A client is admitted to an acute care facility with a myocardial infarction. During the admission history, the nurse learns that the client also has hypertension and progressive systemic sclerosis. For a client with this disease, the nurse is most likely to formulate which nursing diagnosis?

Correct Answer: A

Rationale: For a client with progressive systemic sclerosis, also known as Scleroderma, the nurse is most likely to formulate a nursing diagnosis related to the risk for impaired skin integrity. Scleroderma is a chronic connective tissue disease that can lead to changes in skin texture and thickness, making the skin more prone to breakdown, ulcers, and impaired wound healing. Therefore, assessing and addressing the risk for impaired skin integrity is essential to prevent complications in clients with Scleroderma. While the other options may also be relevant considerations for this client, the priority nursing diagnosis in this case would be related to maintaining skin integrity.

Correct Answer: A

Rationale: Oxygen is not transported in blood plasma. Instead, it is transported bound to hemoglobin within red blood cells. Carbon dioxide, nutrients, and hormones are examples of substances that are transported in blood plasma. Oxygen binds to hemoglobin in the red blood cells as they pass through the lungs, while carbon dioxide is carried back to the lungs and expelled from the body through the respiratory system. Nutrients like glucose and amino acids are carried in the blood plasma to be delivered to various tissues for energy production and cellular processes. Hormones are chemical messengers that are released into the bloodstream by endocrine glands to regulate numerous physiological functions throughout the body.

Correct Answer: B

Rationale: Hand-foot syndrome, also known as dactylitis, is a common manifestation of sickle cell anemia. It is characterized by painful swelling and inflammation of the hands and feet, often resulting in a purplish discoloration due to decreased blood flow and oxygen delivery to the affected areas. This condition typically affects the soft tissues and joints of the hands and feet, leading to pain, swelling, and limited mobility. Unequal growth of fingers and toes, webbing between fingers and toes, and deformities of the wrists and ankles are not typically associated with hand-foot syndrome in sickle cell anemia.

Correct Answer: B

Rationale: It is important for the nurse to acknowledge and address any negative feelings or biases that may arise during patient care, especially when caring for a patient with a stigmatized condition like HIV/AIDS. Discussing these negative feelings with a trusted colleague, such as the charge nurse, can help the nurse process and overcome their biases in a safe and non-judgmental environment. By addressing these feelings, the nurse can ensure that they provide compassionate and professional care to the patient and their partner without any personal biases interfering with the care delivery. Sharing these feelings with the client or avoiding eye contact would be inappropriate and counterproductive to establishing trust and providing care. Developing a written interview form would not address the underlying issue of negative attitudes or biases and may not be effective in promoting unbiased care.

Correct Answer: B

Rationale: The correct answer is B because implementing a needle exchange program is an effective way to reduce transmission of HIV among intravenous drug users. By providing clean needles in exchange for dirty needles, the risk of sharing contaminated needles and spreading the virus is significantly reduced. This approach also helps prevent the transmission of other bloodborne diseases, such as Hepatitis C. The other statements do not demonstrate an understanding of how to reduce HIV transmission - for example, encouraging breastfeeding for HIV-positive mothers can transmit the virus to the baby, birth control pills do not protect against HIV, and natural skin condoms do not offer the same level of protection as latex condoms.