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Christensen: Adult Health Nursing, 6th Edition
Chapter 02: Care of the Surgical Patient
Test Bank
a. | Maintaining the system. |
b. | Recording activations of the system. |
c. | Administering the analgesia to the patient. |
d. | Monitoring the patients pain. |
ANS: C
With the PCA system of medication administration, the patient can self-administer an analgesic by pressing a control button. The nurse should not give medication doses by pushing the control button.
DIF: Cognitive Level: Application REF: Page 50 OBJ: 13
TOP: Medication administration KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
a. | Palliative |
b. | Diagnostic |
c. | Reconstructive |
d. | Ablative |
ANS: D
Ablative is a type of surgery where an amputation, excision of any part of the body, or removal of a growth and harmful substance is performed.
DIF: Cognitive Level: Comprehension REF: Page 18, Table 2-1
OBJ: 2 TOP: Types of surgery
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
a. | Verbal consent |
b. | Medical documentation |
c. | Informed consent |
d. | Informed decision |
ANS: C
The Patients Bill of Rights affirms that the patients must give informed consent (permission obtained from the patient to perform a specific test or procedure) before the beginning of any procedure.
DIF: Cognitive Level: Knowledge REF: Page 24 OBJ: 6
TOP: Informed consent KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe, Effective Care Environment
a. | Pain radiating to the scapula |
b. | An injection of Demerol, 75 mg IM, 1 hour ago |
c. | The presence of jaundice and scleral icterus |
d. | His concern over his insurance company not covering the procedure |
ANS: B
Informed consent should not be obtained if the patient is disoriented and under the influence of sedatives.
DIF: Cognitive Level: Application REF: Page 25 OBJ: 6
TOP: Informed consent KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
a. | general |
b. | regional |
c. | specific |
d. | preoperative |
ANS: A
An anesthesiologist gives general anesthetics by IV and inhalation routes through four stages of anesthesia.
DIF: Cognitive Level: Knowledge REF: Page 37 OBJ: 11
TOP: Anesthesia KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
a. | regional anesthesia. |
b. | specific anesthesia. |
c. | optional sedation. |
d. | conscious sedation. |
ANS: D
Conscious sedation is routinely used for procedures that do not require complete anesthesia but rather a depressed level of consciousness.
DIF: Cognitive Level: Knowledge REF: Page 40 OBJ: 12
TOP: Conscious sedation KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
a. | poor skin turgor resulting in dehydration. |
b. | disturbed body image related to surgical incision. |
c. | his or her bodys response to physiological changes. |
d. | decreased peristalsis related to general anesthesia. |
ANS: C
Of specific concern in older adults is the bodys response to temperature changes, cardiovascular shifts, respiratory needs, and renal function.
DIF: Cognitive Level: Analysis REF: Page 20 OBJ: 7
TOP: Older adult patient KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
a. | Coughing every 2 hours |
b. | Leg exercises every 2 hours |
c. | Monitoring intravenous therapy at 50 ml/hr |
d. | Assessing vital signs every 2 hours |
ANS: A
Coughing increases ICP.
DIF: Cognitive Level: Analysis REF: Page 32, Box 2-6
OBJ: 5 TOP: Postoperative complications
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
a. | Pulse rate |
b. | Temperature |
c. | Blood pressure |
d. | Pain |
ANS: A
An increase in pulse rate is an objective, detectable sign that the body is responding to pain. Other objective changes include a decrease in blood pressure in the immediate postoperative period, restlessness, diaphoresis, and pallor.
DIF: Cognitive Level: Analysis REF: Page 48, Box 2-8
OBJ: 10 TOP: Postoperative complications
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
a. | there is partial or complete wound separation. |
b. | there has been inadequate wound closure. |
c. | abdominal viscera protrude through the walls. |
d. | the wound will not heal well when it is resutured. |
ANS: A
A surgical incision may separate; this action of dehiscence (the separation of a surgical incision or rupture of a wound closure) may occur within 3 days to over 2 weeks postoperatively.
DIF: Cognitive Level: Knowledge REF: Page 48, Figure 2-15
OBJ: 1 TOP: Postoperative complications
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
a. | ambulation. |
b. | an enema. |
c. | encouraging hot liquids. |
d. | administering a laxative. |
ANS: A
Encouraging activity (turning every 2 hours, early ambulation) assists GI activity.
