Hematologic
A 67-year-old patient who is receiving chemotherapy for lung cancer is admitted to the hospital with thrombocytopenia. Which statement made by the patient when the nurse is obtaining the admission history is of most concern?
A. "I've noticed that I bruise more easily since the chemotherapy started."
B. "My bowel movements are soft and dark brown."
C. "I take ibuprofen every day because of my history of osteoarthritis."
D. "My appetite has decreased since the chemotherapy started."
C. "I take ibuprofen every day because of my history of osteoarthritis."
Because nonsteroidal anti-inflammatory drugs will decrease platelet aggregation, patients with thrombocytopenia should not use ibuprofen routinely. Patient teaching about this should be included in the care plan. Bruising is consistent with the patient's admission problem of thrombocytopenia. Soft, dark brown stools indicate that there is no frank or occult blood in the bowel movements. Although the patient's decreased appetite requires further assessment by the nurse, this is a common complication of chemotherapy.
The nurse is caring for a patient with peptic ulcer disease (PUD). Which assessment finding is the most serious?
A. Projectile vomiting
B. Burning sensation 2 hours after eating
C. Coffee-ground emesis
D. Board-like abdomen with shoulder pain
D. Board-like abdomen with shoulder pain
A board-like abdomen with shoulder pain is a symptom of a perforation, which is the most lethal complication of PUD. A burning sensation is a typical report and can be controlled with medications. Projectile vomiting can signal an obstruction. Coffee-ground emesis is typical of slower bleeding, and the patient will require diagnostic testing.
After the nurse receives the change-of-shift report, which patient should be assessed first?
A. A 42-year-old patient with carpal tunnel syndrome who reports pain
B. A 64-year-old patient with osteoporosis awaiting discharge
C. A 28-year-old patient with a fracture who reports that the cast is tight
D. A 56-year-old patient with a left leg amputation who reports phantom pain
C. A 28-year-old patient with a fracture who reports that the cast is tight
The patient with the tight cast is at risk for circulation impairment and peripheral nerve damage. Although all of the other patients' concerns are important and the nurse will want to see them as soon as possible, none of their complaints is urgent. The patient with the tight cast may have risk for injury to a limb, which is more urgent.
A client diagnosed with acquired immunodeficiency syndrome (AIDS) is reporting fatigue. The nurse educates the client on ways to conserve energy. Which statement indicates that the teaching was effective?
A. "Bathe before eating breakfast."
B. "Sit for as many activities as possible."
C. "Stand in the shower instead of taking a bath."
D. "Group all tasks to be performed early in the morning."
B. "Sit for as many activities as possible."
The client is taught to conserve energy by sitting for as many activities as possible, including dressing, shaving, preparing food, and ironing. The client should also sit in a shower chair instead of standing while showering. The client needs to prioritize activities such as eating breakfast before bathing, and the client should intersperse each major activity with a period of rest.
A postoperative client is anemic from blood loss during a recent surgery. Which manifestation of anemia would the nurse expect to note on assessment of the client?
A. Fatigue
B. Bradycardia
C. Muscle cramps
D. Increased respiratory rate
A. Fatigue
The client with anemia is likely to complain of fatigue because of decreased ability of the body to carry oxygen to tissues to meet metabolic demands. The client is unlikely to have bradycardia, because the body is working hard to compensate for the effects of anemia. Muscle cramps are an unrelated finding. Increased respiratory rate is not an associated finding, although some clients may have shortness of breath.
The nurse is providing orientation for a new RN who is preparing to administer packed red blood cells (PRBCs) to a patient who had blood loss during surgery. Which action by the new RN requires that the nurse intervene immediately?
A. Waiting 20 minutes after obtaining the PRBCs before starting the infusion
B. Starting an IV line for the transfusion using a 22-gauge catheter
C. Priming the transfusion set using 5% dextrose in lactated Ringer's solution
D. Telling the patient that the PRBCs may cause a serious transfusion reaction
C. Priming the transfusion set using 5% dextrose in lactated Ringer's solution
Normal saline, an isotonic solution, should be used when priming the IV line to avoid causing hemolysis of red blood cells (RBCs). Ideally, blood products should be infused as soon as possible after they are obtained; however, a 20-minute delay would not be unsafe. Large-bore IV catheters are preferable for blood administration; if a smaller catheter must be used, normal saline may be used to dilute the RBCs. Although the new RN should avoid increasing patient anxiety by indicating that a serious transfusion reaction may occur, this action is not as high a concern as using an inappropriate fluid for priming the IV tubing.
