A client who has tested positive for the human immunodeficiency virus (HIV) antibodies is admitted to the hospital with Pneumocystis Jiroveci Pneumonia (PCP) and a CD4+ T - Cell count of less than 200 cells/ ul. Based on the diagnostic criteria established by the Centers of Disease Control and Prevention (CDC), which statement by the nurse is correct?

"The client meets the criteria for the chronic asymptomatic HIV infection phase."

"The clients CD4+ T cell count is within normal range."

"The client meets the criteria for the acute HIV infection phase."

"The client has developed Acquired Immunodeficiency Syndrome (AIDS)."

Answer and Explanation

The Correct Answer is D

A. Chronic asymptomatic HIV infection refers to a phase with no opportunistic infections and higher CD4+ counts.

B. A CD4+ T cell count below 200 cells/μL is abnormal and diagnostic of AIDS, not within the normal range.

C. The acute HIV infection phase occurs shortly after exposure, characterized by flu-like symptoms and high viral load, not opportunistic infections.

D. The presence of Pneumocystis jiroveci pneumonia (an AIDS-defining illness) and a CD4+ T cell count below 200 cells/μL confirms a diagnosis of AIDS.

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Correct Answer is D

Explanation

A. Hypercalcemia (Calcium > 10.5 mg/dL) can lead to shortened QT intervals, not prolonged ones, and is unlikely to cause Torsades de Pointes.

B. A magnesium level of 3.1 mEq/L is slightly elevated and would not contribute to QT prolongation or Torsades de Pointes. In fact, magnesium supplementation is a treatment for this condition.

C. Hypokalemia (Potassium < 3.5 mEq/L) can prolong the QT interval and contribute to dysrhythmias, but it is less commonly a direct cause of Torsades de Pointes compared to hypomagnesemia. A potassium level of 2.6 mEq/L is low but would not typically result in Torsades without coexisting hypomagnesemia.

D. Hypomagnesemia (Magnesium < 1.5 mEq/L) disrupts the heart's electrical activity, prolonging the QT interval and increasing the risk of polymorphic ventricular tachycardia, like Torsades de Pointes. Magnesium is critical for stabilizing myocardial electrical conduction, and a value of 1.1 mEq/L indicates significant deficiency, consistent with this dysrhythmia.

A. Administer multiple vitamins and minerals in the IV solution. B. Infuse total parenteral nutrition via a central catheter. C. Encourage an oral intake of at least 3000 kcal per day. D. Insert a feeding tube and initiate enteral feedings.

Correct Answer is D

Explanation

A. Administering multiple vitamins and minerals via IV alone would not be sufficient for adequate nutrition in this patient, especially given the large burn surface area.

B. Total parenteral nutrition (TPN) may be used if enteral feeding is not possible, but enteral feeding is usually preferred when feasible.

C. Encouraging oral intake is not appropriate for a client with a 60% TBSA burn, as they would likely require more significant nutritional support than oral intake can provide.

D. Enteral feeding is the preferred method for nutrition in burn patients as it maintains gut integrity and prevents the complications associated with parenteral nutrition. Although the client has absent bowel sounds and a distended abdomen, this can be common early in burn care, and enteral feedings should be started as soon as feasible to prevent malnutrition and promote recovery.

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Naxlex Comprehensive Predictor Exams

Which lab value would be most likely to cause the following dysrhythmia?

Correct Answer is D

Explanation

A client has just been admitted with a 60% total body surface area (TBSA) burn injury. The nurse notes a distended abdomen with absent bowel sounds in all quadrants. To maintain adequate nutrition, the nurse should plan to take which action?

Correct Answer is D

Explanation

After providing discharge teaching, a nurse assesses the client's understanding regarding increased risk for metabolic alkalosis. Which statement indicates that the client needs additional teaching?

The nurse is caring for a client after a heart catheterization. What complication must the nurse intervene for immediately?

While working in the outpatient clinic, the nurse notes that the client has a history of intermittent claudication. Which statement by the client would support this information?

A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which intervention is appropriate for the nurse to perform prior to defibrillating this client?

The nurse is preparing to administer adenosine (Adenocard) to a client experiencing supraventricular tachycardia. When giving this medication, what is important to remember?