DIF: Cognitive Level: Application REF: Page 52, Box 2-10
OBJ: 13 TOP: Postoperative complications
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
a. | Check ankle dressings. |
b. | Check airway for patency. |
c. | Check intravenous site. |
d. | Check vital signs. |
ANS: B
Evaluation of the patient follows the ABCs of immediate postoperative observation: airway, breathing, consciousness, and circulation.
DIF: Cognitive Level: Application REF: Page 45, Table 2-6
OBJ: 12 TOP: Nursing assessment
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
a. | increasing blood pressure. |
b. | decreasing pulse. |
c. | restlessness. |
d. | weakness, apathy. |
ANS: C
A pulse that increases and becomes thready combined with a declining blood pressure, cool and clammy skin, reduced urine output, and restlessness may signal hypovolemic shock.
DIF: Cognitive Level: Comprehension REF: Page 48 OBJ: 10
TOP: Postoperative complications KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
a. | Gastrointestinal |
b. | Endocrine |
c. | Neurological |
d. | Cardiovascular |
ANS: D
Hypotension and cardiac dysrhythmias are the most common cardiovascular complications of the surgical patient, and early recognition and management of these complications before they become serious enough to diminish cardiac output depend on frequent assessment of the patients vital signs.
DIF: Cognitive Level: Comprehension REF: Pages 35, 51, Table 2-4
OBJ: 14 TOP: Postoperative patient
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
a. | Cardiac arrest |
b. | Pneumonia |
c. | Incisional hernias |
d. | Hypoventilation |
ANS: D
Immediate postoperative hypoventilation can result from drugs (anesthetics, narcotics, tranquilizers, sedatives) incisional pain, obesity, chronic lung disease, or pressure on the diaphragm.
DIF: Cognitive Level: Analysis REF: Page 48 OBJ: 13
TOP: Postoperative complications KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity
a. | Nurses notes |
b. | Anesthesia record |
c. | Preoperative checklist |
d. | Physicians order sheet |
ANS: C
When the nurse signs the preoperative checklist, that nurse assumes responsibility for all areas of care included on the list.
DIF: Cognitive Level: Knowledge REF: Page 41, Figure 2-10
OBJ: 9 TOP: Preoperative checklist
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
a. | Place the patient in high Fowlers position. |
b. | Give the patient fluids to prevent shock. |
c. | Replace the dressing with sterile fluffy pads. |
d. | Apply a warm, moist normal saline sterile dressing. |
ANS: D
Cover the wound with a sterile towel moistened with sterile physiological saline (warm).
DIF: Cognitive Level: Application REF: Page 48, Figure 2-15
OBJ: 13 TOP: Postoperative interventions
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
a. | Only when the patient asks. |
b. | Regularly every three to four hours before pain gets severe. |
c. | Only when the physician orders. |
d. | Only when the patient is in severe pain. |
ANS: B
The nurse should ask the patient every 3-4 hours if something is needed for pain because some patients will not ask for an analgesic.
DIF: Cognitive Level: Application REF: Page 49 OBJ: 10
TOP: Medication administration KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity
a. | Pillows under the knee in a position of comfort |
b. | Sitting with the feet flat on the floor |
c. | Early ambulation |
d. | Gentle leg massage |
ANS: C
Early ambulation has been a significant factor in hastening postoperative recovery and preventing postoperative complications.
DIF: Cognitive Level: Application REF: Page 52, Box 2-10
OBJ: 13 TOP: Interventions
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
a. | assess kidney function. |
b. | determine respiratory insufficiency. |
c. | prevent dysrhythmias related to anesthesia. |
d. | measure functional liver capability. |
ANS: C
Serum electrolytes are evaluated if extensive surgery is planned or the patient has extenuating problems. One of the essential electrolytes examined is potassium; if potassium is not available in adequate amounts, dysrhythmias can occur during anesthesia.
DIF: Cognitive Level: Analysis REF: Page 24 OBJ: 9
TOP: Preoperative assessment KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
a. | perioperative phase. |
b. | preoperative phase. |
c. | intraoperative phase. |
d. | postoperative phase. |
ANS: C
Counting of sponges, needles, and instruments with the scrub nurse before surgery and before closing the wound is done during the intraoperative phase of the surgery.
DIF: Cognitive Level: Knowledge REF: Page 24, Box 2-7
OBJ: 8 TOP: Intraoperative responsibilities
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
a. | Emesis that is red |
b. | Complaint of feeling cold |
c. | Nausea |
d. | Complaint of pain |
ANS: A
Any emesis that is red should be reported immediately.
