A client is tested for human immunodeficiency virus (HIV) infection with an enzyme- linked immunosorbent assay (ELISA), and the test result & positive. What would the nurse tell the client?

You probably have a gastrointestinal infection*

"You are confirmed to be infected with the HIV virus.

This is a good result, which means you do not have HIV."

Your result will need to be confirmed with a Western blot test."

Answer and Explanation

The Correct Answer is D

A. "You probably have a gastrointestinal infection":
This statement is incorrect. A positive result on the enzyme-linked immunosorbent assay (ELISA) indicates the presence of antibodies to HIV, which suggests exposure to the virus. It does not point to a gastrointestinal infection. HIV is a viral infection that primarily affects the immune system, not the gastrointestinal system. Misleading the client in this way would delay proper care and understanding of their health status.

B. "You are confirmed to be infected with the HIV virus.":
A positive ELISA test result does not automatically confirm an HIV diagnosis. ELISA is a screening test that detects HIV antibodies, but it can sometimes produce false-positive results. A positive ELISA result must be confirmed with a more specific confirmatory test, such as the Western blot test. Therefore, it would be premature to tell the client that they are "confirmed" to be infected with HIV without further confirmatory testing.

C. "This is a good result, which means you do not have HIV.":
This statement is also incorrect. A positive ELISA test result does not mean that the client does not have HIV. In fact, it indicates potential exposure to the virus. However, because the result is a screening test, it must be followed up with confirmatory testing. Telling the client that this is a "good result" would be misleading and could cause confusion or delay in appropriate care.

D. "Your result will need to be confirmed with a Western blot test.":
This is the correct response. The Western blot test is the confirmatory test used to verify a positive result from the ELISA. If the ELISA result is positive, the client should be informed that further testing, such as the Western blot, is needed to confirm the diagnosis of HIV infection. It is important to explain that the ELISA is a screening tool, and a positive result does not mean a definitive diagnosis without confirmation. This helps to set realistic expectations and ensures the client receives the appropriate follow-up care.

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Correct Answer is ["A","C","D"]

Explanation

The correct answers are:

A. You may start taking warfarin while still on heparin when you are getting ready to be discharged home.

Warfarin takes several days to reach therapeutic levels, so patients often overlap with heparin until the INR (International Normalized Ratio) reaches the target range (typically 2.0-3.0 for most conditions).

C. Use a soft-bristled toothbrush and avoid brushing too aggressively.

Warfarin increases the risk of bleeding, so using a soft toothbrush helps prevent gum bleeding.

D. You should replace straight razors with an electric shaver to avoid cuts.

Since warfarin thins the blood, small cuts can lead to excessive bleeding. An electric shaver reduces the risk of accidental cuts.

B. You will need to have your aPTT monitored frequently while on Warfarin. (Incorrect)

Warfarin is monitored using INR and PT (Prothrombin Time), not aPTT.
aPTT (Activated Partial Thromboplastin Time) is used to monitor heparin therapy, not warfarin.

E. Increase foods high in vitamin K like dark green leafy vegetables while taking Warfarin. (Incorrect)

Vitamin K counteracts warfarin's effects, so patients should keep their vitamin K intake consistent rather than increasing it.

A. Impaired perineal skin intergrity B. Fluid and electrolyte imbalances C. Pain related to abdominal cramping D. Protein-calorie malnutrition

Correct Answer is B

Explanation

A. Impaired perineal skin integrity:
While impaired perineal skin integrity is a concern for clients with severe diarrhea, it is not the priority risk in this case. Diarrhea can lead to irritation and breakdown of the skin, especially in the perineal area, but this can generally be managed with proper skin care and barrier creams. While important, this is not the most critical issue at the moment.

B. Fluid and electrolyte imbalances:
The priority risk for a client with an acute exacerbation of Crohn's disease and severe diarrhea is fluid and electrolyte imbalances. Diarrhea causes significant fluid loss, which can lead to dehydration and imbalances in electrolytes such as sodium, potassium, and chloride. These imbalances can result in life-threatening complications like hypovolemic shock, arrhythmias, and kidney failure. Therefore, ensuring adequate fluid and electrolyte replacement is the top priority in this situation.

C. Pain related to abdominal cramping:
While pain due to abdominal cramping is common in Crohn's disease, it is not the most immediate risk in this scenario. Pain management is important for comfort, but the risk of dehydration, electrolyte imbalances, and potential shock due to fluid loss takes precedence. Pain relief can be addressed after managing the more critical issues.

D. Protein-calorie malnutrition:
Protein-calorie malnutrition is a concern for patients with Crohn's disease, especially with chronic disease or malabsorption. However, in the context of an acute exacerbation with severe diarrhea, the immediate concern is fluid and electrolyte imbalance. Nutritional concerns, including malnutrition, are important for long-term management, but the priority in this acute phase is stabilizing the client’s fluid status to prevent further complications.

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A client is tested for human immunodeficiency virus (HIV) infection with an enzyme- linked immunosorbent assay (ELISA), and the test result & positive. What would the nurse tell the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education for client newly prescribed warfarin in preparation for being discharged home. Which of the following should be included the teaching plan? (Select all that apply.)

Correct Answer is ["A","C","D"]

Explanation

The nurse is caring for a client who was admitted for an acute exacerbation of Crohn's Disease with severe diarrhea for the last two days. The nurse knows that which of the following is the priority risk for this client?

Correct Answer is B

Explanation

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