Choice A rationale
The patient is receiving a nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) for HIV
treatment and reports experiencing malaise, fatigue, and anorexia. These symptoms, along
with the observed increased respiratory rate, could be indicative of liver toxicity, a known
potential side effect of NRTIs. Therefore, reviewing liver function tests would be most
important in this case.
Choice B rationale
While arterial blood gases can provide valuable information about a patient’s respiratory
status, they may not be the most relevant in this context. The patient’s symptoms and the side
effect profile of NRTIs suggest that liver function may be a more pressing concern.

Choice C rationale
A complete blood count (CBC) can provide a broad overview of a patient’s general health, but it
may not provide the specific information needed to assess the patient’s current symptoms and
potential medication side effects.
Choice D rationale
A basic metabolic panel can provide information about a patient’s kidney function, electrolyte
levels, and blood sugar levels, among other things. However, given the patient’s symptoms and
medication regimen, liver function tests may be more relevant.

Choice A rationale

Sildenafil, commonly known as Viagra, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. One of the side effects of sildenafil is visual changes. These changes can be temporary or long-lasting, and can potentially be a sign of a serious condition known as non-arteritic anterior ischemic optic neuropathy (NAION), which can lead to permanent vision loss. Therefore, it is crucial for the client to report these symptoms to the healthcare provider immediately for further evaluation and management.

Choice B rationale

While eye drops can be used to treat various eye conditions, they are not typically used to address visual changes caused by sildenafil. Therefore, instilling prescribed eye drops would not be the appropriate response in this situation.

Choice C rationale

Wearing dark glasses when outside can help protect the eyes from sun damage, but it would not address the underlying issue of visual changes caused by sildenafil. Therefore, this would not be the appropriate instruction for the practical nurse to give to the client.

Choice D rationale

The Amsler grid tool is used to detect vision problems resulting from damage to the macula (the central part of the retina) or the optic nerve. However, this tool would not be useful in this context as the visual changes are a side effect of sildenafil. Therefore, monitoring for visual changes each morning using an Amsler grid tool would not be the appropriate instruction for the practical nurse to give to the client.