DIF: Cognitive Level: Analysis REF: Page 46, Box 2-7
OBJ: 10 TOP: Assessment KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
a. | hypovolemic shock. |
b. | dehiscence. |
c. | atelectasis. |
d. | pulmonary embolus. |
ANS: D
Sudden chest pain combined with dyspnea, tachycardia, cyanosis, diaphoresis, and hypotension is a sign of pulmonary embolism.
DIF: Cognitive Level: Analysis REF: Page 49 OBJ: 13
TOP: Assessment and postoperative complications
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
a. | major, emergency, diagnostic. |
b. | major, urgent, palliative. |
c. | minor, elective, ablative. |
d. | minor, urgent, reconstructive. |
ANS: C
Surgery is classified as elective, urgent, or emergency. Surgery is performed for various purposes, which include diagnostic studies, ablation (an amputation or excision of any part of the body or removal of a growth or harmful substance), and palliative (therapy to relieve or reduce intensity of uncomfortable symptoms without cure), reconstructive, transplant, and constructive purposes.
DIF: Cognitive Level: Comprehension REF: Page 18, Table 2-1
OBJ: 2 TOP: Types of surgery
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
a. | 78-year-old taking an analgesic agent |
b. | 43-year-old taking an antihypertensive agent |
c. | 27-year-old taking an anticoagulant agent |
d. | 10-year-old taking an antibiotic agent |
ANS: C
Anticoagulants alter normal clotting factors and thus increase risk of hemorrhaging. They should be discontinued for 48 hours before surgery.
DIF: Cognitive Level: Analysis REF: Page 21, Box 2-3, Table 2-5
OBJ: 4 TOP: Individuals ability to tolerate surgery
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
a. | Apply a splint directly over the lower abdomen. |
b. | Keep the patient flat with feet flexed. |
c. | Turn her on her right side. |
d. | Apply a splint above and below the incision. |
ANS: A
To ease the pressure on the incision, the nurse helps the patient support the surgical site with a pillow, rolled bath blanket, or the heel of the hand.
DIF: Cognitive Level: Application REF: Pages 31-32, Skill 2-4 Step 10, NCP 2-1
OBJ: 14 TOP: Postoperative nursing interventions
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
a. | Impaired verbal communication. |
b. | Impaired gas exchange. |
c. | Deficient knowledge, postoperative. |
d. | Acute pain. |
ANS: C
Knowledge, deficient regarding implications of surgery related to information misinterpretation is a correct nursing diagnosis.
DIF: Cognitive Level: Analysis REF: Page 20, Box 2-11
OBJ: 14 TOP: Nursing process/diagnosis
KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment
a. | breathing through her nose, holding her breath, and exhaling slowly. |
b. | taking three deep breaths and coughing from the chest. |
c. | inhaling while contracting the abdominal muscles and exhaling while contracting the diaphragm. |
d. | taking short, frequent panting breaths and coughing from the throat to clear accumulated mucus. |
ANS: B
Because lung ventilation is vital, the nurse assists the patient to turn, cough, and breathe deeply every 1 to 2 hours until the chest is clear. Having practiced this combination preoperatively, the patient is usually able to adequately remove trapped mucus and surgical gases.
DIF: Cognitive Level: Application REF: Pages 29-30, Skills 2-2, 2-3
OBJ: 13 TOP: Prevention of postoperative complications
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
a. | Explain the surgical options. |
b. | Explain the operative risks. |
c. | Obtain the patients signature. |
d. | Check form for appropriate signatures. |
ANS: C
A witness is only verifying that this is the person who signed the consent and that it was a voluntary consent. The witness (often a nurse) is not verifying that the patient understands the procedure.
DIF: Cognitive Level: Knowledge REF: Page 25 OBJ: 6
TOP: Informed consent KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
a. | 1 minute. |
b. | 5 to 20 seconds. |
c. | as long as it takes to hear a bowel sound. |
d. | one full inspiration and expiration. |
ANS: A
Normal peristalsis is gauged by hearing 5 to 30 gurgles per minute.
DIF: Cognitive Level: Knowledge REF: Page 52, Box 2-10
OBJ: 10 TOP: Assessment KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
a. | Fear of anesthesia and death |
b. | Fear of death and malnutrition |
c. | Fear of unknown and lack of respect |
d. | Fear of malnutrition and addiction to new medications |
ANS: A
The preoperative anxiety level influences the amount of anesthesia required, the amount of postoperative pain medication needed, and the speed of recovery from surgery.