The nurse is providing the immediate postoperative care for a patient who had fundoplication to reinforce the lower esophageal sphincter for the purpose of a hiatal hernia repair. What is the priority action in the care of this patient?
A. Elevate the head of the bed at least 30 degrees.
B. Assess the nasogastric tube for yellowish-green drainage.
C. Assist the patient to start taking a clear liquid diet.
D. Assess the patient for gas bloat syndrome
A. Elevate the head of the bed at least 30 degrees.
The primary concern in the immediate postoperative period is the potential for airway complications. Elevating the head at least 30 degrees decreases the chance for aspiration and facilitates respiratory effort. The other options are also correct but will occur later in the postoperative period.
The nurse, caring for a client with Buck's traction, is monitoring the client for complications of the traction. Which assessment finding indicates a complication of this form of traction?
A. Weak pedal pulses
B. Drainage at the pin sites
C. Complaints of leg discomfort
D. Toes are warm and demonstrate a brisk capillary refill
A. Weak pedal pulses
Buck's traction is skin traction. Weak pedal pulses are a sign of vascular compromise, which can be caused by pressure on the tissues of the leg by the elastic bandage or prefabricated boot used to secure this type of traction. Skeletal (not skin) traction uses pins. Discomfort is expected. Warm toes with brisk capillary refill is a normal finding.
The nurse is caring for a client diagnosed with acquired immunodeficiency syndrome (AIDS). Which sign/symptom indicates the presence of an opportunistic respiratory infection?
A. Nausea and vomiting
B. Fever and exertional dyspnea
C. An arterial blood gas pH of 7.40
D. A respiratory rate of 20 breaths/min
B. Fever and exertional dyspnea
Fever and exertional dyspnea are signs of Pneumocystis jiroveci pneumonia, which is a common, life-threatening opportunistic infection that afflicts those with AIDS. Option 1 is not associated with respiratory infection. Options 3 and 4 are normal findings.
The laboratory results of a client with a history of chronic ulcerative colitis indicate anemia. The nurse determines that which factor is most likely responsible for this laboratory finding?
A. Diarrhea
B. Blood loss
C. Intestinal malabsorption
D. Decreased intake of dietary iron
B. Blood loss
The client with ulcerative colitis is most likely anemic because of chronic blood loss in small amounts that occurs with exacerbations of the disease. These clients often have bloody stools and are, therefore, at increased risk for anemia. Diarrhea is indirectly related to anemia. In ulcerative colitis, the large intestine is involved, not the small intestine, where intestinal malabsorption of vitamin B12 and folic acid could occur. There is no information in the question to support decreased intake of dietary iron.
Which of these patients who have just arrived at the emergency department should the nurse assess first?
A. Patient who reports several dark, tarry stools and a history of peptic ulcer disease
B. Patient with hemophilia A who is experiencing thigh swelling after a fall
C. Patient who has pernicious anemia and reports paresthesia of the hands and feet
D. Patient with thalassemia major who needs a scheduled blood transfusion
B. Patient with hemophilia A who is experiencing thigh swelling after a fall
Thigh swelling after an injury in a patient with hemophilia likely indicates acute bleeding, which can compromise blood flow and nerve function in the leg and should be treated immediately with the administration of factor replacement. The other patients also need assessment, treatment, or both, but the data do not indicate any immediate threat to life or function.
The nurse determines that the client with gastroesophageal reflux disease (GERD) needs further teaching regarding diet if which statement is made?
A. "I need to avoid coffee, tea, and chocolate."
B. "I should eat four to six small meals a day."
C. "It is important that I drink extra fluids during meals."
D. "I need to avoid snacking for 2 to 3 hours before bedtime."
C. "It is important that I drink extra fluids during meals."
GERD is the backflow of gastric and duodenal contents into the esophagus. Fluids must be taken between meals rather than with meals to prevent the overdistention that leads to reflux. Coffee, tea, cola, and chocolate are eliminated from the diet because they decrease lower esophageal sphincter pressure and can potentiate reflux. Four to six smaller meals per day will help to prevent gastric over distention. One of the primary factors in GERD is an incompetent lower esophageal sphincter. Adequate time needs to pass after snacking and before bedtime to decrease the risk for the reflux of gastric contents.
