A client seeks medical evaluation for fatigue, night sweats, and a 20-lb weight loss in 6 weeks. To confirm that the client has been infected with the human immunodeficiency virus (HIV), the nurse expects the physician to order:

Correct Answer: D

Rationale: The confirmatory test for HIV infection is a Western blot test. However, before a Western blot test is conducted, an initial screening test with high sensitivity, such as the enzyme-linked immunosorbent assay (ELISA), is typically performed. ELISA is used to detect the presence of HIV antibodies in the blood. If the ELISA test is positive, a Western blot test is then performed to confirm the presence of specific HIV antibodies. The Western blot test is a more specific test for HIV antibodies and is used to confirm the diagnosis. Therefore, in this case, the physician would most likely order a Western blot test following a positive ELISA test to confirm the client's HIV infection.

Correct Answer: C

Rationale: The correct statement regarding chlamydia infection is that the clinical manifestations include dysuria and urethral itching in males. Chlamydia is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis. In males, common symptoms include a burning sensation during urination (dysuria) and urethral itching. It is important to note that chlamydia is often asymptomatic, especially in women, which is why regular screening is important to detect and treat the infection early. Option A is incorrect because the treatment of choice for chlamydia is typically antibiotics such as azithromycin or doxycycline, not oral penicillin. Option B is incorrect because nystatin or miconazole are used to treat fungal infections, not chlamydia. Option D is incorrect because small, painful vesicles on genital areas are more indicative of herpes simplex virus infection rather than chlamydia

Correct Answer: A

Rationale: The correct intervention that should be part of the plan of care for a client at risk for impaired skin integrity due to external radiation is avoiding using a soap on the irradiated areas. Soap can be drying to the skin and may exacerbate skin reactions caused by radiation therapy. It is important to keep the skin in the radiation field clean, but avoiding soap will help prevent further irritation and damage to the skin. Instead, a gentle cleanser recommended by the healthcare provider should be used to clean the irradiated areas. Additionally, maintaining good hydration and moisturizing the skin as recommended by the healthcare team can also help minimize skin reactions.

Correct Answer: B

Rationale: When communicating with an elderly client, it is important to use a low-pitched voice because high frequencies can be difficult for older individuals to hear. A low-pitched voice is easier for them to understand and can help enhance communication. Speaking clearly and directly in a calm manner with a lower pitch can make it easier for the elderly client to hear and comprehend what is being said. Additionally, it is important to speak at a moderate pace and volume to ensure effective communication with elderly clients.

Correct Answer: B

Rationale: Strabismus, or misalignment of the eyes, is a common condition in newborns due to the lack of binocularity. Binocularity refers to the ability of both eyes to focus simultaneously on a single point, which is not fully developed in newborns. As a result, it is normal for a newborn's eyes to appear misaligned at times. This lack of coordination between the eyes typically resolves as the infant's visual system matures and they develop the ability to focus both eyes together. Therefore, the presence of strabismus in a newborn is usually considered a normal finding related to the immature visual development rather than a sign of pathology such as congenital cataracts, absence of red reflex, or pupil reactivity issues.