NUR 265 / NUR265 EXAM 4 ADVANCED
CONCEPTS IN MEDICAL-SURGICAL
NURSING EXAM 4 | QUESTIONS AND
ANSWERS RATED A+ | 2026/2027
1. The nurse working in the emergency department (ED) is triaging a client who
has presented with chest pain, shortness of breath, a productive cough, and
reports night sweats. The client's health history includes the presence of acquired
immune deficiency syndrome (AIDS) and a recent laboratory result that reveals a
low CD4+ count. Airborne precautions have been initiated. Which of the following
actions should the nurse take next?
A. Prepare the client for insertion of a chest tube
B. Assess the client for shingles
C. Check the client's temperature
D. Obtain a throat culture
Answer: C — Check the client's temperature
Rationale: A fever is a symptom of an AIDS exacerbation or opportunistic infection.
After initiating airborne precautions for possible TB, the nurse should assess for fever as
part of the focused respiratory assessment. The low CD4+ count indicates
immunocompromise, making the client susceptible to opportunistic infections .
2. The newly hired nurse is developing a plan of care for a client who has acquired
immune deficiency syndrome (AIDS) and was just diagnosed with Pneumocystis
jiroveci pneumonia (PJP) and pain. Which of the following interventions should
the nurse preceptor question?
A. Telling the client to keep the door to the room closed at all times
B. Placing the client on a pressure-relieving mattress
C. Instructing the client to drink at least 2-3 liters of fluid throughout the day
D. Offering the client foods high in calories and protein
,Answer: B — Placing the client on a pressure-relieving mattress
Rationale: A pressure-relieving mattress is not an appropriate intervention for PJP. The
priority interventions include antibiotic therapy, respiratory support, and monitoring
oxygenation. PJP is an airborne opportunistic infection requiring airborne precautions
(closed door). Fluid intake and high-calorie, high-protein foods support recovery .
3. The nurse is caring for a client with AIDS who has just been diagnosed with
cryptococcal meningitis. Which of the following actions should the nurse take?
A. Initiate airborne precautions for the next 72 hours
B. Initiate seizure precautions with padded side rails
C. Administer IV pentamidine isethionate
D. Thicken the client's liquids to honey consistency
Answer: B — Initiate seizure precautions with padded side rails
Rationale: Cryptococcal meningitis can cause seizures. Seizure precautions with padded
side rails help prevent injury during seizure activity. Cryptococcal meningitis is an
opportunistic fungal infection common in AIDS patients with low CD4+ counts. IV
pentamidine is used for PJP, not cryptococcal meningitis .
4. The nurse has provided medication instructions to a client who has human
immunodeficiency virus (HIV) and has been prescribed combination antiretroviral
therapy (cART). Which of the following client statements indicates a correct
understanding of the teaching?
A. "I am less likely to develop opportunistic infections once I begin taking my prescribed
medications."
B. "I should discontinue my medications if I develop severe diarrhea."
C. "I can avoid developing drug resistance if I take 90% of my drugs on time."
D. "I understand that this combination of drugs will kill the virus."
Answer: C — "I can avoid developing drug resistance if I take 90% of my drugs on
time."
Rationale: Taking at least 90% of medications on time is essential to prevent drug
resistance. cART does not cure HIV but suppresses viral replication, allowing the immune
,system to recover. ART reduces viral load, making opportunistic infections less likely, but
HIV is not killed. Diarrhea should be reported, not treated by stopping medications .
5. The nurse working in a community health center has instructed a group of
clients who have acquired immune deficiency syndrome (AIDS) about ways to
prevent infection. Which of the following statements, if made by a client, would
indicate the need for additional teaching?
A. "I will eat plenty of fresh fruits and raw vegetables."
B. "I will make sure no one uses my deodorant or toothpaste."
C. "I will avoid planting vegetables and flowers in our garden."
D. "I will wear gloves and then wash my hands immediately if I need to change my cat's
litter box."
Answer: A — "I will eat plenty of fresh fruits and raw vegetables."
Rationale: Clients with AIDS should avoid fresh fruits and raw vegetables due to the risk
of bacterial contamination and infection in immunocompromised patients. All produce
should be cooked thoroughly. The other statements reflect correct infection prevention
practices .