The nurse performs an assessment on a client newly diagnosed with rheumatoid arthritis. The nurse expects to note which early manifestations of the disease? Select all that apply.
A. Fatigue
B. Anorexia
C. Weakness
D. Low-grade fever
E. Joint deformities
F. Joint inflammation
A. Fatigue, B. Anorexia, C. Weakness, D. Low-grade fever, F. Joint inflammation
Rheumatoid arthritis is a chronic, progressive, systemic inflammatory autoimmune disease process that primarily affects the synovial joints. It also affects other joints and body tissues. Early manifestations include fatigue, anorexia, weakness, joint inflammation, low-grade fever, and paresthesia. Joint deformities are late manifestations.
A client diagnosed with acquired immunodeficiency syndrome (AIDS) is now diagnosed with Pneumocystis jiroveci pneumonia. Which findings would the nurse expect to note during the assessment?
A. Temperature 98.6° F, pulse 80 beats per minute, respiration 32 breaths per minute
B. Temperature 98.6° F, pulse 80 beats per minute, respiration 18 breaths per minute
C. Temperature 101.5° F, pulse 80 beats per minute, respiration 18 breaths per minute
D. Temperature 101.5° F, pulse 120 beats per minute, respiration 32 breaths per minute
D. Temperature 101.5° F, pulse 120 beats per minute, respiration 32 breaths per minute
The clinical manifestations of Pneumocystis jiroveci pneumonia include fever, tachycardia, and tachypnea. Therefore, option 4 is correct. Option 1 identifies a normal temperature and pulse rate and an elevated respiratory rate. Option 2 identifies normal vital signs. Option 3 identifies an elevated temperature but normal pulse and respiratory rates.
The nurse is caring for a client who had an orthopedic injury of the leg that required surgery and the application of a cast. Postoperatively, which nursing assessment is of highest priority to assure client safety?
A. Monitoring for heel breakdown
B. Monitoring for bladder distention
C. Monitoring for extremity shortening
D. Monitoring for blanching ability of the toe nail beds
D. Monitoring for blanching ability of the toe nail beds
With cast application, concern for compartment syndrome development is of the highest priority. If postsurgical edema compromises circulation, the client will demonstrate numbness, tingling, loss of blanching of toenail beds, and pain that will not be relieved by opioids. Although heel breakdown, bladder distention, or extremity lengthening or shortening can occur, these complications are not potentially life-threatening complications.
A patient who has sickle cell disease is admitted with vaso-occlusive crisis and reports severe abdominal and flank pain. Which of the analgesic medications on the pain treatment protocol will be best for the nurse to administer initially?
A. Ibuprofen 800 mg PO
B. Morphine sulfate 4 mg IV
C. Hydromorphone liquid 5 mg PO
Fentanyl 25 mcg/hr transdermal patch
B. Morphine sulfate 4 mg IV
Guidelines for the management of vaso-occlusive crisis suggest the rapid use of parenteral opioids for patients who have moderate to severe pain. The other medications may also be appropriate for the patient as the crisis resolves but are not the best choice for rapid treatment of severe pain.
The nursing instructor teaching a group of nursing students about preventive measures for diverticular disease would recommend which intervention for the prevention of this disease? Select all that apply.
A. High fluid intake
B. A high-fiber diet
C. High intake of fat
D. Low intake of red meat
E. A diet consisting mainly of fruits and vegetables
A. High fluid intake, B. A high-fiber diet, D. Low intake of red meat, E. A diet consisting mainly of fruits and vegetables
The goal of treatment for the client with acute diverticular disease is to allow the colon to rest to decrease inflammation. In the prevention of diverticular disease, increased fluid intake and a high-fiber diet consisting mainly of fruits and vegetables are recommended. A low intake of fat and red meat also assists in prevention. In addition, high levels of physical activity help in decreasing this risk.
The nurse is preparing a discussion of musculoskeletal health maintenance for a group of older adults. Which key points would the nurse be sure to include? Select all that apply.
