What dietary advice should the nurse give to clients with HIV/AIDS?

Correct Answer: B

Rationale: In the context of HIV/AIDS, the nurse should advise clients to increase their intake of water-soluble vitamins in amounts two to five times the Recommended Dietary Allowance (RDA). This is because HIV/AIDS can lead to malabsorption issues and increased nutrient requirements, especially for water-soluble vitamins like B vitamins and vitamin C which are crucial for maintaining immune function. Option A is incorrect because encouraging the intake of fat-soluble vitamins in excess of the RDA can lead to toxicity since these vitamins are stored in the body and can accumulate to harmful levels. Option C is incorrect because while iron and zinc are important nutrients, excessive intake can also lead to toxicity and may not be necessary for all clients with HIV/AIDS. Option D is incorrect as decreasing the intake of trace elements and antioxidant supplements may actually be detrimental for clients with HIV/AIDS, as these nutrients play a role in supporting immune function and overall health. Educationally, it is important for nurses to understand the specific nutritional needs of clients with HIV/AIDS and how the disease can impact nutrient absorption and utilization. By providing accurate dietary advice, nurses can support the overall health and well-being of their clients living with HIV/AIDS.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Administer first dose of varicella vaccine. This answer should be questioned because the patient is currently on prednisone, a corticosteroid that can suppress the immune system's response. Administering a live attenuated vaccine like the varicella vaccine can pose a risk of causing an infection in an immunocompromised individual like the patient with SLE. Option A) Discontinuing prednisone abruptly can lead to adrenal insufficiency and exacerbation of the lupus symptoms. It is important to taper corticosteroid doses gradually. Option C) Checking the patient's C-reactive protein (CRP) is a valid monitoring parameter to assess inflammation levels in SLE and response to treatment. Option D) Giving ibuprofen is not contraindicated in this scenario as it can help with managing inflammation and pain in SLE, although long-term use should be monitored due to potential side effects on the gastrointestinal system and kidneys. Educationally, this question highlights the importance of understanding drug interactions and contraindications, especially in patients with autoimmune conditions like SLE who are on immunosuppressive therapy. It emphasizes the need for healthcare providers to be vigilant in assessing medication orders to prevent potential harm to patients.

Correct Answer: C

Rationale: In the treatment of exacerbations of systemic lupus erythematosus (SL), corticosteroids (Option C) are often used due to their potent anti-inflammatory properties. Corticosteroids help reduce inflammation and suppress the overactive immune response seen in SL, providing relief from symptoms such as joint pain, skin rashes, and organ involvement. They are a mainstay in managing acute flares of autoimmune diseases like SL. Option A, Antiemetics, are used to treat nausea and vomiting, which are not primary symptoms of SL exacerbations. Option B, Antineoplastics, are medications used to treat cancer and are not indicated for SL treatment. Option D, Antibiotics, are used to treat bacterial infections and do not target the underlying autoimmune response in SL. In an educational context, understanding the rationale behind using corticosteroids in SL exacerbations highlights the importance of anti-inflammatory therapy in managing autoimmune diseases. It also emphasizes the need for targeted and appropriate treatment to address the underlying pathophysiology of the condition, rather than just symptomatic relief. This knowledge is crucial for healthcare professionals involved in the care of patients with autoimmune disorders like SL.

Correct Answer: C

Rationale: The primary difference between healing by primary intention and healing by secondary intention lies in the amount of granulation tissue formed during the healing process. In primary intention healing, the wound edges are brought together and sutured, resulting in minimal granulation tissue formation and less scarring. On the other hand, in secondary intention healing, the wound is left open to heal, leading to the formation of more granulation tissue, which in turn causes more scarring. Option A is incorrect because surgical debridement is not a requirement for healing by secondary intention. Debridement may be necessary in certain cases to remove necrotic tissue, but it is not a defining factor of secondary intention healing. Option B is incorrect because primary intention healing involves the approximation of wound edges and the formation of a minimal amount of granulation tissue, rather than suturing two layers of granulation tissue together. Option D is incorrect because healing by secondary intention takes longer primarily due to the increased formation of granulation tissue, which is a necessary step in the natural healing process for wounds left open to heal. Understanding the differences between primary and secondary intention healing is crucial in clinical practice as it informs healthcare professionals about the expected outcomes, healing timelines, and potential complications associated with each type of wound healing. This knowledge allows for appropriate wound management decisions to be made based on the specific characteristics of the wound and the patient's overall health status.

Correct Answer: C

Rationale: In pharmacology, understanding the importance of preventing pressure ulcers is crucial for nurses. The most important nursing intervention for the prevention and treatment of pressure ulcers is repositioning the patient a minimum of every 2 hours (Option C). This is because pressure ulcers, also known as bedsores, develop due to prolonged pressure on the skin, leading to tissue damage. Repositioning helps redistribute pressure, relieving stress on vulnerable areas and promoting better blood flow. Option A, using pressure-reduction devices, is a helpful intervention but may not be as effective if the patient is not repositioned regularly. Massaging pressure areas with lotion (Option B) can actually be harmful as it can further damage fragile skin tissues. Using lift sheets and trapeze bars (Option D) may aid in patient movement but does not directly address the root cause of pressure ulcers, which is prolonged pressure on specific areas of the skin. Educationally, nurses need to understand the pathophysiology of pressure ulcers and the importance of preventive measures like regular repositioning. By implementing proper repositioning techniques, nurses can significantly reduce the risk of pressure ulcers in patients, promoting better overall outcomes and quality of care.