A nurse is caring for a client who has HIV.
Which of the following laboratory values is the nurse's priority?
WBC 5,000/mm³.
Platelets 150,000/mm³.
O Positive Western blot test.
CD4-T-cell count 180 cells/mm.
The Correct Answer is D
Choice A rationale:
A WBC count of 5,000/mm³ is within the normal range (4,500 to 11,000 cells/mm³) and is not a priority.
Choice B rationale:
A platelet count of 150,000/mm³ is within the normal range (150,000 to 450,000/mm³) and is not a priority.
Choice C rationale:
A positive Western blot test confirms HIV infection, but it is not a priority in this case.
Choice D rationale:
A CD4-T-cell count of 180 cells/mm³ is below the normal range (500 to 1,500 cells/mm³), indicating severe immune system damage in a client with HIV. This is the nurse’s priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Checking the catheter tubing for kinks or twisting helps to maintain a patent urinary drainage system, preventing urinary stasis that can lead to infection.
Choice B rationale:
Irrigating the catheter once each shift is not recommended as it can introduce bacteria into the bladder.
Choice C rationale:
Cleaning the perineal area with an antiseptic solution daily can disrupt the normal flora and cause irritation, potentially leading to infection.
Choice D rationale:
Replacing the catheter every 3 days is not recommended as it can increase the risk of urinary tract infection.
Correct Answer is A
Explanation
Choice A rationale:
Diabetes insipidus is characterized by excessive thirst and excretion of large amounts of severely dilute urine, leading to dehydration.
Choice B rationale:
Bradycardia is not a typical finding in diabetes insipidus.
Choice C rationale:
Polyphagia (excessive hunger) is more commonly associated with diabetes mellitus, not diabetes insipidus.
Choice D rationale:
Hyperglycemia is a symptom of diabetes mellitus, not diabetes insipidus.
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