A. Be aware of and consume foods rich in calcium and vitamin D.
B. Wear hats and long sleeves to avoid sun exposure at all times.
C. Consider exercise with low impact to avoid risk for injury.
D. If you smoke, consider a smoking cessation program.
E. Excessive alcohol intake can interfere with vitamins and nutrients for bone growth.
F. Weight-bearing activities decrease the risk for osteoporosis.
A. Be aware of and consume foods rich in calcium and vitamin D, C. Consider exercise with low impact to avoid risk for injury, D. If you smoke, consider a smoking cessation program, E. Excessive alcohol intake can interfere with vitamins and nutrients for bone growth, F. Weight-bearing activities decrease the risk for osteoporosis
Many health problems of the musculoskeletal system can be prevented through health promotion strategies and avoidance of risky lifestyle behaviors. Weight-bearing activities such as walking can reduce risk factors for osteoporosis and maintain muscle strength. Young men are at the greatest risk for trauma related to motor vehicle crashes. Older adults are at the greatest risk for falls that result in fractures and soft tissue injury. High-impact sports, such as excessive jogging or running, can cause musculoskeletal injury to soft tissues and bone. Tobacco use slows the healing of musculoskeletal injuries. Excessive alcohol intake can decrease vitamins and nutrients a person needs for bone and muscle tissue growth. Hats and long sleeves are recommended to prevent sunburn, but the nurse would recommend 20 minutes of sun exposure several times a week for vitamin D, which contributes to bone health.
The evening nurse reviews the nursing documentation in a client's chart and notes that the day nurse has documented that the client has a stage II pressure ulcer in the sacral area. Which finding would the nurse expect to note on assessment of the client's sacral area?
A. Intact skin
B. Full-thickness skin loss
C. Exposed bone, tendon, or muscle
D. Partial-thickness skin loss of the dermis
D. Partial-thickness skin loss of the dermis
In a stage II pressure ulcer, the skin is not intact. Partial-thickness skin loss of the dermis has occurred. It presents as a shallow open ulcer with a red-pink wound bed, without slough. It may also present as an intact or open/ruptured serum-filled blister. The skin is intact in stage I. Full-thickness skin loss occurs in stage III. Exposed bone, tendon, or muscle is present in stage IV.
The nurse is caring for a patient who had a dual-energy x-ray absorptiometry scan and is now prescribed calcium with vitamin D twice a day. The patient asks the nurse the purpose of this drug. What is the nurse's best response? Select all that apply.
A. "When your calcium and vitamin D levels are low, your risk for osteoporosis and osteomalacia increases."
B. "When your vitamin D level is high, your bones release calcium to keep your blood calcium level in the normal range."
C. "When your blood calcium is low, calcium is released from your bones increasing your risk for fractures."
D. "When blood calcium is normal, long bones are formed, increasing a person's height."
E. "The extra calcium and vitamin D will help protect your bones from damage such as fractures."
F. "You can also get extra vitamin D by increasing your intake of beef and pork sources."
A. "When your calcium and vitamin D levels are low, your risk for osteoporosis and osteomalacia increases.", C. "When your blood calcium is low, calcium is released from your bones increasing your risk for fractures.", E. "The extra calcium and vitamin D will help protect your bones from damage such as fractures."
Vitamin D and its metabolites are produced in the body and transported in the blood to promote the absorption of calcium and phosphorus from the small intestine. There is a relationship between calcium and phosphorus so that if a patient's phosphorus level is higher than normal, the calcium level will drop, and vice versa. A decrease in the body's vitamin D level can result in osteomalacia (softening of bone) in an adult. When serum calcium levels are lowered, parathyroid hormone (PTH, or parathormone) secretion increases and stimulates bone to promote osteoclastic activity and release calcium to the blood. PTH reduces the renal excretion of calcium and facilitates its absorption from the intestine. Sources of vitamin D include sunlight, fatty fish, and vitamin D–enriched foods.
The nurse is preparing to perform an assessment on a child being admitted to the hospital with a diagnosis of sickle cell crisis, vaso-occlusive crisis. Which findings should the nurse expect to note on assessment of the child? Select all that apply.
A. Pallor
B. Fever
C. Joint swelling
D. Blurred vision
E. Abdominal pain
A. Pallor, B. Fever, C. Joint swelling, E. Abdominal pain
Sickle cell crises are acute exacerbations of the disease. Vaso-occlusive crisis is caused by stasis of blood with clumping of cells in the microcirculation, ischemia, and infarction. Manifestations include pallor; fever; painful swelling of hands, feet, and joints; and abdominal pain. Blurred vision is not a manifestation of vaso-occlusive crisis.
