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

Answer and Explanation

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.

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Correct Answer is D

Explanation

A) Mask-like face and shuffling gait:
While the mask-like face and shuffling gait are common clinical features of Parkinson's Disease (PD), they do not directly explain the fever or the patchy infiltrates seen on the chest x-ray. The mask-like face is due to reduced facial muscle activity and is associated with the motor symptoms of PD, while the shuffling gait results from bradykinesia (slowness of movement).

B) Lack of arm swing and bradykinesia:
Lack of arm swing and bradykinesia are motor symptoms of PD that are indicative of decreased movement and muscle rigidity. While they impact a patient’s mobility and dexterity, they are not directly associated with lung infiltrates or fever.

C) Pill rolling of fingers and flat affect:
Pill rolling (a characteristic tremor where patients move their fingers as if rolling a pill) and flat affect (a reduced emotional expression) are hallmark features of Parkinson's Disease, but again, they do not explain the fever or lung infiltrates.

D) Difficulty swallowing and immobility:
Difficulty swallowing (dysphagia) is a common and serious symptom in patients with Parkinson's Disease. Due to the loss of control over the muscles involved in swallowing, patients with PD are at high risk for aspiration (food, liquids, or saliva entering the lungs), which can lead to aspiration pneumonia. This condition often presents with fever, chest infiltrates, and respiratory distress, which directly correlates with the patient's fever and lung infiltrates seen on the chest x-ray.

A. Equal but sluggishly reactive pupils B. Widening pulse pressure C. Altered level of consciousness D. Tachycardia and hypotension

Correct Answer is C

Explanation

A) Equal but sluggishly reactive pupils:
Pupillary changes, including sluggish or unequal responses, are significant signs of increasing intracranial pressure (ICP) and should be monitored closely. However, altered level of consciousness (LOC) is typically one of the earliest signs of increased ICP. The response of the pupils to light can become abnormal later, once pressure increases within the brain, particularly when brainstem function is impacted.

B) Widening pulse pressure:
A widening pulse pressure is part of Cushing’s triad, which is a late sign of increased ICP. Cushing’s triad consists of hypertension, bradycardia, and irregular respirations (often seen as Cheyne-Stokes). These changes occur in the later stages of elevated ICP as a compensatory mechanism to preserve cerebral perfusion. While this is an important finding, altered LOC would precede the development of Cushing’s triad.

C) Altered level of consciousness:
Altered level of consciousness (LOC) is typically the first and most sensitive indicator of increased ICP. As pressure increases within the skull, it compresses brain tissue and affects the brainstem, which controls basic functions like consciousness. LOC can range from mild confusion and disorientation to full loss of consciousness or coma, depending on the severity of the ICP increase.

D) Tachycardia and hypotension:
Tachycardia and hypotension can be associated with shock or other conditions, but they are not characteristic of early increased ICP. In fact, as ICP rises, the body typically responds with bradycardia (slower heart rate) and hypertension (increased blood pressure), which are part of the compensatory mechanisms.

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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?

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Naxlex Comprehensive Predictor Exams

The client diagnosed with Parkinson's Disease (PD) is being admitted with a fever and patchy infiltrates in the lung fields on the chest x-ray. Which clinical manifestations of PD would explain this assessment data?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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