Certified Medical-Surgical Registered Nurse Practice Test

A patient with acquired immunodeficiency syndrome (AIDS) develops P. jiroveci pneumonia. Which nursing diagnosis has the highest priority for this patient?

1. Impaired gas exchange

2. Impaired oral mucous membranes

3. Imbalanced nutrition: Less than body requirements

4. Activity intolerance

The correct answer is: Impaired gas exchange

For a patient with Acquired Immunodeficiency Syndrome (AIDS) developing Pneumocystis jiroveci pneumonia, the highest priority nursing diagnosis would be impaired gas exchange (Option A). Pneumocystis jiroveci pneumonia is a severe fungal infection that affects the lungs, leading to impaired gas exchange due to the accumulation of fluid and debris in the air sacs. This condition can cause hypoxemia, respiratory distress, and potentially respiratory failure. Ensuring optimal gas exchange is crucial for this patient to maintain adequate oxygenation. Nursing interventions for impaired gas exchange may include monitoring respiratory status, administering oxygen therapy, assisting with positioning for improved ventilation, and closely monitoring for signs of respiratory distress. While the other nursing diagnoses (Impaired oral mucous membranes, Imbalanced nutrition: Less than body requirements, and Activity intolerance) may also be relevant for a patient with AIDS, they are not as immediately life-threatening as impaired gas exchange in a patient with Pneumocystis jiroveci pneumonia.