The nurse is providing dietary instructions to a client with a diagnosis of ulcerative colitis. Which food would the nurse instruct the client to avoid?
A. Whole-grain cereals
B. Fresh corn on the cob
C. Broiled chicken breast
D. Bagels with cream cheese
B. Fresh corn on the cob
A low-residue (low-fiber) diet places less strain on the intestines because this type of diet is easier to digest. This diet is used for ulcerative colitis, diverticulitis, and irritable bowel syndrome. The item that contains the high residue and thus would place strain on the intestines is the fresh corn on the cob.
The nurse is preparing to teach a patient with a new diagnosis of osteoporosis about strategies to prevent falls. Which teaching points should the nurse be sure to include? Select all that apply.
A. Wear a hip protector when ambulating.
B. Remove throw rugs and other obstacles at home.
C. Exercise to help build your strength.
D. Expect a few bumps and bruises when you go home.
E. Rest when you are tired.
F. Avoid consuming three or more alcoholic drinks per day.
A. Wear a hip protector when ambulating. , B. Remove throw rugs and other obstacles at home. , C. Exercise to help build your strength., E. Rest when you are tired.
The purpose of this teaching is to help the patient prevent falls. The hip protector can prevent hip fractures if the patient falls. Throw rugs and obstacles in the home increase the risk of falls. Patients who are tired are also more likely to fall. Exercise helps to strengthen muscles and improve coordination. Women should not consume more than one drink per day, and men should not consume more than two drinks per day.
The nurse works with high-risk clients in an urban outpatient setting. Which groups should be tested for human immunodeficiency virus (HIV)? Select all that apply.
A. Injection drug abusers
B. Prostitutes and their clients
C. People with sexually transmitted infections (STIs)
D. People who have had frequent episodes of pneumonia
E. People who recently received a blood transfusion for a surgical procedure
A. Injection drug abusers, B. Prostitutes and their clients, C. People with sexually transmitted infections (STIs)
Human immunodeficiency virus (HIV) can cause acquired immunodeficiency syndrome, which is a viral disease that destroys T cells, thereby increasing susceptibility to infection and malignancy. Injection drug abusers, those engaged in prostitution, and people with STIs are high-risk groups that should be tested for HIV per the Centers for Disease Control and Prevention's recommendations. Those who have had frequent episodes of pneumonia and those who recently received a blood transfusion for a surgical procedure are not at risk for HIV unless another compounding factor places them at risk. However, if a blood transfusion was received between 1978 and 1985, the client should be tested.
The nurse is performing an assessment on a client who had a partial gastrectomy and is suspected of having vitamin B12 deficiency. For which manifestations of this disorder should the nurse assess the client? Select all that apply.
A. Weight loss
B. Slight jaundice
C. Facial flushing
D. Difficulty with gait
E. Smooth, beefy red tongue
F. Paresthesia of the hands and feet
A. Weight loss, B. Slight jaundice, D. Difficulty with gait, E. Smooth, beefy red tongue, F. Paresthesia of the hands and feet
Vitamin B12 deficiency can occur from poor intake of foods containing vitamin B12 and conditions that can lead to poor absorption of vitamin B12. Manifestations of this deficiency include weight loss; slight jaundice; severe pallor; difficulty with gait; smooth, beefy red tongue; paresthesia of the hands and feet; and fatigue.
The nurse develops a care plan for a client diagnosed with thrombocytopenia. Which interventions would the nurse include in the plan of care for this client? Select all that apply.
A. Apply heat to all areas of trauma.
B. Provide the client with soft foods.
C. Take axillary or tympanic temperatures.
D. Monitor the client for signs of bleeding.
E. Provide the client with an electric razor.
F. Instruct the client to avoid flossing the teeth.
B. Provide the client with soft foods, C. Take axillary or tympanic temperatures, D. Monitor the client for signs of bleeding, E. Provide the client with an electric razor, F. Instruct the client to avoid flossing the teeth
Thrombocytopenia is a condition in which the number of circulating platelets is reduced, placing the client at risk for bleeding. The nurse must implement bleeding precautions, including monitoring the client for signs of bleeding; handling the client gently; avoiding injections and venipunctures as much as possible and using the smallest-gauge needle possible if injections and venipunctures are necessary; applying firm pressure to a needlestick site for 5 to 10 minutes or until the site no longer oozes blood; applying ice to all areas of trauma; avoiding rectal temperatures, enemas, and suppositories; using an electric razor; avoiding mouth trauma by using a soft-bristled toothbrush and avoiding flossing or chewing on hard food; avoiding nose blowing; and avoiding contact sports.
