A group of nurses are discussing risk factors for the transmission of human immunodeficiency virus (HIV) from clients. Which of the following individuals should the nurse identify as being at the greatest risk for contracting HIV?

A personal trainer who works with a client who has HIV.

An occupational therapist who works with a client who has HIV.

A phlebotomist who collects blood from clients who have HIV.

A nurse who works for an insurance company and collects urine samples from clients who have HIV.

Answer and Explanation

The Correct Answer is C

Choice A reason:
A personal trainer working with a client who has HIV is at low risk for contracting the virus. HIV is not transmitted through casual contact, sweat, or saliva. The risk would increase only if there were exposure to blood or other body fluids through an open wound or mucous membrane.

Choice B reason:
An occupational therapist working with a client who has HIV also has a low risk of contracting the virus. Similar to a personal trainer, unless there is direct exposure to blood or body fluids, the transmission risk is minimal.

Choice C reason:
A phlebotomist who collects blood from clients who have HIV is at the greatest risk among the listed individuals. Phlebotomists are healthcare professionals who are frequently exposed to blood, which is a bodily fluid that can transmit HIV if proper precautions are not taken.

Choice D reason:
A nurse who collects urine samples is at a lower risk compared to a phlebotomist. HIV is not typically transmitted through urine unless it contains blood. However, the risk is still present if there is exposure to blood-contaminated urine through cuts or mucous membranes.

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Correct Answer is B

Explanation

Choice A reason:
This choice suggests a pH of 7.50, which is indicative of alkalosis, and not typically expected in a client with chronic kidney disease (CKD). CKD often leads to metabolic acidosis due to the accumulation of acids in the body as the kidneys fail to excrete them. The HCO₃⁻ level of 20 mEq/L is slightly lower than the normal range (22-26 mEq/L), and the PaCO₂ of 32 mm Hg is within the normal range (35-45 mm Hg), but these values do not align with the expected acidosis associated with CKD.

Choice B reason:
This set of values is consistent with metabolic acidosis, which is commonly seen in clients with CKD. A pH of 7.25 indicates acidemia, and an HCO₃⁻ level of 19 mEq/L is below the normal range, suggesting a primary metabolic acidosis. The PaCO₂ of 30 mm Hg is at the lower end of the normal range, which may indicate a compensatory respiratory response to the metabolic acidosis.

Choice C reason:
A pH of 7.30, while on the lower side, is not as acidic as one would expect in a client with CKD. The HCO₃⁻ level of 26 mEq/L is within the normal range, and a PaCO₂ of 50 mm Hg suggests respiratory acidosis, which is not the primary disorder in CKD.

Choice D reason:
This choice indicates a pH of 7.55, which is too alkaline and not characteristic of CKD, where metabolic acidosis is the expected finding. An HCO₃⁻ level of 30 mEq/L is higher than the normal range, suggesting metabolic alkalosis. The PaCO₂ of 31 mm Hg is slightly below the normal range, possibly indicating a compensatory response, but it does not align with the metabolic acidosis typically seen in CKD.

A. Alendronate B. Colchicine C. Allopurinol D. Prednisone

Correct Answer is A

Explanation

Choice A reason:
Alendronate is a bisphosphonate, which is commonly prescribed for Paget's disease of the bone. Bisphosphonates help regulate bone growth and can be a lifelong medication for managing this condition. They work by inhibiting osteoclasts, the cells that break down bone tissue, which helps to normalize the bone remodeling process.

Choice B reason:
Colchicine is used to treat gout and not typically used for Paget's disease. It works by reducing the inflammation caused by uric acid crystals but does not affect the bone remodeling process that is characteristic of Paget's disease.

Choice C reason:
Allopurinol is also used to treat gout by decreasing uric acid production in the body. Like colchicine, it is not used to treat Paget's disease because it does not address the abnormal bone metabolism associated with the condition.

Choice D reason:
Prednisone is a corticosteroid used to reduce inflammation in various conditions. While it may be used in some cases to manage pain and inflammation associated with Paget's disease, it is not a primary treatment for the disease itself and does not regulate bone growth like bisphosphonates do.

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A group of nurses are discussing risk factors for the transmission of human immunodeficiency virus (HIV) from clients. Which of the following individuals should the nurse identify as being at the greatest risk for contracting HIV?

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