A nurse is caring for a client hospitalized with AIDS. A friend comes to visit the client and privately asks the nurse about the risk of contracting HIV when visiting the client. What is the nurse's best response?

Correct Answer: C

Rationale: The correct answer is C: "AIDS isn't transmitted by casual contact." This is the best response because it is accurate and provides the friend with correct information. HIV is not transmitted through casual contact, so the friend visiting the client is not at risk of contracting the virus. A: "Do you think that you might already have HIV?" - This response is inappropriate as it raises unnecessary concerns and does not address the friend's question directly. B: "Your immune system is likely very healthy." - This response is irrelevant to the friend's concern about contracting HIV and does not provide any information related to the risk of transmission. D: "You can't normally contract AIDS in a hospital setting." - While this statement is generally true due to universal precautions in healthcare settings, it does not directly address the friend's specific concern about HIV transmission through visiting the client.

Correct Answer: B

Rationale: The correct initial response is B: "How has this affected your life?" This response demonstrates therapeutic communication by acknowledging the patient's feelings and concerns, and encourages the patient to express their thoughts and emotions. By asking about the impact on her life, the nurse can gather more information about the patient's symptoms, daily activities, and overall well-being, which can help in developing a comprehensive care plan. Choice A is incorrect because simply instructing the patient to continue taking supplements without further assessment of the situation may not address the underlying issues causing the fatigue. Choice C is incorrect as it suggests a solution without understanding the patient's specific situation. Choice D is incorrect because it assumes stress is the primary cause of the tiredness without exploring other potential factors contributing to the symptoms.

Correct Answer: A

Rationale: The correct answer is A: Corticosteroid. Corticosteroids are typically the first-line treatment for autoimmune hemolytic anemia as they help suppress the immune system's attack on red blood cells. They reduce inflammation and prevent further destruction of red blood cells. Blood transfusions (B) may be necessary in severe cases to address anemia but do not treat the underlying autoimmune process. Immunosuppressant drugs (C) are used if corticosteroids are ineffective or not tolerated. Removal of the spleen (D) may be considered in refractory cases but is not usually the initial treatment choice.

Correct Answer: D

Rationale: The correct answer is D: Verifies that the client has given informed consent. Before performing any invasive procedure like a bone marrow aspiration, it is crucial for the nurse to ensure that the client has given informed consent. This involves explaining the procedure, risks, benefits, and alternatives to the client, allowing them to ask questions, and obtaining their signature on the consent form. This step is essential to ensure the client understands the procedure and willingly agrees to it. Choice A is incorrect because cleaning the biopsy site with an antiseptic should be done in the treatment room, not before taking the client there. Choice B, holding the client's hand and asking about concerns, is a good practice for providing emotional support but does not address the necessary step of verifying informed consent. Choice C, reviewing the client's platelet count, is important for assessing the client's readiness for the procedure but does not address the consent aspect, which is crucial before any invasive procedure.

Correct Answer: C

Rationale: The Schilling test assesses the client's ability to absorb vitamin B12, as it evaluates the absorption of an orally administered radioactive B12. First, the client is given a dose of radioactive B12 orally, and urine samples are collected to measure how much of the radioactive B12 is excreted. If the client is unable to absorb vitamin B12 properly, a second test is performed with intrinsic factor to determine the cause. Choices A, B, and D are incorrect as the Schilling test specifically focuses on the absorption, not storage, digestion, or production of vitamin B12.