DIF: Cognitive Level: Assessment REF: Pages 20, 24, Box 2-4
OBJ: 4 TOP: Nursing diagnosis
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
a. | immediately before surgery to eliminate fear. |
b. | 2 months in advance so the patient can prepare. |
c. | 1 to 2 days before the surgery when anxiety is not as high. |
d. | in the surgical holding area. |
ANS: C
Preop teaching is provided 1 to 2 days prior to surgery when anxiety is low.
DIF: Cognitive Level: Implementation REF: Page 24 OBJ: 8
TOP: Nursing diagnosis KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
a. | Lowest position with side rails elevated with oxygen and suction equipment available |
b. | Highest position with side rails elevated with IV pole and pump at bedside |
c. | Lowest position with side rails down on the receiving side |
d. | Highest position with the side rails down on receiving side and up on opposite side |
ANS: D
In preparation for the return of the surgical patient, the patients bed should be in the highest position to be level with the surgical gurney and should have the side rail down on the receiving side, with the opposite side rail up to prevent the patient from falling out of bed during transfer.
DIF: Cognitive Level: Implementation REF: Page 43 OBJ: 13
TOP: Nursing diagnosis KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance
a. | they arent educated. |
b. | they arent paying attention. |
c. | they believe eye contact is disrespectful. |
d. | they believe they are superior to the nurse. |
ANS: C
Southeast Asians and Native Americans may believe eye contact is disrespectful.
DIF: Cognitive Level: Application REF: Page 22, Cultural Considerations box
OBJ: N/A TOP: Nursing diagnosis
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
a. | Age, health, occupation, mental status |
b. | Financial income, health, nutritional status |
c. | Age, mental state, nutritional status, health |
d. | Occupation, age, nutritional status, health |
e. | Financial Income, occupation, age, health |
ANS: C
Each system of the body is affected by the patients age, health, nutritional status, and mental state.
DIF: Cognitive Level: Assessment REF: Page 24 OBJ: 4
TOP: Nursing diagnosis KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
MULTIPLE RESPONSE
a. | Care of the wound site and any dressings |
b. | When he may operate a motor vehicle |
c. | Signs and symptoms to report to the physician |
d. | Call the physicians office once he arrives home |
e. | Report bowel movements to the physician |
f. | Actions and side effects of any medications |
ANS: A, B, C, F
As the day of discharge approaches, the nurse should be certain that the patient has vital information.
DIF: Cognitive Level: Analysis REF: Page 56, Box 2-13
OBJ: 13 TOP: Discharge instructions
KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment
a. | pre- and postoperative teaching. |
b. | lower morbidity and mortality. |
c. | quick assessment skills. |
d. | surgery causes much physiological stress. |
ANS: A, D
Surgery places greater stress on older than on younger patients. Teaching should be given at the older persons level of understanding.
DIF: Cognitive Level: Application REF: Page 20, Life Span Considerations box
OBJ: 7 TOP: Older adult considerations
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
a. | Vital signs |
b. | Insertion of N/G tube |
c. | Enema |
d. | Height and weight |
e. | Obtain operative consent |
f. | Sterile gowning |
ANS: A, C, D
The AP can perform vital signs, enema, and height and weight.
DIF: Cognitive Level: Application REF: Page 38 OBJ: 16
TOP: Nursing diagnosis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
COMPLETION
ANS:
Palliative
Palliative therapy is designed to relieve or reduce intensity of uncomfortable symptoms without cure.
DIF: Cognitive Level: Knowledge REF: Page 18, Table 2-1
OBJ: 1 TOP: Palliative therapy
KEY: Nursing Process Step: Assessment MSC: NCLEX: Comprehension
ANS:
preoperative, recuperative
Discharge planning for a surgical procedure begins in the preoperative and continues through the recuperative period.
DIF: Cognitive Level: Knowledge REF: Page 55 OBJ: 15
TOP: Nursing diagnosis KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
a. | System review |
b. | Breathing |
c. | Circulation |
d. | Airway |
e. | Level of consciousness |
ANS: D, B, E, C, A
DIF: Cognitive Level: Application REF: Page 45, Table 2-6
OBJ: 12 TOP: Nursing assessment
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
Christensen: Adult Health Nursing, 6th Edition
Chapter 16: Care of the Patient with HIV/AIDS
Test Bank
a. | This patient would not be a risk for your baby if you use standard precautions and avoid direct contact with blood or body fluids. |
b. | You should ask for a transfer to another unit because contact with this patient would put you and your baby at risk for AIDS. |
c. | Wear a mask, gown, and gloves every time you go into his room and use disposable trays, plates, and utensils to serve his meals. |
d. | We should recommend that this patient be transferred to an isolation unit. |
ANS: A
HIV is transmitted from human to human through infected blood, semen, cervicovaginal secretions, and breast milk. The utilization of standard precautions by all staff members for all patients all the time simplifies this issue.
