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)

Answer and Explanation

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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Correct Answer is A

Explanation

A. Petechiae are small, red or purple spots on the skin that indicate bleeding under the skin and are a classic sign of thrombocytopenia, a condition characterized by a low platelet count.
B. A decreased white blood cell count is more indicative of leukopenia, not thrombocytopenia. Thrombocytopenia specifically affects platelet counts.
C. Increased fatigue can be a symptom of many conditions but is not specific to thrombocytopenia. It may occur due to anemia or other side effects of chemotherapy.
D. Unexplained bone pain is not a typical symptom of thrombocytopenia. It might be related to other conditions or side effects but is not specific to low platelet counts.

A. A change in the Glasgow Coma Scale score from 13 to 10 B. Diplopia C. Ataxia D. A drop in heart rate from 76 to 70/min

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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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?

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Naxlex Comprehensive Predictor Exams

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