A nurse is providing ongoing care for a client who is positive for human immunodeficiency virus (HIV), and assessment reveals a client with a newly delayed and shortened speech pattern. The client, who previously had no neurological or motor deficits, has forgotten that they are in the hospital and has trouble getting out of bed. Which problem is the client most likely experiencing related to these signs and symptoms?

Correct Answer: D

Rationale: The client is most likely experiencing signs of subcortical neurodegenerative disease. The symptoms of delayed and shortened speech pattern, memory loss, and difficulty with motor skills point towards a subcortical neurological issue affecting the basal ganglia or other subcortical structures. This disease can lead to cognitive and motor deficits, as seen in the client's presentation. Choice A, Cryptococcal meningitis, typically presents with fever, headache, and neck stiffness, not cognitive and motor deficits. Choice B, Cytomegalovirus retinitis, primarily affects the eyes and vision, not speech and motor skills. Choice C, Peripheral neuropathy, involves damage to peripheral nerves, causing numbness and tingling in extremities, not cognitive and motor impairments. Therefore, the most likely problem based on the client's signs and symptoms is subcortical neurodegenerative disease.

Correct Answer: C

Rationale: Rationale: A high reticulocyte value indicates increased bone marrow production to compensate for chronic anemia. A low hematocrit indicates anemia severity but not chronicity. INR and platelet count are not specific to chronic anemia.

Correct Answer: A

Rationale: The correct answer is A. By asking the client what activities they were able to do 6 months ago compared to the present, the nurse can assess the decline in the client's activity level over time, providing valuable information on the extent of activity intolerance. This question helps establish a baseline and track changes in the client's functional status. Choice B is incorrect as it focuses on the duration of the problem rather than the client's current activity tolerance. Choice C does not directly address the client's activity level but rather their ability to keep up with usual activities. Choice D is also incorrect as it only asks about tiredness and does not provide a direct comparison of the client's activity level over time.

Correct Answer: A

Rationale: Rationale for Choice A (Correct Answer - An autoimmune disorder): 1. Aplastic anemia is often associated with autoimmune disorders where the immune system attacks the bone marrow cells. 2. In aplastic anemia of unknown cause, autoimmune reactions are a common underlying mechanism. 3. Autoimmune disorders can disrupt the bone marrow's ability to produce healthy blood cells. Summary of Other Choices: B: Chemotherapy drugs - While chemotherapy can cause aplastic anemia, the question specifies an unknown cause. C: Radiation exposure - Radiation exposure can lead to aplastic anemia, but the question specifies an unknown cause. D: Toxins - Toxins can contribute to aplastic anemia, but the question implies an undiagnosed origin.

Correct Answer: B

Rationale: The correct answer is B: Ferritin. Ferritin is the major metabolically available storage form of iron in the body. It stores excess iron in a soluble and non-toxic form, releasing it when needed for various physiological functions. Rationale: 1. Ferritin is a protein that binds and stores iron within its structure. 2. It helps regulate the levels of iron in the body by storing excess iron and releasing it when needed. 3. Hemosiderin is an insoluble form of iron storage, not readily available for metabolism. 4. Transferrin is a transport protein that carries iron in the blood, not a storage form. 5. Hemoglobin is a protein in red blood cells that carries oxygen, not a storage form of iron. Summary: Ferritin is the correct answer as it is the primary metabolically available storage form of iron, while the other choices are incorrect as they do not serve as major storage forms of iron in the body.