The practical nurse (PN) knows that AIDS is a viral infection that compromises the effectiveness of the immune system. Which component of the immune system is characteristically affected?

Choice A reason: Placing the food and utensils in the client's left visual field and leaving him alone does not address the underlying issue of the visual field deficit. While it may temporarily solve the problem of the client eating only the food on the left side, it does not encourage the client to adapt to or compensate for the right homonymous hemianopsia. The goal of rehabilitation is to help the client develop strategies to manage their condition independently, and this approach does not foster such skills.
Choice B reason: Feeding the client foods that are on the right side of his visual field is not the most effective approach, as it does not promote the client's independence or help them adapt to their visual field deficit. While it ensures the client consumes the food on the right side, it does not teach the client to compensate for their hemianopsia, which is an essential aspect of their rehabilitation.
Choice C reason: Reminding the client to look all over the tray to view and eat all the foods provided is the best approach. This action helps the client become more aware of their visual field deficit and encourages them to develop the habit of scanning their environment. Teaching the client to consistently look around their entire visual field promotes independence and helps them adapt to daily activities despite their condition. This strategy supports the goal of rehabilitation, which is to enhance the client's ability to manage their visual impairment independently.
Choice D reason: Prompting the client to rotate his plate to see foods on the right side of the tray is a practical solution, but it does not address the broader need for the client to learn to scan their environment. While rotating the plate may temporarily help the client access the food on the right side, it does not encourage the development of compensatory strategies for the visual field deficit. Encouraging the client to look all over the tray is a more effective approach for long-term adaptation and independence.

Choice A reason: Assessing urine for ketones is an important step in diagnosing diabetic ketoacidosis (DKA), a serious complication of diabetes. Ketones are produced when the body breaks down fat for energy due to a lack of insulin. High levels of ketones in the urine can indicate DKA. However, while this is a necessary assessment, it is not the immediate priority. The most urgent action is to measure the blood glucose to determine if hyperglycemia is present, which is a key indicator of DKA.
Choice B reason: Auscultating breath sounds is an important assessment to evaluate the client's respiratory status. Deep, rapid respirations (Kussmaul respirations) are often associated with DKA as the body attempts to compensate for metabolic acidosis. While auscultating breath sounds is valuable, it is not the first action to take. The primary concern is to confirm hyperglycemia, which is a critical step in diagnosing and managing DKA.
Choice C reason: Elevating the head of the bed can help improve the client's comfort and respiratory function, especially if they are experiencing difficulty breathing. However, this action does not directly address the underlying issue of hyperglycemia and potential DKA. While it can be part of supportive care, the immediate priority is to measure the blood glucose levels to assess the severity of the condition and initiate appropriate treatment.
Choice D reason: Measuring the blood glucose is the most critical and immediate action. Deep, rapid respirations and a fruity breath odor are classic signs of DKA, a life-threatening condition that requires prompt diagnosis and treatment. By measuring the blood glucose, the practical nurse can confirm hyperglycemia and initiate interventions to manage blood sugar levels, such as insulin administration and fluid replacement. Early detection and treatment are essential to prevent complications and stabilize the client’s condition.