A nurse is caring for a client who has human immunodeficiency virus (HIV). Which of the following laboratory values would be most concerning to the nurse?

Positive Western blot test

CD4-T-cell count 505 cells/mm³ (nl. 500-1500 cells/mm³)

Platelets 115,000/mm³ (nl. 140,000-400,000/mm³)

White blood cell (WBC) count 800/mm³ (nl. 5000-10,000/mm³)

Answer and Explanation

The Correct Answer is D

A. A positive Western blot test confirms the diagnosis of HIV, but it is not concerning once the diagnosis has been established.
B. A CD4-T-cell count of 505 cells/mm³ is low but not critically low. While it does indicate immunosuppression, it is not the most concerning value presented.
C. A platelet count of 115,000/mm³ is lower than normal and may indicate a risk for bleeding, but it is not as concerning as a critically low white blood cell count.
D. A WBC count of 800/mm³ is severely low and indicates a high risk for infection, which is particularly concerning in a client with HIV, as it suggests significant immunosuppression and vulnerability to opportunistic infections.

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Correct Answer is D

Explanation

A. Foods high in protein, like fish and chicken, are generally recommended in a low-fat diet but are not specific to managing biliary colic.
B. Low-fat dairy products are usually recommended as part of a low-fat diet and are not typically avoided for cholecystitis.
C. High-carbohydrate foods like pie and donuts are not advised for general health but are not specifically targeted for managing biliary colic.
D. Avoiding foods high in fat, such as fried chicken, is important for managing biliary colic and chronic cholecystitis. Fatty foods can stimulate gallbladder contractions and exacerbate symptoms.

A. An unconscious adult client who has no respirations, capillary refill is > 2 seconds, and paramedics have already tried to reposition airway without results B. A conscious adult client who has a broken tibia, blood pressure of 160/90 mm Hg, and heart rate of 118 beats per minute C. An unconscious adult client who has a sucking chest wound, SpO2 of 85%, and capillary refill of < 2 seconds D. A conscious adult client who reports shortness of breath, has a respiratory rate of 24/min, and capillary refill of <2 seconds

Correct Answer is C

Explanation

C. The unconscious adult client with a sucking chest wound and low SpO2 (85%) is in immediate need of intervention. A sucking chest wound is a life-threatening injury that can lead to respiratory distress and compromised oxygenation. This client requires immediate attention to address the chest wound and improve oxygenation.
A. The unconscious client with no respirations and an ineffective airway attempt is likely beyond rescue, making them lower priority compared to those with potentially reversible conditions.
B. The conscious client with a broken tibia and elevated vital signs is stable enough to be seen after more critical cases are addressed.
D. The conscious client with shortness of breath and a high respiratory rate is concerning but not as immediately life-threatening as a client with a sucking chest wound.

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A nurse is caring for a client who has human immunodeficiency virus (HIV). Which of the following laboratory values would be most concerning to the nurse?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

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