A client with HIV-III and wasting syndrome has inadequate nutrition. What assessment finding by the nurse best indicates that goals have been met for this client problem?

The client has a weight gain of 2 lb (1 kg) per month.

The client eats 90% of meals and snacks.

The client chooses high-protein food.

The client has decreased oral discomfort.

Answer and Explanation

The Correct Answer is A

Choice A rationale:
Weight gain is the most objective and reliable indicator of improved nutritional status in clients with wasting syndrome. It directly reflects an increase in lean body mass, which is essential for restoring health and function.
A weight gain of 2 lb (1 kg) per month is considered a safe and achievable goal for clients with HIV-III and wasting syndrome. This rate of weight gain promotes gradual replenishment of nutrient stores without overwhelming the body's systems.
While other assessment findings, such as increased food intake or decreased oral discomfort, may be positive signs, they do not necessarily guarantee that nutritional goals have been met. It's possible for a client to consume more calories without experiencing weight gain due to factors such as malabsorption or increased metabolic demands. Similarly, decreased oral discomfort may improve appetite but not ensure adequate nutrient intake.
Choice B rationale:
While eating 90% of meals and snacks is a positive sign, it does not guarantee adequate nutrient intake or weight gain. The client may still be consuming insufficient calories or experiencing malabsorption.
The focus of nutritional intervention for wasting syndrome is to increase lean body mass, which is best reflected by weight gain. Eating patterns alone may not accurately capture this progress.
Choice C rationale:
Choosing high-protein foods is important for supporting tissue repair and immune function, but it does not guarantee adequate overall caloric intake or weight gain. The client may still be consuming insufficient calories or experiencing malabsorption.
Weight gain is a more comprehensive indicator of improved nutritional status, as it reflects both protein intake and overall caloric balance.
Choice D rationale:
Decreased oral discomfort can improve appetite and facilitate food intake, but it does not guarantee adequate nutrient intake or weight gain. The client may still be consuming insufficient calories or experiencing malabsorption.
Weight gain is a more direct and reliable indicator of improved nutritional status, as it reflects the actual utilization of nutrients for tissue repair and growth.

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Correct Answer is C

Explanation

A. "Diseases such as arthritis, which we term 'autoimmune,' make you more likely to catch viruses and other bugs."

This statement incorrectly suggests that autoimmune diseases like arthritis increase the likelihood of catching viruses and other bugs. In reality, autoimmune diseases occur when the immune system mistakenly attacks the body's own tissues, but they do not necessarily make individuals more susceptible to infections. This statement could lead to confusion and misunderstanding about the relationship between autoimmune diseases and infectious illnesses.

B. "Changes that we call 'mutations in your cells make your organs more vulnerable to chronic illness and germs."

This statement introduces the concept of mutations in cells, which can lead to various health conditions, including cancer. However, it does not specifically address the role of the immune response and autoimmune activity in the aging process. While mutations can indeed affect organ function and susceptibility to illness, this statement does not provide a comprehensive explanation of how the aging immune system contributes to these processes.

C. "You may have more difficulty fighting off infections because of a weaker immune system, and it is possible your body will attack itself."

This statement effectively communicates two important aspects of the aging immune system: the weakening of the immune system, leading to increased susceptibility to infections, and the potential for autoimmune activity, where the body's immune system mistakenly attacks its own tissues. It accurately describes how these factors contribute to the aging process and its impact on immune function, making it a clear and relevant explanation for the client.

D. "Our bodies seem to have an 'expiration date,' after which all people are far more likely to get infections and develop chronic illness."

This statement oversimplifies the aging process by suggesting that everyone has an "expiration date" after which they are more likely to experience infections and chronic illness. While it is true that aging is associated with changes in immune function and increased susceptibility to certain health conditions, such as infections and chronic diseases, the aging process is complex and varies among individuals. This statement does not provide a nuanced explanation of the role of the immune response and autoimmune activity in aging.

A. "Provided you signed a directive on admission, your records will not be made public." B. "Privacy legislation ensures that your medical records will not leave this hospital." C. "The law protects your right to confidentiality and health information from being released into unintended hands." D. "Anything that is discussed between us is confidential and will not be shared with anyone else."

Correct Answer is C

Explanation

A. "Provided you signed a directive on admission, your records will not be made public."

This response may not be entirely accurate or reassuring for the client. While directives or forms signed upon admission might address aspects of confidentiality or consent, they typically pertain to specific legal or medical procedures rather than general confidentiality protections. Additionally, stating that records "will not be made public" might oversimplify the issue, as confidentiality extends beyond just making records public and involves safeguarding information from unauthorized access or disclosure.

B. "Privacy legislation ensures that your medical records will not leave this hospital."

While privacy legislation does indeed protect the confidentiality of medical records, this response might be overly restrictive or misleading. Confidentiality protections extend beyond the physical location of the hospital and involve various legal and ethical standards governing the handling and disclosure of health information. The statement could give the impression that the client's information is completely confined within the hospital, whereas confidentiality extends to all interactions involving healthcare providers, insurers, and others involved in the client's care.

C. "The law protects your right to confidentiality and health information from being released into unintended hands."

This response accurately conveys the essence of confidentiality protections under the law. It reassures the client that their health information is safeguarded against unauthorized disclosure and emphasizes the importance of confidentiality in healthcare. By mentioning "unintended hands," it underscores the broader scope of confidentiality beyond just making information public. This response is likely to provide the client with a sense of security regarding the privacy of their medical information.

D. "Anything that is discussed between us is confidential and will not be shared with anyone else."

While this response emphasizes the confidentiality of discussions between the nurse and the client, it might oversimplify the issue. Confidentiality in healthcare extends beyond verbal exchanges and encompasses all forms of health information, including medical records, test results, and treatment plans. While it is essential for the client to understand that their conversations with healthcare providers are confidential, they should also be aware of broader confidentiality protections governing their health information within the healthcare system.

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A client with HIV-III and wasting syndrome has inadequate nutrition. What assessment finding by the nurse best indicates that goals have been met for this client problem?

Nursing Test Bank

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