A nurse is caring for a client who has human immunodeficiency virus (HIV). Which of the following laboratory values would be most concerning to the nurse?
Positive Western blot test
CD4-T-cell count 505 cells/mm³ (nl. 500-1500 cells/mm³)
Platelets 115,000/mm³ (nl. 140,000-400,000/mm³)
White blood cell (WBC) count 800/mm³ (nl. 5000-10,000/mm³)
The Correct Answer is D
A. A positive Western blot test confirms the diagnosis of HIV, but it is not concerning once the diagnosis has been established.
B. A CD4-T-cell count of 505 cells/mm³ is low but not critically low. While it does indicate immunosuppression, it is not the most concerning value presented.
C. A platelet count of 115,000/mm³ is lower than normal and may indicate a risk for bleeding, but it is not as concerning as a critically low white blood cell count.
D. A WBC count of 800/mm³ is severely low and indicates a high risk for infection, which is particularly concerning in a client with HIV, as it suggests significant immunosuppression and vulnerability to opportunistic infections.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Foods high in protein, like fish and chicken, are generally recommended in a low-fat diet but are not specific to managing biliary colic.
B. Low-fat dairy products are usually recommended as part of a low-fat diet and are not typically avoided for cholecystitis.
C. High-carbohydrate foods like pie and donuts are not advised for general health but are not specifically targeted for managing biliary colic.
D. Avoiding foods high in fat, such as fried chicken, is important for managing biliary colic and chronic cholecystitis. Fatty foods can stimulate gallbladder contractions and exacerbate symptoms.
Correct Answer is A
Explanation
A. A decrease in the Glasgow Coma Scale score from 13 to 10 indicates a significant change in consciousness and may suggest worsening of the brain injury. This is a critical sign that requires immediate reporting and evaluation.
B. Diplopia (double vision) can be a concerning symptom, but it is not as immediately critical as a significant change in the Glasgow Coma Scale score. It still warrants attention but may not be the highest priority.
C. Ataxia (lack of voluntary coordination of muscle movements) is a serious symptom that could indicate worsening of the brain injury but is not as immediately critical as a significant change in the Glasgow Coma Scale score.
D. A drop in heart rate from 76 to 70/min is generally not significant in the context of mild TBI. Changes in heart rate are less critical compared to changes in the level of consciousness.
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