6. The nurse is precepting a newly hired nurse who is caring for a client who has
AIDS and has developed Kaposi's sarcoma (KS). It requires additional teaching by
the preceptor if the newly hired nurse:
A. Keeps open, weeping lesions clean and covered with prescribed dressing
B. Applies a surgical mask before entering the client's room
C. Inspects the client's mouth at least once every 8 hours
D. Instructs the client that make-up can be applied to lesions that are not open
Answer: B — Applies a surgical mask before entering the client's room
Rationale: Kaposi's sarcoma is not transmitted through the respiratory route; only
standard precautions are required. KS is the most common AIDS-related malignancy,
presenting as small, purplish-brown raised lesions on skin or mucous membranes. An
N95 respirator may be needed for airborne precautions if TB is suspected, but not for KS
.
, 7. What CD4+ count indicates progression from HIV to AIDS?
A. Below 500 cells/mm³
B. Below 300 cells/mm³
C. Below 200 cells/mm³
D. Below 100 cells/mm³
Answer: C — Below 200 cells/mm³
Rationale: The CDC defines AIDS as a CD4+ T-cell count below 200 cells/mm³ OR the
presence of an AIDS-defining opportunistic infection. Normal CD4+ count is 500-1500
cells/mm³. As CD4+ count drops, the risk of opportunistic infections increases .
8. What is the most common AIDS-related malignancy?
A. Lymphoma
B. Kaposi's sarcoma
C. Leukemia
D. Squamous cell carcinoma
Answer: B — Kaposi's sarcoma
Rationale: Kaposi's sarcoma is the most common AIDS-related malignancy. It presents
as small, purplish-brown raised lesions on the skin or mucous membranes. It is caused
by human herpesvirus 8 (HHV-8) and is more common in men who have sex with men .
9. A client with AIDS and a CD4+ count below 200 is most likely to experience
which opportunistic infection?
A. Common cold
B. Pneumocystis jiroveci pneumonia (PJP)
C. Sinusitis
D. Urinary tract infection
Answer: B — Pneumocystis jiroveci pneumonia (PJP)
Rationale: Pneumocystis jiroveci pneumonia is a defining opportunistic infection when
CONCEPTS IN MEDICAL-SURGICAL
NURSING EXAM 4 | QUESTIONS AND
ANSWERS RATED A+ | 2026/2027
1. The nurse working in the emergency department (ED) is triaging a client who
has presented with chest pain, shortness of breath, a productive cough, and
reports night sweats. The client's health history includes the presence of acquired
immune deficiency syndrome (AIDS) and a recent laboratory result that reveals a
low CD4+ count. Airborne precautions have been initiated. Which of the following
actions should the nurse take next?
A. Prepare the client for insertion of a chest tube
B. Assess the client for shingles
C. Check the client's temperature
D. Obtain a throat culture
Answer: C — Check the client's temperature
Rationale: A fever is a symptom of an AIDS exacerbation or opportunistic infection.
After initiating airborne precautions for possible TB, the nurse should assess for fever as
part of the focused respiratory assessment. The low CD4+ count indicates
immunocompromise, making the client susceptible to opportunistic infections .
2. The newly hired nurse is developing a plan of care for a client who has acquired
immune deficiency syndrome (AIDS) and was just diagnosed with Pneumocystis
jiroveci pneumonia (PJP) and pain. Which of the following interventions should
the nurse preceptor question?
A. Telling the client to keep the door to the room closed at all times
B. Placing the client on a pressure-relieving mattress
C. Instructing the client to drink at least 2-3 liters of fluid throughout the day
D. Offering the client foods high in calories and protein
,Answer: B — Placing the client on a pressure-relieving mattress
Rationale: A pressure-relieving mattress is not an appropriate intervention for PJP. The
priority interventions include antibiotic therapy, respiratory support, and monitoring
oxygenation. PJP is an airborne opportunistic infection requiring airborne precautions
(closed door). Fluid intake and high-calorie, high-protein foods support recovery .
3. The nurse is caring for a client with AIDS who has just been diagnosed with
cryptococcal meningitis. Which of the following actions should the nurse take?
