Page 1614 - Saunders Comprehensive Review For NCLEX-RN

interpretations.
Test-Taking Strategy: Eliminate options 3 and 4 first because they are comparable
or alike. From the remaining options, recalling that the client with HIV infection is
immunosuppressed will assist in determining the interpretation of the area of
induration.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Analysis
Content Area: Adult Health: Respiratory
Health Problem: Adult Health: Respiratory: Tuberculosis
Priority Concepts: Evidence; Infection
Reference: Ignatavicius, Workman, Rebar (2018), p. 607.

577. Answer: 1

Rationale: Histoplasmosis is an opportunistic fungal infection that can occur in
the client with AIDS. The infection begins as a respiratory infection and can progress
to disseminated infection. Typical signs and symptoms include fever, dyspnea,
cough, and weight loss. Enlargement of the client’s lymph nodes, liver, and spleen
may occur as well.
Test-Taking Strategy: Focus on the subject, manifestations of histoplasmosis.
Recalling that histoplasmosis is an infectious process will help you eliminate option
4. Because the client has AIDS and another infection, weight gain is an unlikely
symptom and can be eliminated next. Knowing that histoplasmosis begins as a
respiratory infection helps you choose dyspnea over headache as the correct option.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Respiratory
Health Problem: Adult Health: Respiratory: Viral, bacterial, fungal infections
Priority Concepts: Clinical Judgment; Infection
Reference: Ignatavicius, Workman, Rebar (2018), p. 347.

578. Answer: 4

Rationale: Dry cough and dyspnea are typical early manifestations of pulmonary
sarcoidosis. Later manifestations include night sweats, fever, weight loss, and skin
nodules.
Test-Taking Strategy: Note the strategic word, early. Because sarcoidosis is a
pulmonary problem, eliminate options 1 and 3 first. Select the correct option over
option 2 because the shortness of breath (and impaired ventilation) appears first and
would cause the fatigue as a secondary symptom.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Evaluation
Content Area: Adult Health: Respiratory
Health Problem: Adult Health: Respiratory: Environmental

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