A nurse is caring for a client with reported nausea, exhaustion, and unplanned weight loss of 24 pounds over 3 months. The client's lab results from 8 months ago indicate negative HIV and hepatitis status.
The nurse should anticipate which of the following healthcare provider orders?
CBC.
PPD test.
Chest x-ray.
HIV test.
The Correct Answer is D
Choice A rationale
A complete blood count (CBC) analyzes cellular components of blood, including red and white blood cells and platelets. While a CBC can reveal general health status and signs of infection or anemia, it does not directly diagnose the underlying cause of unexplained weight loss and fatigue in this context, especially given the historical negative HIV status.
Choice B rationale
A purified protein derivative (PPD) test screens for tuberculosis infection by detecting an immune response to mycobacterial antigens. While unexplained weight loss can be a symptom of tuberculosis, the initial presentation with nausea and exhaustion, coupled with negative HIV status 8 months prior, suggests a broader differential diagnosis requiring a more comprehensive initial screening.
Choice C rationale
A chest x-ray provides an image of the heart, lungs, and blood vessels, primarily used to diagnose respiratory conditions like pneumonia or tuberculosis. While lung pathology can cause fatigue and weight loss, a chest x-ray is a focused diagnostic tool and may not be the most appropriate initial screening test for the client's constellation of symptoms.
Choice D rationale
Given the client's symptoms of nausea, exhaustion, and significant unplanned weight loss, a repeat HIV test is crucial. Despite a negative test 8 months prior, these symptoms are highly suggestive of a retroviral syndrome or progression to AIDS, which can manifest with constitutional symptoms and opportunistic infections leading to profound weight loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
The pathway of flow through the body is not the primary determinant for the severity and management of radiation burns. Unlike electrical burns where current pathway is critical, radiation burns are localized tissue damage caused by energy deposition. While systemic effects can occur with high doses, the immediate burn care focuses on the affected areas.
Choice B rationale
The duration of contact with the agent is a significant factor, as longer exposure generally correlates with a higher absorbed dose of radiation, leading to more severe burns. However, it is not the sole determinant, as the type and intensity of the radiation also play crucial roles. The overall dose is a combination of dose rate and exposure time.
Choice C rationale
The temperature to which the skin is heated is the primary mechanism of thermal burns, where heat directly coagulates proteins and damages cells. Radiation burns, however, are caused by the ionization of molecules and formation of free radicals within the tissue, leading to cellular damage and death, rather than direct heating. The burn severity is not primarily determined by temperature.
Choice D rationale
The type, dose, and length of exposure are the most critical factors determining the severity and clinical presentation of radiation burns. Different types of radiation (alpha, beta, gamma, neutron) have varying penetrative abilities and biological effectiveness. The absorbed dose quantifies the energy deposited, and the duration of exposure directly influences the total dose received, all impacting tissue damage.
Correct Answer is ["A","C","D","E"]
Explanation
Choice A rationale
Cough can be a manifestation of a systemic Type I hypersensitivity reaction, indicating bronchospasm or laryngeal edema due to mast cell degranulation and histamine release in the respiratory tract, leading to airway narrowing and irritation.
Choice B rationale
Allergic rhinitis is typically a localized Type I hypersensitivity reaction, characterized by nasal congestion, sneezing, and rhinorrhea. While uncomfortable, it does not usually indicate a systemic, life-threatening response as seen in anaphylaxis.
Choice C rationale
Pruritus, or itching, is a common cutaneous manifestation of systemic Type I hypersensitivity, resulting from widespread histamine release acting on sensory nerve endings in the skin, causing intense irritation and discomfort.
Choice D rationale
Hypotension is a critical systemic manifestation of Type I hypersensitivity, particularly anaphylaxis. It results from massive vasodilation and increased capillary permeability due to systemic histamine release, leading to profound reduction in systemic vascular resistance and circulatory collapse.
Choice E rationale
Wheezing is a significant respiratory manifestation of systemic Type I hypersensitivity, caused by widespread bronchoconstriction and airway edema. This narrows the bronchial passages, leading to turbulent airflow and the characteristic high-pitched whistling sound during respiration.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.