A patient tests positive for HIV
These medications should keep the viral load suppressed
Headache, nausea, vomiting. and anorexia are known side effects of these
medications.
There are no side effects of ART
ART causes insomnia, so it should be taken at night
If you miss a dose of medication, take two of that pill as soon as you think of it
Take ART with antiacids to ensure they do not upset the stomach
We will measure the effectiveness of ART by measuring CD4+T cell counts
ART medications will cause wasting syndrome
Correct Answer : A,B,G
A. Antiretroviral therapy (ART), including dolutegravir and lamivudine, inhibits HIV replication, reducing viral load to undetectable levels, which is a primary goal of treatment. This aligns with the patient’s regimen, as suppressing viral load prevents disease progression and reduces transmission risk.
B. Dolutegravir and lamivudine can cause side effects such as headache, nausea, vomiting, and anorexia, which are well-documented in clinical data. Educating the patient about these potential effects is crucial for adherence and managing expectations.
C. ART does not have zero side effects. Clinical evidence shows dolutegravir and lamivudine can cause adverse effects, including gastrointestinal issues and, rarely, liver problems, making this statement incorrect for patient education.
D. While dolutegravir may cause insomnia in some patients, it is not a universal effect requiring nighttime dosing. The prescribed morning dose of dolutegravir is standard to optimize adherence and efficacy, making this statement incorrect.
E. Doubling a missed dose is incorrect and potentially harmful. ART regimens require consistent dosing; patients should take the missed dose as soon as remembered unless it’s close to the next dose, to avoid toxicity and maintain efficacy.
F. Taking ART with antacids is not recommended, as antacids can reduce dolutegravir absorption, decreasing its effectiveness. Patients should be advised to avoid antacids or follow specific timing guidelines, making this statement incorrect.
G. CD4+T cell counts are a key measure of ART effectiveness, as they reflect immune system recovery. Monitoring CD4+T counts every 3 months, as ordered, assesses treatment success, making this statement correct for patient education.
H. ART, including dolutegravir and lamivudine, does not cause wasting syndrome. Wasting syndrome is associated with untreated HIV or older regimens, not modern ART, making this statement incorrect for patient education.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A","dropdown-group-3":"C"}
Explanation
A. Pneumocystis pneumonia is a common opportunistic infection in HIV+ patients, particularly when CD4 counts fall below 200 cells/mm³, signaling severe immunosuppression. This aligns with the patient’s HIV+ status, as opportunistic infections exploit weakened immune systems. The DSM-5 does not directly address physical infections but notes that medical conditions like HIV can exacerbate mental health issues, which may be relevant in holistic care.
B. Tuberculosis is an opportunistic infection in HIV+ patients, often occurring at CD4 counts below 350 cells/mm³. However, it is less specific than Pneumocystis pneumonia as a hallmark of AIDS-defining illness in HIV+ patients, making it a less precise choice for this context.
C. Influenza is not typically an opportunistic infection in HIV+ patients. It affects immunocompetent individuals and does not specifically indicate HIV-related immunosuppression, making this choice incorrect.
D. Pneumocystis jirovecii is the causative organism of Pneumocystis pneumonia, directly linked to the opportunistic infection in HIV+ patients. This fungal pathogen thrives in immunocompromised hosts, aligning with the patient’s condition.
E. Mycobacterium tuberculosis causes tuberculosis, which is an opportunistic infection in HIV+ patients but less commonly the primary indicator compared to Pneumocystis jirovecii for Pneumocystis pneumonia, making it less accurate here.
F. Influenza virus causes influenza, which is not an opportunistic infection specific to HIV+ patients. This makes it an incorrect choice for the causative organism.
G. Trimethoprim-sulfamethoxazole is the first-line treatment for Pneumocystis pneumonia in HIV+ patients, effectively targeting Pneumocystis jirovecii. It is widely recommended in clinical guidelines for both treatment and prophylaxis, fitting the patient’s needs.
H. Isoniazid is used for tuberculosis treatment or prophylaxis, not Pneumocystis pneumonia. Since the correct infection is Pneumocystis pneumonia, this choice is inappropriate.
I. Oseltamivir treats influenza, which is not an opportunistic infection in HIV+ patients, making this an incorrect treatment option for the context of the question.
Correct Answer is A
Explanation
Choice A reason: Administering insulin infusion is the priority in DKA to correct hyperglycemia and halt ketogenesis. Insulin lowers blood glucose by facilitating cellular uptake and inhibits lipolysis, reducing ketone production. This addresses the underlying metabolic derangement, preventing further acidosis and stabilizing the patient’s condition rapidly, critical for life-threatening DKA.
Choice B reason: Providing oral glucose is contraindicated in DKA, as the client already has severe hyperglycemia. Adding glucose would worsen the condition, increasing osmotic diuresis and acidosis. The focus is on lowering blood sugar with insulin and fluids, not adding more glucose, which could exacerbate dehydration and metabolic imbalance.
Choice C reason: Sodium bicarbonate may be used in severe DKA with profound acidosis (pH < 7.0), but it is not the priority. Insulin and fluid resuscitation correct the underlying cause of acidosis by stopping ketone production and restoring perfusion. Bicarbonate is an adjunct and may cause complications like hypokalemia if used prematurely.
Choice D reason: Deep breathing exercises do not address the metabolic cause of DKA. While compensatory hyperventilation (Kussmaul respirations) occurs to correct acidosis, encouraging breathing exercises does not treat hyperglycemia or ketosis. Insulin and fluids are critical to reverse the underlying pathology, making breathing exercises a low-priority intervention in this acute condition.
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