DIF: Cognitive Level: Application REF: Pages 736, 737, 758, 763
OBJ: 6 TOP: Transmission of AIDS
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
a. | You will need to be tested in 6 weeks and regularly for the next 10 years, because that is the average length of time it takes to detect the virus by testing. |
b. | You will need to be tested in 3 months and again in 6 months, because 95% of people seroconvert to antibody-positive in 3 months and 99% in 6 months. |
c. | Transmission by occupational exposure is rare. There is no need for you to be concerned. |
d. | You will need to be tested in 3 weeks, because most people seroconvert in that length of time. |
ANS: B
Seroconversion is the development of antibodies from HIV, which takes place approximately 5 days to 3 months after exposure, generally within 1 to 3 weeks.
DIF: Cognitive Level: Analysis REF: Page 745 OBJ: 6
TOP: Prevention of infection KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment
a. | Counsel this patient about her sexual history, risk reduction measures, and testing for HIV. |
b. | Refer this patient to a family planning clinic. |
c. | Counsel this patient about testing for HIV and what the test results mean. |
d. | Counsel this patient about abstinence and a monogamous relationship. |
ANS: A
Unfortunately, the risk of acquiring HIV and other sexually transmitted disease still exists.
DIF: Cognitive Level: Analysis REF: Page 771, Table 16-9
OBJ: 8 TOP: Risk for infection
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance
a. | Most people get AIDS within 3 to 12 weeks after they are infected with HIV. |
b. | Dont worry. You may never get AIDS if you eat properly, exercise, and get plenty of rest. |
c. | It varies with every individual, but the average time is 8 to 10 years from the time a person is infected, and some go much longer. |
d. | You can expect to develop signs and symptoms of AIDS within 6 months. |
ANS: C
A typical progressor of HIV has a period of relative clinical latency, occurring immediately after the primary infection, that can last for several years. Long-term nonprogressors remain symptom-free for 10 years or more.
DIF: Cognitive Level: Analysis REF: Page 742 OBJ: 4
TOP: Progression of disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
a. | HIV attacks the immune system, a system that protects the body from foreign invaders, making it unable to protect the body from organisms that cause diseases. |
b. | HIV breaks down the circulatory system, making the body unable to assimilate oxygen and nutrients. |
c. | HIV attacks the respiratory system, making the lungs more susceptible to organisms that cause pneumonia. |
d. | HIV attacks the digestive system, decreasing the absorption of essential nutrients and causing weight loss and fatigue. |
ANS: A
HIV disease results from the progressive deterioration of the immune system over time; a diagnosis of AIDS is made in a later stage of this progression.
DIF: Cognitive Level: Analysis REF: Page 742, Table 16-2
OBJ: 7 TOP: Progression of disease
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Adaptation
a. | CD4+ count below 500, chronic fatigue, night sweats. |
b. | HIV-positive test result, CD4+ count below 200, history of opportunistic disease. |
c. | weight loss, persistent generalized lymphadenopathy, chronic diarrhea. |
d. | fever, chills, CD4+ count below 200. |
ANS: B
Patients who have progressed from HIV disease to AIDS will have the condition in which the CD4+ cell count drops below 200 cells/mm3.
DIF: Cognitive Level: Comprehension REF: Pages 736, 747, Box 16-2, Table 16-1
OBJ: 5 TOP: Progression of disease
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
a. | The blood is tested with the highly sensitive test called the Western blot. |
b. | The blood is tested with an ELISA; if positive, it is tested again with an ELISA, followed by a Western blot if the second ELISA is positive. |
c. | A series of HIV tests is performed to confirm if the patient has AIDS. |
d. | If the HIV tests are seronegative, John can be assured that he is not infected. |
ANS: B
The individuals blood is tested with ELISA or enzyme immunoassay (ELA), antibody tests that detect the presence of HIV antibodies. If the ELA is positive for HIV, then the same blood is tested a second time. If the second ELA is positive, a more specific confirming test such as the Western blot is done. Blood that is reactive or positive in all three steps is reported to be HIV-positive.
DIF: Cognitive Level: Application REF: Pages 736, 747, Box 16-2, Table 16-1
OBJ: 8 TOP: Diagnostic procedures
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenanc
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