A client with HIV has had a sudden decline in status with a large increase in viral load.
What action would the nurse take first?
Assess the client for adherence to the drug regimen.
Ask the client about travel to any foreign countries.
Determine if the client has any new sexual partners.
Request information about new living quarters or pets.
The Correct Answer is A
Choice A rationale
A sudden decline in status with a large increase in viral load in an HIV-positive client often indicates treatment failure. The most common reason for a sudden, significant increase in viral load and clinical decline while on antiretroviral therapy (ART) is non-adherence to the prescribed drug regimen, which leads to drug levels too low to suppress viral replication and can foster drug resistance.
Choice B rationale
While international travel could increase exposure to new or resistant pathogens, non-adherence to ART is a far more immediate and common cause of sudden viral load increase and clinical decline. Assessing adherence addresses the primary, modifiable factor within the client's direct control regarding their treatment effectiveness, making it the most immediate and impactful action.
Choice C rationale
New sexual partners primarily relate to the transmission risk of HIV, not the immediate reason for a sudden increase in the existing client's viral load. A change in viral load in a client already diagnosed and on therapy is highly correlated with the effectiveness of their current treatment, making adherence a more pertinent initial focus than sexual behavior changes.
Choice D rationale
Changes in environment or new pets are relevant for assessing exposure to opportunistic infections like Toxoplasma gondii (from cat feces) or certain fungi, which can exacerbate the disease. However, the most direct cause of a sharp increase in viral load is a breakdown in effective antiretroviral suppression, making adherence the priority assessment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Hydroxychloroquine (HCQ) is an anti-malarial and disease-modifying anti-rheumatic drug (DMARD). While it can have gastrointestinal side effects, significant weight fluctuations are not a common or primary reported adverse effect requiring specific client monitoring or education. The main concern with this medication involves toxicity to sensory organs.
Choice B rationale
HCQ can cause irreversible retinal damage, known as retinopathy, which is a cumulative dose-dependent toxicity. The drug concentrates in melanin-containing tissues, leading to bull's eye maculopathy that can cause vision loss. Because of this serious potential for eye problems, baseline and subsequent annual ophthalmologic examinations are mandatory for safe use.
Choice C rationale
HCQ generally has a favorable gastrointestinal profile compared to other DMARDs. Although some patients may experience mild nausea or diarrhea, the development of severe gastric or peptic ulcers is not a characteristic or prominent adverse effect of hydroxychloroquine, unlike non-steroidal anti-inflammatory drugs (NSAIDs).
Choice D rationale
Hydroxychloroquine actually has a beneficial side effect of improving the lipid profile by lowering total cholesterol and low-density lipoprotein (LDL) levels, rather than causing high cholesterol. Therefore, informing the client about high cholesterol as a potential problem would be scientifically inaccurate.
Correct Answer is ["42"]
Explanation
Step 1 is to add the units of regular insulin to the units of NPH insulin:. 14 units (regular) + 28 units (NPH) = 42 units. The total number of units of insulin that the nurse should prepare in the insulin syringe is 42 units.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.