ATI RN
Concept of Family Centered Care Questions
Question 1 of 5
The nurse is reviewing laboratory results for a patient who has HIV. Which result would be strongly suggestive of a diagnosis of AIDS?
Correct Answer: A
Rationale: The correct answer is A because a CD4+ count of 180/μL is significantly below the normal range (500-1500/μL) and indicative of severe immunosuppression, which is a hallmark of AIDS. CD4+ percentage alone (choice B) may not provide the full picture. CD8+ count (choice C) doesn't directly indicate immune system status in HIV/AIDS. The CD4+/CD8+ ratio (choice D) may be altered in various conditions, not specific to AIDS.
Question 2 of 5
The nurse is preparing to read the Mantoux tuberculin skin test placed on the forearm of a patient with HIV. Which finding should the nurse report as a positive test for this patient?
Correct Answer: D
Rationale: The correct answer is D (5 mm) for a positive Mantoux test in a patient with HIV. In HIV-positive individuals, a positive test is considered when the induration is ≥5 mm. This is because the immune system may be compromised, leading to a delayed immune response. Choices A, B, and C (2 mm, 3 mm, 4 mm) are not considered positive for HIV-positive individuals due to their weakened immune system, requiring a larger induration size to indicate a positive test.
Question 3 of 5
The nurse is preparing to provide education related to HIV transmission at a local community health fair. Which statements should the nurse recommend for inclusion in the teaching? (Select all that apply.)
Correct Answer: B
Rationale: Step 1: Using a new condom for each sex act helps reduce the risk of HIV transmission by preventing the exchange of bodily fluids. Step 2: This practice ensures that there is no risk of contamination from a previously used condom. Step 3: It is a crucial aspect of safe sex practices to protect oneself and others from contracting HIV. Summary: Choice B is correct as it promotes safe sex practices. Choices A, C, and D are incorrect as they do not contribute to reducing the risk of HIV transmission.
Question 4 of 5
A patient was admitted last night with a hip fracture sustained in a fall while intoxicated. The patient points to the Buck traction and screams, 'Somebody tied me up with ropes.' The patient is experiencing:
Correct Answer: A
Rationale: The correct answer is A: illusion. An illusion is a misinterpretation of a real external stimulus. In this case, the patient is misperceiving the traction as ropes due to the altered mental state from intoxication. It is a sensory distortion based on a real object. Delusion (B) is a fixed false belief, not related to sensory perceptions. Hallucinations (C) are false sensory perceptions without external stimulus. Hypnagogic phenomenon (D) refers to sensory experiences during the transition from wakefulness to sleep, not applicable here.
Question 5 of 5
A patient asks for information about Alcoholics Anonymous (AA). Which is the nurse’s best response?
Correct Answer: A
Rationale: The correct answer is A: "It is a self-help group with the goal of sobriety." This is the best response because Alcoholics Anonymous (AA) is indeed a self-help group focused on achieving and maintaining sobriety through shared experiences and support. Choice B is incorrect because AA is not led by a psychiatrist but rather by individuals who are also in recovery. Choice C is incorrect as AA does not focus on learning about drinking but rather on supporting recovery. Choice D is incorrect as AA does not advocate for punishment but rather emphasizes compassion and understanding towards individuals struggling with alcohol addiction.