NR 464 EXAM STUDY GUIDE 2025 QUESTIONS WITH
ANSWERS GUARANTEE A+
✔✔A complete blood cell count is performed on a client with systemic lupus
erythematosus (SLE). The nurse suspects that which finding will be reported with this
blood test?
1. Increased neutrophils
2. Increased red blood cell count
3. Increased white blood cell count
4. Decreased numbers of all cell types - ✔✔4. Decreased numbers of all cell types
In the client with SLE, a complete blood cell count commonly shows pancytopenia, a
decrease in all cell types. This probably is caused by a direct attack on all blood cells or
bone marrow by immune complexes. The other options are incorrect.
✔✔The nurse is reviewing the health care record of a client with a new diagnosis of
rheumatoid arthritis (RA). The nurse should recognize that which are early clinical
manifestations of this disorder? Select all that apply.
1. Fatigue
2. Anorexia
3. High fever
4. Weight loss
5. Generalized weakness - ✔✔1. Fatigue
2. Anorexia
5. Generalized weakness
Early manifestations of RA include fatigue, anorexia, generalized weakness, low-grade
fever, paresthesias. Weight loss is one of the late manifestations.
✔✔The nurse is caring for a client with acquired immunodeficiency syndrome (AIDS)
who has begun to experience multiple opportunistic infections. Which laboratory test
would be most helpful in assessing the client's need for reassessment of treatment?
1. Western blot
,2. B lymphocyte count
3. CD4+ cell or T lymphocyte count
4. Enzyme-linked immunosorbent assay (ELISA) - ✔✔3. CD4+ cell or T lymphocyte
count
The T lymphocyte or CD4+ cell count indicates whether the client is responding to the
medication treatment. The count should increase if the client is responding and should
decrease if the client's response is poor. The Western blot and ELISA are tests to assist
in diagnosing human immunodeficiency virus infection. The B lymphocyte count is not a
priority marker to monitor with AIDS clients.
✔✔A client with acquired immunodeficiency syndrome has been started on therapy with
zidovudine. The nurse assesses the complete blood cell (CBC) count, knowing that
which is an adverse effect of this medication?
1. Polycythemia
2. Leukocytosis
3. Thrombocytosis
4. Agranulocytopenia - ✔✔4. Agranulocytopenia
✔✔A client is suspected of having systemic lupus erythematosus (SLE). On reviewing
the client's record, the nurse should expect to note documentation of which
characteristic sign of SLE?
1. Fever
2. Fatigue
3. Skin lesions
4. Elevated red blood cell count - ✔✔3. Skin lesions
The major skin manifestation of SLE is a dry, scaly, raised rash on the face known as
the butterfly rash. Fever and fatigue may occur before and during exacerbation, but
these signs and symptoms are vague. Anemia is most likely to occur in SLE.
✔✔The home care nurse provides instructions to a client with systemic lupus
erythematosus (SLE) about home care measures. Which statements by the client
indicate the need for further instruction? Select all that apply.
1. "I need to sit whenever possible."
, 2. "I need to be sure to eat a balanced diet."
3. "I need to take a hot bath every evening."
4. "I need to rest for long periods of time every day."
5. "I should engage in moderate low-impact exercise when I am not tired." - ✔✔3. "I
need to take a hot bath every evening."
4. "I need to rest for long periods of time every day."
Hot baths may exacerbate the fatigue. To help reduce fatigue in the client with SLE, the
nurse should instruct the client to sit whenever possible, avoid hot baths, engage in
moderate low-impact exercises when not fatigued, and maintain a balanced diet. The
client is instructed not to rest for long periods because it promotes joint stiffness.
✔✔A client seen in an ambulatory clinic has a facial rash that is present on both cheeks
and across the bridge of the nose. The nurse interprets that this finding is consistent
with manifestations of which disorder?
1. Hyperthyroidism
2. Pernicious anemia
3. Cardiopulmonary disorders
4. Systemic lupus erythematosus (SLE) - ✔✔4. Systemic lupus erythematosus (SLE)
✔✔A client asks the nurse about obtaining a home test kit to test for human
immunodeficiency virus (HIV) status. What should the nurse tell the client?
1. Home test kits are not available for testing at this time.
2. Home test kits may not be as reliable as laboratory blood tests.
3. Home test kits are most reliable immediately after a risk event occurs.
4. Home test kits should not be used; rather, it is important to contact the health care
provider (HCP) with concerns about the HIV status. - ✔✔2. Home test kits may not be
as reliable as laboratory blood tests.
✔✔A client reports to the health care clinic for testing for human immunodeficiency virus
(HIV) immediately after being exposed to HIV. The test results are negative, and the
client expresses relief about not contracted HIV. What should the nurse emphasize
when explaining the test results to the client?
