In a client who has human immunodeficiency virus (HIV) infection, CD4+ levels are measured to determine the:

Questions 68

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Pharmacology and the Nursing Process 10th Edition Test Bank Quizlet Questions

Question 1 of 9

In a client who has human immunodeficiency virus (HIV) infection, CD4+ levels are measured to determine the:

Correct Answer: B

Rationale: Step-by-step rationale: 1. CD4+ cells are a type of white blood cell crucial for immune function. 2. HIV targets and destroys CD4+ cells, leading to immune system damage. 3. Measuring CD4+ levels helps determine the extent of this damage. 4. Therefore, the correct answer is B. Summary: A: Presence of opportunistic infections - CD4+ levels indirectly affect susceptibility, but not measured for this purpose. C: Level of the viral load - Measured separately from CD4+ levels. D: Resistance to antigens - CD4+ levels do not directly indicate resistance.

Question 2 of 9

A total thyroidectomy is ordered following discovery of a cold nodule. In this case of hyperthyroidism versus malignancy, the nurse anticipates that the patient will have:

Correct Answer: A

Rationale: The correct answer is A: A complete thyroidectomy also. In the case of a cold nodule, which indicates potential malignancy, a total thyroidectomy is warranted to remove the entire thyroid gland to prevent the spread of cancer. A partial thyroidectomy, as in choices B and C, would not be sufficient in addressing malignancy. Administering thyroid medication, as in choice D, would not be appropriate for treating malignancy. Therefore, the correct approach is to perform a total thyroidectomy to ensure complete removal of the affected gland and to address both hyperthyroidism and potential malignancy.

Question 3 of 9

The physician orders local application of epinephrine 1:1000 solution to treat a nosebleed. The patient asks how this will help. Which of the ff. responses by the nurse is best?

Correct Answer: D

Rationale: The correct answer is D. Epinephrine, when applied locally, constricts blood vessels, reducing blood flow and slowing down bleeding. This vasoconstrictive effect helps control nosebleeds effectively. Choice A is incorrect because although epinephrine can raise blood pressure, it is not the primary mechanism for treating nosebleeds. Choice B is incorrect as epinephrine's bronchodilation effect is not relevant in this context. Choice C is incorrect as while promoting blood clotting is beneficial, epinephrine primarily acts by vasoconstriction to control bleeding.

Question 4 of 9

A patient has reduced muscle strength following a left-sided stroke and is at risk for falling. Which intervention is most appropriate for the nursing diagnostic statement Risk for falls?

Correct Answer: D

Rationale: The correct answer is D. This intervention is appropriate because it addresses the patient's reduced muscle strength following a left-sided stroke and the risk for falling. Assisting the patient into and out of bed regularly helps prevent falls by ensuring safe mobility and reducing the likelihood of accidents. It promotes independence while also providing necessary support. A: Keeping all side rails down at all times may increase the risk of falls as it removes a safety measure that can help prevent falls. B: Encouraging the patient to remain in bed most of the shift can lead to deconditioning and muscle weakness, increasing the risk of falls. C: Placing the patient in a room away from the nurses' station does not directly address the risk for falls and may hinder timely assistance in case of emergencies. In summary, option D is the most appropriate intervention as it addresses the patient's needs, promotes safety, and supports mobility to prevent falls effectively.

Question 5 of 9

When the patient’s signature is witnessed by the nurse on the surgical consent, which of the following does the nurse’s signature indicate?

Correct Answer: D

Rationale: The correct answer is D because the nurse's signature indicates that they verified the patient's signature on the consent form. This step ensures that the patient has signed the document willingly. Choice A is incorrect because the nurse doesn't obtain informed consent, that's the responsibility of the physician. Choice B is incorrect because nurses do not provide informed consent. Choice C is incorrect as the nurse witnessing the signature doesn't imply they answered all surgical procedure questions.

Question 6 of 9

A nurse is providing education to a patient about self-administering subcutaneous injections. The patient demonstrates the self-injection. Which type of indicator did the nurse evaluate?

Correct Answer: B

Rationale: The correct answer is B: Health behavior. Evaluating the patient's demonstration of self-injection assesses their ability to perform a specific health-related action. This choice focuses on the patient's actions and behaviors related to their health, aligning with the scenario provided. Choice A: Health status is incorrect because it refers to the patient's current physical condition, not their ability to perform a specific health action. Choice C: Psychological self-control is incorrect as it pertains to the patient's ability to regulate their emotions and impulses, not their ability to self-administer injections. Choice D: Health service utilization is incorrect as it relates to the frequency and pattern of healthcare services used by the patient, not their ability to perform a specific health behavior.

Question 7 of 9

A client has type1 diabetes. Her husband finds her unconscious at home and administers glucagons, 0.5 mg S.C. She awakens in 5 minutes .Why her husband offer a complex carbohydrate snack to her as soon as possible?

Correct Answer: B

Rationale: The correct answer is B. After administering glucagon for hypoglycemia, the body may deplete its glycogen stores from the liver. Offering a complex carbohydrate snack will help restore liver glycogen, preventing secondary hypoglycemia. This is crucial for maintaining blood glucose levels in individuals with type 1 diabetes. Choices A, C, and D are incorrect because offering a complex carbohydrate snack is primarily aimed at restoring liver glycogen to prevent further hypoglycemic episodes, not to address nausea/vomiting, stimulate appetite, or decrease glycogen levels.

Question 8 of 9

Which of the ff conditions are more likely to develop in a client who is relatively immobile for the rest of his or her life? Choose all that apply

Correct Answer: A

Rationale: The correct answer is A: Bladder infection. Immobility can lead to urinary stasis, causing bacteria to multiply in the bladder, leading to a higher risk of bladder infections. B: Constipation can also occur due to immobility, but it is not directly related to the urinary system. C: Calculus formation is more related to factors like diet and hydration, not immobility. D: Bladder inflammation can be a result of infection but is not as directly linked to immobility as bladder infections.

Question 9 of 9

The multilumen pulmonary artery catheter allows the nurse to measure hemodynamic pressures at different points in the heart. When the tip enters the small branches of the pulmonary artery, the nurse can assess all of the following except:

Correct Answer: C

Rationale: The correct answer is C: Pulmonary artery obstructive pressure (PACP). The multilumen pulmonary artery catheter measures hemodynamic pressures in the heart. When the catheter tip enters small branches of the pulmonary artery, it can assess Central Venous Pressure (A), Pulmonary Artery Capillary Pressure (B), and Pulmonary Artery Wedge Pressure (D). Pulmonary artery obstructive pressure is not a standard hemodynamic measurement and is not assessed using this catheter. It is crucial to differentiate between the various pressures measured to accurately assess the patient's cardiac status.

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