ATI RN
ATI N120n122 Med Surg Exam Questions
Extract:
Question 1 of 5
A nurse is providing education to a client diagnosed with sickle cell anemia. Which of the following can be anticipated will be a trigger for a sickle cell crisis?
Correct Answer: B
Rationale: Dehydration is a significant trigger for sickle cell crises, as it can lead to increased blood viscosity and sickling of red blood cells. Over-hydration is not a trigger for a sickle cell crisis; in fact, adequate hydration helps prevent sickling of the cells. Non-steroidal anti-inflammatory drugs (NSAIDs) are often used to manage pain associated with sickle cell crises, but they do not trigger a crisis. Vaccinations are important for preventing infections in individuals with sickle cell anemia but are not associated with triggering a sickle cell crisis.
Question 2 of 5
A nurse is presenting a community-based program about HIV and AIDS. A client asks the nurse to describe the initial symptoms experienced with HIV infection. Which manifestation(s) should the nurse include?
Correct Answer: B
Rationale: Flu-like symptoms and night sweats are common initial manifestations of acute HIV infection, often occurring within 2-4 weeks after exposure. Fungal and bacterial infections can occur later as the immune system becomes compromised, but they are not initial symptoms of HIV infection. Kaposi's sarcoma is a type of cancer associated with advanced HIV/AIDS and not an initial symptom of infection. Pneumocystis lung infection typically occurs later in the course of HIV disease when the immune system is severely weakened, not during the initial infection stage.
Question 3 of 5
A nurse is caring for a client with sickle cell anemia. The client asks, 'Why am I in so much pain?' What is an appropriate response from the nurse to make to this client?
Correct Answer: B
Rationale: Sickle cell anemia causes red blood cells to become rigid and shaped like a sickle, which can obstruct blood flow and lead to vaso-occlusive crises, resulting in pain. While deep breathing can help alleviate pain, it is not the primary cause of pain in sickle cell anemia; this response could minimize the client's experience. Although sickle cell anemia is a genetic disorder, simply stating that the mutated gene causes increased pain is too vague and does not explain the pain mechanism adequately. While anemia can contribute to fatigue and some discomfort, the pain in sickle cell anemia is primarily due to the sickling of red blood cells and subsequent blockage of blood flow, rather than just the lack of hemoglobin.
Question 4 of 5
A nurse is caring for a client with HIV. Which laboratory test would be used to assess the effectiveness of therapy?
Correct Answer: A
Rationale: Viral load count is the primary test used to assess the effectiveness of HIV therapy by measuring the amount of HIV RNA in the blood, indicating how well the treatment is controlling the virus. The Western blot is used as a confirmatory test for HIV diagnosis rather than monitoring therapy effectiveness. The Enzyme immunoassay (EI
A) test is used for initial HIV screening but does not measure viral load or therapy effectiveness. Platelet count can be affected in HIV infection, especially with advanced disease, but it does not directly measure the effectiveness of HIV therapy.
Question 5 of 5
A nurse is caring for a client who has human immunodeficiency virus (HIV). Which laboratory value should the nurse alert the provider of?
Correct Answer: B
Rationale: A CD4-T-cell count of 180 cells/mm³ is significantly low (normal range: 500 to 1500 cells/mm³) and indicates severe immunosuppression, putting the client at increased risk for opportunistic infections, warranting immediate attention from the provider. A positive Western blot test indicates an HIV diagnosis, which is expected in a client with HIV and does not require urgent intervention. A platelet count of 150,000/mm³ is at the lower end of the normal range and does not typically require immediate intervention unless there are clinical symptoms associated. A WBC count of 5,000/mm³ is within the normal range and does not indicate a need for urgent intervention.