The nurse caring for a client diagnosed with inflammatory bowel disease (IBD) recognizes that which classifications of medications may be prescribed to treat the disease and induce remission? Select all that apply.
A. Antidiarrheal
B. Antimicrobial
C. Corticosteroid
D. Aminosalicylate
E. Biological therapy
F. Immunosuppressant
B. Antimicrobial, C. Corticosteroid, D. Aminosalicylate, E. Biological therapy, F. Immunosuppressant
Pharmacological treatment for IBD aims to decrease the inflammation to induce and then maintain a remission. Five major classes of medications used to treat IBD are antimicrobials, corticosteroids, aminosalicylates, biological and targeted therapy, and immunosuppressants. Medications are chosen based on the location and severity of inflammation. Depending on the severity of the disease, clients are treated with either a "step-up" or "step-down" approach. The step-up approach uses less toxic therapies (e.g., aminosalicylates and antimicrobials) first, and more toxic medications (e.g., biological and targeted therapy) are started when initial therapies do not work. The step-down approach uses biological and targeted therapy first. Option 1, antidiarrheals, is incorrect. Although an antidiarrheal may be used to treat the symptoms of IBD, it does not treat the disease (the inflammation) or induce remission. In addition, antidiarrheals should be used cautiously in IBD because of the danger of toxic megacolon (colonic dilation greater than 5 cm).
The nurse, caring for a client who has been placed in Buck's extension traction while awaiting surgical repair of a fractured femur, would perform a complete neurovascular assessment of the affected extremity that includes which interventions? Select all that apply.
A. Vital signs
B. Bilateral lung sounds
C. Pulse in the affected extremity
D. Sensation in the affected leg
E. Skin color of the affected extremity
F. Capillary refill of the affected toes
C. Pulse in the affected extremity, D. Sensation in the affected leg, E. Skin color of the affected extremity, F. Capillary refill of the affected toes
A complete neurovascular assessment of an extremity includes color, sensation, movement, capillary refill, and pulse of the affected extremity. Options 1 and 2 are not related to neurovascular assessment.
The nurse is caring for a client with newly diagnosed human immunodeficiency virus (HIV). Besides preventing the transmission of the disease, what are the goals of medication therapy? Select all that apply.
A. Decreasing the viral load
B. Delaying disease progression
C. Administering the HIV vaccine
D. Eliminating the use of illegal drugs
E. Maintaining or increasing CD4+ T cell counts
F. Preventing HIV-related symptoms and opportunistic diseases
A. Decreasing the viral load, B. Delaying disease progression, E. Maintaining or increasing CD4+ T cell counts , F. Preventing HIV-related symptoms and opportunistic diseases
Besides preventing HIV transmission, the goals of medication therapy include decreasing the viral load, delaying disease progression, maintaining or increasing CD4+ T cell counts, and preventing HIV-related symptoms and opportunistic diseases. Administering the HIV vaccine and eliminating the use of illegal drugs are not included in the goals of medication therapy. Antiretroviral therapy (ART) can delay disease progression, and when taken consistently and correctly, ART can reduce viral loads by 90% to 99%. This makes adherence to treatment regimens extremely important. Although it is usually not possible to eradicate opportunistic diseases once they occur, prophylactic medications can significantly decrease morbidity and mortality rates.
The nurse is creating a plan of care for a client diagnosed with acquired immunodeficiency syndrome (AIDS). The nurse would document which goals for the client in the plan of care? Select all that apply.
A. Maintains a normal temperature
B. Demonstrates no increased platelet aggregation
C. Produces a urinary output of at least 50 mL/hr
D. No reports of experiencing any type of respiratory distress
E. Presents with no evidence of a dissecting aortic aneurysm
A. Maintains a normal temperature, D. No reports of experiencing any type of respiratory distress
A common, life-threatening opportunistic infection that occurs in clients with AIDS is Pneumocystis jiroveci pneumonia. Its symptoms include fever, exertional dyspnea, and nonproductive cough. The absence of respiratory distress and that of a fever are two of the goals that the nurse sets as priorities. The remaining options are not specifically related to AIDS.