer to increased vascularity of the skin tissue. Ecchymosis is a bruise caused by capillary bleeding into the tissues, unrelated to generalized edema. Unilateral edema is swelling in a specific area of the body, not the generalized edema observed in anasarca.

5. Which of these medications is least likely to cause tinnitus?

• A. Aspirin
• B. Lasix
• C. Gentamicin
• D. Fluoxetine

Correct answer: D

Rationale: The correct answer is Fluoxetine. Among the options provided, Fluoxetine is the medication least likely to cause tinnitus. Gentamicin, Lasix, and Aspirin are known ototoxic medications that have a potential side effect of causing tinnitus, a ringing in the ear. Gentamicin is an antibiotic, Lasix is a diuretic, and Aspirin is a common pain reliever that can lead to tinnitus. In contrast, Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) primarily used as an antidepressant, and it has a lower risk of causing tinnitus compared to the other options.

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