A. Initiate airborne precautions for the next 72 hours
B. Initiate seizure precautions with padded side rails
C. Administer IV pentamidine isethionate
D. Thicken the client's liquids to honey consistency
Answer: B — Initiate seizure precautions with padded side rails
Rationale: Cryptococcal meningitis can cause seizures. Seizure precautions with padded
side rails help prevent injury during seizure activity. Cryptococcal meningitis is an
opportunistic fungal infection common in AIDS patients with low CD4+ counts. IV
pentamidine is used for PJP, not cryptococcal meningitis .
4. The nurse has provided medication instructions to a client who has human
immunodeficiency virus (HIV) and has been prescribed combination antiretroviral
therapy (cART). Which of the following client statements indicates a correct
understanding of the teaching?
A. "I am less likely to develop opportunistic infections once I begin taking my prescribed
medications."
B. "I should discontinue my medications if I develop severe diarrhea."
C. "I can avoid developing drug resistance if I take 90% of my drugs on time."
D. "I understand that this combination of drugs will kill the virus."
Answer: C — "I can avoid developing drug resistance if I take 90% of my drugs on
time."
Rationale: Taking at least 90% of medications on time is essential to prevent drug
resistance. cART does not cure HIV but suppresses viral replication, allowing the immune
,system to recover. ART reduces viral load, making opportunistic infections less likely, but
HIV is not killed. Diarrhea should be reported, not treated by stopping medications .
5. The nurse working in a community health center has instructed a group of
clients who have acquired immune deficiency syndrome (AIDS) about ways to
prevent infection. Which of the following statements, if made by a client, would
indicate the need for additional teaching?
A. "I will eat plenty of fresh fruits and raw vegetables."
B. "I will make sure no one uses my deodorant or toothpaste."
C. "I will avoid planting vegetables and flowers in our garden."
D. "I will wear gloves and then wash my hands immediately if I need to change my cat's
litter box."
Answer: A — "I will eat plenty of fresh fruits and raw vegetables."
Rationale: Clients with AIDS should avoid fresh fruits and raw vegetables due to the risk
of bacterial contamination and infection in immunocompromised patients. All produce
should be cooked thoroughly. The other statements reflect correct infection prevention
practices .
6. The nurse is precepting a newly hired nurse who is caring for a client who has
AIDS and has developed Kaposi's sarcoma (KS). It requires additional teaching by
the preceptor if the newly hired nurse:
A. Keeps open, weeping lesions clean and covered with prescribed dressing
B. Applies a surgical mask before entering the client's room
C. Inspects the client's mouth at least once every 8 hours
D. Instructs the client that make-up can be applied to lesions that are not open
Answer: B — Applies a surgical mask before entering the client's room
Rationale: Kaposi's sarcoma is not transmitted through the respiratory route; only
standard precautions are required. KS is the most common AIDS-related malignancy,
presenting as small, purplish-brown raised lesions on skin or mucous membranes. An
N95 respirator may be needed for airborne precautions if TB is suspected, but not for KS
.
, 7. What CD4+ count indicates progression from HIV to AIDS?
A. Below 500 cells/mm³
B. Below 300 cells/mm³
C. Below 200 cells/mm³
D. Below 100 cells/mm³
Answer: C — Below 200 cells/mm³
Rationale: The CDC defines AIDS as a CD4+ T-cell count below 200 cells/mm³ OR the
presence of an AIDS-defining opportunistic infection. Normal CD4+ count is 500-1500
cells/mm³. As CD4+ count drops, the risk of opportunistic infections increases .
8. What is the most common AIDS-related malignancy?
A. Lymphoma
B. Kaposi's sarcoma
C. Leukemia
D. Squamous cell carcinoma
Answer: B — Kaposi's sarcoma
Rationale: Kaposi's sarcoma is the most common AIDS-related malignancy. It presents
as small, purplish-brown raised lesions on the skin or mucous membranes. It is caused
by human herpesvirus 8 (HHV-8) and is more common in men who have sex with men .
9. A client with AIDS and a CD4+ count below 200 is most likely to experience
which opportunistic infection?
A. Common cold
B. Pneumocystis jiroveci pneumonia (PJP)
C. Sinusitis
D. Urinary tract infection
Answer: B — Pneumocystis jiroveci pneumonia (PJP)
Rationale: Pneumocystis jiroveci pneumonia is a defining opportunistic infection when
