Which of the following questions is most important to ask a client who might have been exposed to HIV after being sexually assaulted?

Who was the individual who assaulted you?

What day and time did the assault take place?

Where did the assault occur?

Do you give us permission to call the police?

Answer and Explanation

The Correct Answer is B

Choice A reason:
Asking about the identity of the assailant, while important for legal purposes, does not contribute to the immediate medical care of the client. The priority is to address potential health issues, such as exposure to HIV.

Choice B reason:
The timing of the assault is critical because it determines the eligibility for PEP. PEP should be initiated as soon as possible, ideally within 2 hours, but it can be effective up to 72 hours after exposure. Knowing the exact time of the assault helps healthcare providers act swiftly to mitigate the risk of HIV transmission.

Choice C reason:
While knowing where the assault occurred can provide context and may be relevant for legal proceedings, it does not influence the immediate medical treatment plan for potential HIV exposure.

Choice D reason:
Consent to involve law enforcement is a separate issue from medical treatment. While it's important to respect the client's wishes regarding reporting, it does not impact the decision-making process regarding HIV prophylaxis.

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Correct Answer is D

Explanation

Choice A reason:
Immunoglobulin G (IgG) is the most common type of antibody found in blood circulation and is involved in the body's immune response to fight infections. However, IgG is not typically associated with allergic reactions, which are immediate hypersensitivity reactions.

Choice B reason:
Immunoglobulin A (IgA) plays a critical role in mucosal immunity and is found in high concentrations in the mucous membranes, particularly those lining the respiratory passages and gastrointestinal tract. Like IgG, IgA is not primarily responsible for the allergic response seen in conditions such as seasonal allergies.

Choice C reason:
Immunoglobulin M (IgM) is usually the first antibody produced by the immune system when it detects an infection. IgM antibodies are larger and are involved in the primary immune response but are not the antibodies that mediate typical allergic reactions.

Choice D reason:
Immunoglobulin E (IgE) is the antibody that plays a central role in the pathophysiology of allergic diseases, including seasonal allergies. IgE antibodies are produced as a response to allergens and are responsible for the symptoms of an allergic reaction. An elevation in IgE levels typically indicates a positive result for an allergy test such as RAST.

A. Restrict the client's oral fluid intake. B. Remind the client he might feel a constant urge to void. C. Monitor the client's urine output every 6 hours. D. Weigh the client every evening.

Correct Answer is B

Explanation

Choice A reason:
Restricting the client's oral fluid intake is not typically recommended as part of postoperative care following TURP. In fact, maintaining adequate hydration is important to help flush the bladder and prevent clot formation.

Choice B reason:
It is common for clients to feel a constant urge to void due to the irritation of the bladder from the catheter and the continuous bladder irrigation. Reminding the client that this sensation is normal and expected can help alleviate anxiety and provide reassurance.

Choice C reason:
Monitoring the client's urine output is important to ensure that the bladder irrigation is effective and that there are no signs of obstruction. However, it should be done more frequently than every 6 hours, especially in the immediate postoperative period, to promptly detect any complications.

Choice D reason:
Weighing the client every evening is not directly related to the management of continuous bladder irrigation. While monitoring weight can be part of overall postoperative care, it does not address the specific needs related to TURP and continuous bladder irrigation.

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Which of the following questions is most important to ask a client who might have been exposed to HIV after being sexually assaulted?

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Naxlex Comprehensive Predictor Exams

A nurse in an allergy clinic is caring for a client who has a history of seasonal allergy symptoms. The client had a radioallergosorbent test (RAST) completed on a previous visit. The nurse should recognize that an elevation in which of the following immunoglobulins indicates a positive result?

Correct Answer is D

Explanation

A nurse is planning care for a client who is 2 hours postoperative following a transurethral resection of the prostate (TURP). The client is receiving continuous bladder irrigation. Which of the following interventions should the nurse include?

Correct Answer is B

Explanation

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