A client underwent an antibody test for human immunodeficiency virus (HIV) as part of a screening process and has just been told that the results were positive. Which anticipatory guidance regarding the next step should the nurse provide to the client?

Correct Answer: C

Rationale: The correct answer is C: Follow-up testing will be promptly performed to confirm the result. This is the most appropriate next step as a positive result on an antibody test does not confirm HIV infection. Follow-up testing, such as a confirmatory test like Western blot or PCR, is needed to confirm the diagnosis. This step is crucial to avoid unnecessary anxiety or premature treatment initiation. Explanation for incorrect choices: A: The client will be started on fluoxetine in 1 month - This choice is incorrect because fluoxetine is an antidepressant and not a treatment for HIV. B: Antiretroviral therapy will begin within 3 months - This choice is incorrect because starting antiretroviral therapy should be based on confirmed diagnosis, not just a positive antibody test result. D: The client will be monitored for signs and symptoms of HIV to determine the need for treatment - This choice is incorrect because monitoring signs and symptoms alone is not sufficient to confirm HIV infection or determine the need for treatment.

Correct Answer: B

Rationale: The correct answer is B because pernicious anemia is typically caused by the absence of intrinsic factor, a protein necessary for the absorption of vitamin B12. Without intrinsic factor, the body cannot properly absorb vitamin B12, leading to anemia. The other choices are incorrect because: A: Schilling's test is used to diagnose pernicious anemia, but an elevated result is not a distinguishing laboratory finding. C: Sedimentation rate is a nonspecific test for inflammation and is not specific to pernicious anemia. D: RBC count of 5.0 million is within the normal range and is not a distinguishing feature of pernicious anemia.

Correct Answer: C

Rationale: Step 1: Drinking coffee or tea with meals can inhibit iron absorption due to the presence of tannins and polyphenols. Step 2: Tannins bind to iron, making it less available for absorption in the body. Step 3: Polyphenols in coffee and tea also interfere with iron absorption. Step 4: Therefore, by drinking coffee or tea with meals, the client is hindering the absorption of iron from their diet. Summary: A: Adding dried fruit provides iron and is beneficial for anemia. B: Cooking in iron pots can increase dietary iron intake. D: Adding vitamin C enhances iron absorption, indicating understanding of nutritional counseling. C: Drinking coffee or tea with meals limits iron absorption, indicating a lack of understanding.

Correct Answer: D

Rationale: The correct answer is D because anemia reduces the number of red blood cells, leading to decreased oxygen delivery to tissues, causing fatigue. The nurse's response highlights the underlying issue of inadequate oxygen supply due to anemia. Choice A focuses on sleep duration, which is not directly related to anemia. Choice B mentions iron deficiency, a common cause of anemia, but it does not address the specific issue of oxygen delivery. Choice C suggests rest for sickness, not addressing the chronic fatigue associated with anemia. Thus, the correct answer D provides a clear and logical explanation for the client's tiredness.

Correct Answer: A

Rationale: The correct answer is A: MCH (Mean Corpuscular Hemoglobin). MCH represents the average weight of hemoglobin per red blood cell. The normal range is 27-33 pg. MCV (Mean Corpuscular Volume) measures the average volume of RBCs, not the weight of hemoglobin. MCHC (Mean Corpuscular Hemoglobin Concentration) measures the concentration of hemoglobin in a given volume of packed red blood cells, not the weight of hemoglobin. RDW (Red Cell Distribution Width) measures the variation in RBC size, not the weight of hemoglobin. Therefore, A is correct as it directly relates to the average weight of hemoglobin per red blood cell.