ANSWERS GUARANTEE A+
✔✔A complete blood cell count is performed on a client with systemic lupus
erythematosus (SLE). The nurse suspects that which finding will be reported with this
blood test?
1. Increased neutrophils
2. Increased red blood cell count
3. Increased white blood cell count
4. Decreased numbers of all cell types - ✔✔4. Decreased numbers of all cell types
In the client with SLE, a complete blood cell count commonly shows pancytopenia, a
decrease in all cell types. This probably is caused by a direct attack on all blood cells or
bone marrow by immune complexes. The other options are incorrect.
✔✔The nurse is reviewing the health care record of a client with a new diagnosis of
rheumatoid arthritis (RA). The nurse should recognize that which are early clinical
manifestations of this disorder? Select all that apply.
1. Fatigue
2. Anorexia
3. High fever
4. Weight loss
5. Generalized weakness - ✔✔1. Fatigue
2. Anorexia
5. Generalized weakness
Early manifestations of RA include fatigue, anorexia, generalized weakness, low-grade
fever, paresthesias. Weight loss is one of the late manifestations.
✔✔The nurse is caring for a client with acquired immunodeficiency syndrome (AIDS)
who has begun to experience multiple opportunistic infections. Which laboratory test
would be most helpful in assessing the client's need for reassessment of treatment?
1. Western blot
,2. B lymphocyte count
3. CD4+ cell or T lymphocyte count
4. Enzyme-linked immunosorbent assay (ELISA) - ✔✔3. CD4+ cell or T lymphocyte
count
The T lymphocyte or CD4+ cell count indicates whether the client is responding to the
medication treatment. The count should increase if the client is responding and should
decrease if the client's response is poor. The Western blot and ELISA are tests to assist
in diagnosing human immunodeficiency virus infection. The B lymphocyte count is not a
priority marker to monitor with AIDS clients.
✔✔A client with acquired immunodeficiency syndrome has been started on therapy with
zidovudine. The nurse assesses the complete blood cell (CBC) count, knowing that
which is an adverse effect of this medication?
1. Polycythemia
2. Leukocytosis
3. Thrombocytosis
4. Agranulocytopenia - ✔✔4. Agranulocytopenia
✔✔A client is suspected of having systemic lupus erythematosus (SLE). On reviewing
the client's record, the nurse should expect to note documentation of which
characteristic sign of SLE?
1. Fever
2. Fatigue
3. Skin lesions
4. Elevated red blood cell count - ✔✔3. Skin lesions
The major skin manifestation of SLE is a dry, scaly, raised rash on the face known as
the butterfly rash. Fever and fatigue may occur before and during exacerbation, but
these signs and symptoms are vague. Anemia is most likely to occur in SLE.
✔✔The home care nurse provides instructions to a client with systemic lupus
erythematosus (SLE) about home care measures. Which statements by the client
indicate the need for further instruction? Select all that apply.
1. "I need to sit whenever possible."
, 2. "I need to be sure to eat a balanced diet."
3. "I need to take a hot bath every evening."
4. "I need to rest for long periods of time every day."
5. "I should engage in moderate low-impact exercise when I am not tired." - ✔✔3. "I
need to take a hot bath every evening."
4. "I need to rest for long periods of time every day."
Hot baths may exacerbate the fatigue. To help reduce fatigue in the client with SLE, the
nurse should instruct the client to sit whenever possible, avoid hot baths, engage in
moderate low-impact exercises when not fatigued, and maintain a balanced diet. The
client is instructed not to rest for long periods because it promotes joint stiffness.
✔✔A client seen in an ambulatory clinic has a facial rash that is present on both cheeks
and across the bridge of the nose. The nurse interprets that this finding is consistent
with manifestations of which disorder?
1. Hyperthyroidism
2. Pernicious anemia
3. Cardiopulmonary disorders
4. Systemic lupus erythematosus (SLE) - ✔✔4. Systemic lupus erythematosus (SLE)
✔✔A client asks the nurse about obtaining a home test kit to test for human
immunodeficiency virus (HIV) status. What should the nurse tell the client?
1. Home test kits are not available for testing at this time.
2. Home test kits may not be as reliable as laboratory blood tests.
3. Home test kits are most reliable immediately after a risk event occurs.
4. Home test kits should not be used; rather, it is important to contact the health care
provider (HCP) with concerns about the HIV status. - ✔✔2. Home test kits may not be
as reliable as laboratory blood tests.
✔✔A client reports to the health care clinic for testing for human immunodeficiency virus
(HIV) immediately after being exposed to HIV. The test results are negative, and the
client expresses relief about not contracted HIV. What should the nurse emphasize
when explaining the test results to the client?
