The nurse is preparing a teaching plan for a group of clients who were found to be HIV positive within the last year. Members of the group express an interest in learning about the pathology of AIDS.
The nurse should explain that HIV acts in which way to suppress the immune system?

Proliferation of suppressor T-cells.

Deficiency of cytotoxic T-cells.

Increase in B-lymphocytes and IgM.

Destruction of helper T-cells and CD4 cells.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Incorrect. Suppressor T-cells (also known as regulatory T-cells) play a role in regulating the immune response, but their proliferation is not the primary mechanism by which HIV suppresses the immune system. In fact, HIV can disrupt the function of suppressor T-cells, leading to an impaired ability to control immune responses.

Choice B rationale:

Incorrect. Cytotoxic T-cells (also known as CD8+ T-cells) are important for killing infected cells, but their deficiency is not the direct cause of immune suppression in HIV. However, HIV can indirectly lead to a deficiency of cytotoxic T-cells by disrupting their production and function.

Choice C rationale:

Incorrect. B-lymphocytes produce antibodies, and IgM is an early antibody produced in response to infection. However, an increase in B-lymphocytes and IgM is not characteristic of HIV infection. In fact, HIV can impair B-cell function, leading to decreased antibody production.

Choice D rationale:

Correct. HIV primarily targets and destroys helper T-cells (also known as CD4+ T-cells). These cells play a crucial role in coordinating the immune response by activating other immune cells, such as cytotoxic T-cells and B-cells. The depletion of helper T-cells leads to a progressive weakening of the immune system, rendering the body vulnerable to opportunistic infections and cancers.

Specific mechanisms of CD4+ T-cell destruction by HIV:

Direct infection and lysis: HIV can directly infect CD4+ T-cells and replicate within them, eventually leading to the death of the infected cells.

CD4+ T-cell apoptosis: HIV can induce programmed cell death (apoptosis) in CD4+ T-cells through various mechanisms, including the activation of pro-apoptotic pathways and the disruption of anti-apoptotic signals.

Immune dysregulation: HIV infection can also dysregulate the immune system, leading to chronic inflammation and immune activation. This can further contribute to CD4+ T-cell depletion and dysfunction.

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Correct Answer is A

Explanation

Choice A rationale:

Direct identification of the causative organism: A culture for sensitive organisms is the most direct and definitive way to identify the specific bacteria or other microorganisms that are causing the infection in the wound. This information is crucial for guiding the selection of the most appropriate antibiotic therapy.

Tailored antibiotic therapy: By knowing the exact organism responsible, healthcare providers can prescribe antibiotics that are specifically effective against that organism, ensuring optimal treatment and reducing the risk of antibiotic resistance.

Informed infection control measures: The results of the culture can also inform appropriate infection control measures to prevent the spread of the infection to other patients or healthcare workers.

Monitoring treatment effectiveness: Cultures can also be used to monitor the effectiveness of antibiotic therapy. If the culture results show that the bacteria are no longer present after a course of antibiotics, this indicates that the treatment has been successful.

Choice B rationale:

Non-specific marker of inflammation: C-reactive protein (CRP) is a non-specific marker of inflammation that can be elevated in various conditions, including infections, but also in non-infectious conditions such as autoimmune diseases and trauma.

Limited diagnostic value for wound infections: While an elevated CRP level may suggest the presence of an infection, it does not provide information about the specific causative organism, which is essential for guiding antibiotic therapy.

Supplementary role: CRP levels can be used in conjunction with other clinical findings and laboratory tests to assess the severity of an infection and monitor the response to treatment, but it should not be relied upon as a sole diagnostic tool for wound infections.

Choice C rationale:

Not directly indicative of wound infection: Blood pH level primarily reflects the acid-base balance of the body and is not directly indicative of a wound infection.

Alterations in other conditions: Blood pH can be altered in various conditions, including respiratory and metabolic disorders, and is not specific to wound infections.

Limited role in diagnosis: While significant alterations in blood pH may suggest a serious systemic infection, it does not provide information about the location or causative organism of the infection.

Choice D rationale:

Not directly related to wound infection: Serum blood glucose level is primarily used to monitor diabetes and is not directly related to wound infections.

Impaired wound healing in diabetes: While elevated blood glucose levels can impair wound healing and increase the risk of infections in diabetic patients, it is not a diagnostic test for wound infections in general.

Secondary consideration: Blood glucose levels may be considered as part of the overall assessment of a patient with a wound infection, particularly in those with diabetes, but it is not a primary diagnostic tool.

A. Hemoccult test on sputum collected from hemoptysis. B. Sputum culture positive for Mycobacterium tuberculosis. C. Positive purified protein derivative (PPD) skin test. D. Chest X-ray or computed tomography (CT).

Correct Answer is B

Explanation

Choice A rationale:

Hemoccult test on sputum collected from hemoptysis is not a diagnostic test for TB. It is a test for blood in the stool, which can be a symptom of TB but is not specific to TB.

Hemoptysis, or coughing up blood, can occur in various conditions, including bronchitis, pneumonia, lung cancer, and TB. The Hemoccult test cannot differentiate between these causes, making it an unreliable test for diagnosing TB.

Choice B rationale:

Sputum culture positive for Mycobacterium tuberculosis is the definitive diagnostic test for TB.

It involves collecting a sample of sputum, which is the mucus coughed up from the lungs, and culturing it in a laboratory to see if Mycobacterium tuberculosis, the bacteria that causes TB, grows.

This test is highly specific for TB, meaning that a positive result is almost always indicative of TB infection. It is also sensitive, meaning that it can detect TB infection even when there are few bacteria present.

Choice C rationale:

Positive purified protein derivative (PPD) skin test indicates exposure to TB but does not confirm active infection.

The PPD skin test involves injecting a small amount of tuberculin, a protein derived from Mycobacterium tuberculosis, into the skin.

If a person has been exposed to TB, their immune system will react to the tuberculin, causing a raised red bump to appear at the injection site.

However, a positive PPD skin test does not necessarily mean that a person has active TB infection.

It could also mean that they have been exposed to TB in the past but have successfully fought off the infection. Further testing, such as a sputum culture, is needed to confirm the diagnosis of TB.

Choice D rationale:

Chest X-ray or computed tomography (CT) can show abnormalities in the lungs that are suggestive of TB, but they cannot definitively diagnose TB.

These imaging tests can reveal changes in the lungs, such as nodules, inflammation, or fluid buildup, which can be caused by TB or other conditions.

Therefore, a chest X-ray or CT scan alone is not sufficient to diagnose TB. A sputum culture is still needed to confirm the diagnosis.

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The nurse is preparing a teaching plan for a group of clients who were found to be HIV positive within the last year. Members of the group express an interest in learning about the pathology of AIDS.The nurse should explain that HIV acts in which way to suppress the immune system?

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Naxlex Comprehensive Predictor Exams

While changing a client’s postoperative dressing, the nurse observes purulent drainage at the wound.Before reporting this finding to the healthcare provider, which of the client’s laboratory values should the nurse note?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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The nurse is preparing a teaching plan for a group of clients who were found to be HIV positive within the last year. Members of the group express an interest in learning about the pathology of AIDS.
The nurse should explain that HIV acts in which way to suppress the immune system?