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 B

Explanation

A. A face shield is necessary when there is a risk of splashes, but not required for simply checking a pulse.
B. Clean gloves are appropriate for contact with the client or the wound, as MRSA is transmitted through direct contact. This prevents contamination while assessing the client.
C. Sterile gloves are not required for checking a pulse unless performing a sterile procedure.
D. An N95 respirator mask is used for airborne precautions, not necessary for MRSA, which is contact-transmitted.

A. "I should drink 1 to 1.5 L of fluid each day." B. "I can use aspirin for management of gout pain." C. "I will focus on losing weight to achieve a normal body mass index (BMI)." D. "I will take allopurinol for an acute gout attack in the future."

Correct Answer is C

Explanation

A. A higher fluid intake, ideally 2 to 3 liters per day, is typically recommended to help flush uric acid from the body and prevent gout attacks, not just 1 to 1.5 L.
B. Aspirin is not recommended for gout pain management; nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids are more appropriate.
C. Focusing on losing weight to achieve a normal BMI is important for managing gout, as obesity is a risk factor for gout and can exacerbate symptoms. Weight loss can help reduce uric acid levels and improve overall management of the condition.
D. Allopurinol is used for long-term management to reduce uric acid levels and prevent attacks, but it is not used during acute attacks. Colchicine or NSAIDs are more appropriate for acute gout attacks.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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