The nurse is providing care for a client who has tested positive for human immunodeficiency virus (HIV). Which of the following findings would confirm the diagnosis of acquired immunodeficiency syndrome (AIDS) in this client?
CD4 count of less than 200 cells/uL, (ranges 500-1800) and new diagnosis of pneumocystis pneumonia
CD4 count of 1200 cells/uL (ranges 500-1800) and a new diagnosis hepatitis A
low grade fever with the diagnosis of influenza A
New atopic dermatitis and a White Blood count 11 million/mm3
The Correct Answer is A
A) CD4 count of less than 200 cells/uL, and new diagnosis of pneumocystis pneumonia:
A CD4 count of less than 200 cells/uL and the diagnosis of a severe opportunistic infection, such as pneumocystis pneumonia (PCP), are major criteria for the diagnosis of acquired immunodeficiency syndrome (AIDS). AIDS is the final stage of HIV infection, where the immune system is severely compromised, and the individual is highly susceptible to opportunistic infections like PCP, tuberculosis, and others. The CD4 count, which measures the number of immune system cells (specifically T-helper cells), is used to monitor disease progression, with values below 200 cells/uL indicating a diagnosis of AIDS.
B) CD4 count of 1200 cells/uL and a new diagnosis of hepatitis A:
While hepatitis A is an important condition that should be managed, it is not an opportunistic infection associated with AIDS. A CD4 count of 1200 cells/uL is within the normal range (500-1800 cells/uL), indicating that the immune system is not severely compromised.
C) Low grade fever with the diagnosis of influenza A:
A low-grade fever and a diagnosis of influenza A do not indicate AIDS. Influenza is a viral infection that can affect both individuals with and without HIV. It is common to experience flu-like symptoms in the early stages of HIV infection, but the presence of a fever and influenza does not confirm AIDS. A low-grade fever is also not specific to AIDS or opportunistic infections.
D) New atopic dermatitis and a white blood count of 11 million/mm³:
Atopic dermatitis is a chronic inflammatory skin condition that is not specifically associated with HIV or AIDS. The white blood cell (WBC) count of 11 million/mm³ is elevated, but this alone does not confirm a diagnosis of AIDS. Elevated WBC counts can occur with various conditions, including infections and allergic reactions, but they are not a diagnostic feature of AIDS.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["13.7"]
Explanation
Given:
Ordered dose of Furosemide: 1 mg/kg
Patient weight: 121 lbs
Concentration of Furosemide: 40 mg/10 mL (4 mg/mL)
Step 1: Convert patient weight from pounds to kilograms:
1 pound (lb) = 0.453592 kilograms (kg)
Patient weight in kg = 121 lbs x 0.453592 kg/lb = 54.877832 kg
Step 2: Calculate the total dose of Furosemide:
Total dose (mg) = Ordered dose (mg/kg) x Patient weight (kg)
Total dose (mg) = 1 mg/kg x 54.877832 kg
Total dose (mg) = 54.877832 mg
Step 3: Calculate the volume to be administered:
Volume (mL) = Total dose (mg) / Concentration (mg/mL)
Volume (mL) = 54.877832 mg / 4 mg/mL
Volume (mL) = 13.719458 mL
Step 4: Round to the nearest tenth:
Volume (mL) ≈ 13.7 mL
Correct Answer is B
Explanation
A) Fever and cardiac dysrhythmias:
Fever and cardiac dysrhythmias are not the hallmark signs of an intracerebral hemorrhage (ICH) following thrombolytic therapy. While fever can occur in the aftermath of a stroke, it is more commonly linked to infection or other complications. Cardiac dysrhythmias can occur in stroke patients due to autonomic dysfunction or other underlying conditions but are not specific to a hemorrhagic complication.
B) Decline in neurological status and elevated blood pressure:
A decline in neurological status (e.g., deterioration of consciousness, confusion, or focal deficits) and elevated blood pressure are classic signs of an intracerebral hemorrhage (ICH) following thrombolytic therapy, especially when tissue plasminogen activator (tPA) is administered. tPA works by dissolving blood clots but increases the risk of bleeding. An ICH could present with sudden worsening neurological symptoms, such as decreased level of consciousness, weakness, or sensory loss, and elevated blood pressure is a compensatory response to the hemorrhage.
C) Abdominal distention and anorexia:
Abdominal distention and anorexia are not typical indicators of an intracerebral hemorrhage following tPA therapy. These symptoms may indicate other issues, such as gastrointestinal problems or metabolic imbalances, but they are not directly related to hemorrhagic complications following thrombolytic therapy for stroke.
D) Positive Coombs test and low urine output:
A positive Coombs test indicates the presence of antibodies against red blood cells, which may suggest hemolytic anemia or an autoimmune process. Low urine output can result from a variety of conditions, including kidney dysfunction, dehydration, or shock, but these are not specific indicators of an intracerebral hemorrhage following tPA.
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