The nurse reviews the CD4 cell count of a client who is HIV-positive. A result less than which count would indicate to the nurse that the client has AIDS?
1,000 cells/mm3
700 cells/mm3
450 cells/mm3
200 cells/mm3
The Correct Answer is D
A. 1,000 cells/mm3:
A CD4 cell count of 1,000 cells/mm3 is within the normal range for a healthy individual. In HIV-positive individuals, a CD4 count at this level would generally indicate that the immune system is functioning well and has not been significantly compromised by the virus. Therefore, a CD4 count of 1,000 cells/mm3 would not suggest a diagnosis of AIDS.
B. 700 cells/mm3:
Similarly, a CD4 cell count of 700 cells/mm3 is also within the normal range for immune function. While this count may be lower than the typical CD4 count in a healthy individual, it is still considered relatively high and would not indicate immune compromise to the extent seen in AIDS.
C. 450 cells/mm3:
A CD4 cell count of 450 cells/mm3 is also within a range that suggests the immune system is functioning reasonably well. While it may be lower than normal, it is not at a level indicative of severe immune suppression characteristic of AIDS.
D. 200 cells/mm3:
When the CD4 cell count drops below 200 cells/mm3, it indicates significant immune suppression and an increased risk of opportunistic infections. This threshold is used to diagnose AIDS in HIV-positive individuals. At this level, the immune system is severely compromised, leaving the individual vulnerable to various infections and diseases associated with AIDS.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Deep tendon reflexes 2+: Deep tendon reflexes are typically assessed to monitor for signs of magnesium sulfate toxicity. A normal finding of 2+ deep tendon reflexes suggests that the client is not experiencing magnesium sulfate toxicity. However, it does not specifically indicate whether the medication is at a therapeutic level.
B. Respiratory rate of 10 breaths/minute: A respiratory rate of 10 breaths/minute is below the normal range, and it could indicate respiratory depression, a potential side effect of magnesium sulfate toxicity. While this finding suggests a potential adverse reaction to the medication, it does not confirm whether the medication is at a therapeutic level.
C. Urinary output of 20 mL per hour: Adequate urinary output is essential for excreting magnesium sulfate and preventing toxicity. A urinary output of 20 mL per hour is within an acceptable range and suggests adequate renal function, which is important for maintaining therapeutic levels of the medication. However, it alone does not confirm whether the medication is at a therapeutic level.
D. Difficulty in arousing: Difficulty in arousing is a concerning sign of magnesium sulfate toxicity and suggests central nervous system depression. It indicates that the client may be experiencing an adverse reaction to the medication and that the dose may need adjustment. While this finding suggests a potential issue with medication dosing or toxicity, it does not confirm whether the medication is at a therapeutic level.
Correct Answer is C
Explanation
A. Disseminated intravascular coagulation (DIC):
DIC is a serious condition characterized by abnormal clotting throughout the body's blood vessels, leading to both bleeding and clotting simultaneously. While it can occur in severe cases of HELLP syndrome, it is not a specific finding used to diagnose HELLP syndrome. Instead, it's a complication that can develop due to various underlying conditions, including HELLP syndrome.
B. Elevated platelet count:
In HELLP syndrome, platelet count is typically decreased, not elevated. HELLP syndrome stands for Hemolysis, Elevated Liver enzymes, and Low Platelets. The low platelet count is a key diagnostic feature of HELLP syndrome and contributes to the risk of bleeding complications.
C. Elevated liver enzymes:
Elevated liver enzymes, particularly elevated levels of AST (aspartate aminotransferase) and ALT (alanine aminotransferase), are hallmark features of HELLP syndrome. Liver involvement is a significant component of this syndrome, and elevated liver enzymes are part of the diagnostic criteria.
D. Hyperglycemia:
While hyperglycemia can occur in various conditions, it is not a characteristic finding of HELLP syndrome. HELLP syndrome primarily affects the liver, blood clotting factors, and platelets, leading to features such as elevated liver enzymes, low platelet count, and hemolysis (destruction of red blood cells).
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