The client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine. The client develops a temperature of 101°F (38.3°C). The nurse continues to assess the client, knowing that this sign most likely indicates which condition?

Correct Answer: D

Rationale: Step 1: The client has acquired immunodeficiency syndrome, which impairs the immune system. Step 2: Pneumocystis jiroveci infection is an opportunistic infection common in immunocompromised individuals. Step 3: Pentamidine is used to treat Pneumocystis jiroveci infection but can cause leukopenia (decreased white blood cells). Step 4: Leukopenia increases the risk of developing other infections. Step 5: Fever (temperature of 101°F) is a common sign of infection. Step 6: Therefore, the most likely condition indicated by the fever is another infection due to leukopenic effects of the medication, making choice D the correct answer. Summary: A: Incorrect. Temperature elevation is not typically related to a low dose of medication. B: Incorrect. Toxic effects of pentamidine would likely present with different symptoms. C: Incorrect. Inadequacy of thermore

Correct Answer: D

Rationale: The correct answer is D: Renal cell carcinoma. In this case, the presentation of flank pain, hematuria, high hemoglobin, and high calcium levels is classic for renal cell carcinoma. The flank pain suggests tumor involvement, hematuria is a common symptom, high Hb can be due to erythropoietin production by the tumor, and high Ca can be from paraneoplastic syndrome. Polycystic kidney disease (A) typically presents with enlarged kidneys but not with these symptoms. Pheochromocytoma (B) usually presents with hypertension and palpitations. Adrenal carcinoma (C) is less likely given the presentation of flank pain and hematuria, which are more indicative of renal involvement.

Correct Answer: B

Rationale: The correct answer is B: Obtain α-fetoprotein and CT scan. In a patient with hemochromatosis presenting with weight loss, liver pain, and other concerning symptoms, the best next step is to evaluate for possible hepatocellular carcinoma (HCC) due to the increased risk in patients with liver disease. Obtaining α-fetoprotein levels and performing a CT scan can help detect any potential liver malignancy. Increasing phlebotomy (Choice A) may exacerbate the symptoms without addressing the underlying issue. Checking serum ferritin (Choice D) is not sufficient to rule out HCC. Hepatitis B serology (Choice C) is not indicated based on the patient's presentation.

Correct Answer: A

Rationale: The correct answer is A: Refer to surgeon. Given the presence of a palpable breast mass in a woman over 30, further evaluation is necessary to rule out malignancy. Referring to a surgeon for a biopsy or excision is crucial for definitive diagnosis. Choice B delays necessary evaluation. Choice C is not indicated as oral contraceptives have no role in evaluating breast masses. Choice D is inappropriate without further assessment.

Correct Answer: B

Rationale: The correct answer is B: Iron deficiency anemia. This woman presents with fatigue, heavy periods, low iron, and ferritin levels, which are classic symptoms of iron deficiency anemia. Iron is essential for red blood cell production, and a deficiency leads to decreased oxygen-carrying capacity causing fatigue. Thalassemia (choice A) would show microcytic anemia with normal iron studies. Sideroblastic anemia (choice C) presents with ringed sideroblasts on bone marrow biopsy. Anemia of chronic disease (choice D) is typically normocytic or microcytic and occurs in chronic inflammatory conditions.