A client with acquired immune deficiency syndrome (AIDS) and Pneumocystis jiroveci pneumonia has a CD4+ T cell count of 200 cells/mm³ (20%). The client asks the nurse why they have these recurring massive infections. Which pathophysiologic mechanism should the nurse describe in response to this client's question?
Reference Range:
T-helper CD4 cells [600 to 1500 cells/mm³ (60 to 75%)]
The humoral immune response lacks B cells that form antibodies and opportunistic infections result.
Inadequate numbers of T lymphocytes are available to initiate cellular immunity and macrophages.
Bone marrow suppression of white blood cells causes insufficient cells to phagocytize organisms.
Exposure to multiple environmental infectious agents overburdens the immune system until it fails.
The Correct Answer is B
Choice A reason: This is incorrect because the humoral immune response involves B cells that produce antibodies against specific antigens. However, AIDS affects the cellular immune response, which involves T cells that activate other immune cells and directly kill infected cells.
Choice B reason: This is correct because AIDS is caused by human immunodeficiency virus (HIV), which infects and destroys CD4+ T cells, also known as helper T cells. These cells are essential for initiating and regulating both humoral and cellular immunity. Without enough CD4+ T cells, the body cannot mount an effective response against pathogens, especially opportunistic infections that take advantage of a weakened immune system.
Choice C reason: This is incorrect because bone marrow suppression of white blood cells is not a direct consequence of AIDS. However, some drugs used to treat AIDS, such as zidovudine, may cause bone marrow suppression as a side effect.
Choice D reason: This is incorrect because exposure to multiple environmental infectious agents does not cause AIDS. However, people with AIDS are more susceptible to infections from various sources due to their impaired immune system.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Jogging or running are not excellent aerobic exercises for an older adult client with osteoarthritis. These activities can put a lot of stress and impact on the joints, especially the knees, hips, and ankles, which can worsen the pain and inflammation of osteoarthritis. The nurse should advise the client to avoid high-impact exercises that can damage the cartilage and bones.
Choice B reason: Tennis or racquetball are not ideal exercises for an older adult client with osteoarthritis. These activities involve sudden movements, twists, and turns that can strain the joints, especially the elbows, wrists, and shoulders, which can aggravate the symptoms of osteoarthritis. The nurse should advise the client to avoid exercises that can cause joint instability and injury.
Choice C reason: Limiting the exercise to just the daily activities is not a good advice for an older adult client with osteoarthritis. Exercise is important for maintaining joint health, mobility, and function, as well as preventing muscle loss, obesity, and cardiovascular diseases. The nurse should encourage the client to engage in regular moderate exercise that can improve the quality of life and reduce the complications of osteoarthritis.
Choice D reason: Swimming is an excellent exercise for an older adult client with osteoarthritis. Swimming is a low-impact aerobic exercise that can strengthen the muscles, improve the cardiovascular fitness, and enhance the flexibility of the joints without putting too much pressure or stress on them. Swimming can also reduce the pain and stiffness of osteoarthritis by providing a soothing and relaxing effect on the body. The nurse should recommend swimming as a safe and effective exercise for the client.
Correct Answer is D
Explanation
Choice A reason: Measuring capillary glucose level is not a priority action for a client with a rigid abdomen and rebound tenderness. These signs indicate peritonitis, which is a serious complication of IBD that requires immediate attention. Corticosteroids can increase blood glucose levels, but this is not an urgent concern in this situation.
Choice B reason: Encouraging ambulation in the room is not appropriate for a client with a rigid abdomen and rebound tenderness. These signs indicate peritonitis, which is a serious complication of IBD that requires immediate attention. Ambulation can worsen the pain and inflammation, and increase the risk of bowel perforation.
Choice C reason: Monitoring for bloody diarrheal stools is important for a client with IBD, but not a priority action for a client with a rigid abdomen and rebound tenderness. These signs indicate peritonitis, which is a serious complication of IBD that requires immediate attention. Bloody stools can be a sign of ulceration or bleeding in the bowel, but they are not specific to peritonitis.
Choice D reason: Obtaining vital sign measurements is the priority action for a client with a rigid abdomen and rebound tenderness. These signs indicate peritonitis, which is a serious complication of IBD that requires immediate attention. Vital signs can reveal signs of infection, inflammation, shock, and organ failure, which can guide the appropriate interventions and treatments.
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