Exam 1 LATEST 2025/2026
1. Shortly after being diagnosed with HIV, a client has begun highly active
antiretroviral therapy (HAART). The client asks, My doctor tells me that my viral
load is going down. What does that mean? The nurse's best response is:
Your HAART medications are working to slow the progression of the disease
2. The nurse caring for a population of HIV clients needs to be assessing for which
of the following diseases that amounts to the leading cause of death for people
with HIV?
A) Leukemia
B) Tuberculosis
C) Pneumonia
D) Toxoplasmosis
Ans: B
Feedback:
Although HIV-positive people can develop all types of cancer, have viral or bacterial
pneumonia, and be infected with the parasite that causes toxoplasmosis, tuberculosis is
the disease that leads to death most often. Tuberculosis (TB) is the leading cause of
death for people with HIV infection worldwide and is often the first manifestation of
HIV infection. In 2011, 23% of those with TB tested positive for HIV.
3 HIV-positive persons who display manifestations of laboratory category 3 or clinical
category C are considered to have:
A) Zero viral load
B) Seroconversion
C) Complete remission
D) AIDS-defining illnesses
Ans: D
Feedback:
Laboratory category 3 and clinical category C are the most serious and indicate the
presence of AIDS-defining illnesses. Seroconversion is clinical category A; zero viral
load and remission could also be category A.
4 A client was diagnosed as HIV positive several years ago. Which of the following
blood test results reflects the fact that the client now has developed AIDS?
350,000 platelets/mL
Patho
, CD4+ T-cell count less than 200 cells/mL
Viral load 500,000 copies/mL
White blood cell count of 5300 cmm
B
Feedback:
CD4+ cell counts are the primary measure that is used for the staging of HIV infection.
Viral load, platelets, and leukocytes are also important assessments, but these are not
used to stage HIV.
5. A client with a diagnosis of aplastic anemia has undergone allogenic bone marrow
transplantation. Which of the following signs and symptoms would most clearly suggest
the existence of graft versus host disease (GVHD)?
A) Shortness of breath, audible crackles, and decreasing PaO2
B) Presence of a pruritic rash that has begun to slough off
C) Development of metabolic acidosis
D) Diaphoresis, fever, and anxiety
Ans: B
Feedback:
In cases of GVHD, there is development of a pruritic, maculopapular rash that begins on
the palms and soles and frequently extends over the entire body, with subsequent
desquamation. Respiratory complications are atypical, and neither metabolic acidosis
nor diaphoresis and fever are common.
6. A client with a diagnosis of cirrhosis has experienced an acute rejection of a donor liver.
Which of the following cells is responsible for the rejection of the client's transplanted
organ?
A) Natural killer cells
B) Mast cells
C) T cells
D) Neutrophils
Ans: C
Feedback:
Although different patterns of rejection exist, a general commonality is that T cells play
a central role in the process of rejection. Mast cells and leukocytes do not participate
directly in the physiology of rejection.
7. The clinic nurse suspects the client is having a genetically determined
hypersensitivity to common environmental allergens since the client is experiencing
which of the following clinical manifestations? Select all that apply.
A) Hives
Patho
, B) Runny nose
C) Diarrhea
D) Topical pustules
E) Wheezes
Ans: A, B, E
Feedback:
Localized, inherited allergic reactions mediated by IgE are known as atopic reactions,
such as urticaria (hives). Atopic reactions are immediate (not delayed such as type IV
poison ivy rash). Infections are not part of type I hypersensitivity. Autoimmune
reactions are in response to antigens, not allergens.
8. A child has experienced a “bee-sting” while at the park. The health care provider is
walking by and notices the child has swelling around the eyes, lips, and face in general.
What priority assessment should the nurse make at this time?
A) Palpate for carotid pulses in the neck.
B) Assess skin on the truck and back for development of hives.
C) Assess and establish an open airway.
D) Try to listen to breath sounds by placing your ear on the child's chest.
Ans: C
Feedback:
The initial management of anaphylaxis focuses on the establishment of a stable airway
and intravenous access and the administration of epinephrine. Epinephrine produces
relaxation of bronchial smooth muscle and inhibits the immediate life-threatening
cardiovascular effects of anaphylaxis. All the other assessments (pulse rate, skin, and
breath sounds) can be done after the airway is assessed and managed.
9. A 5-year-old child is experiencing itchy, watery eyes and an increased respiratory rate
with some inspiratory wheezes. He has been outside playing in the yard and trees. The
mother asks, “Why does he get like this?” The health care worker's best response is:
A)
B)
C)
D)
Ans:
Patho