A nurse is assessing a patient admitted with diagnosis of acquired immunodeficiency syndrome (AIDS). The nurse finds that the patient is experiencing a progressive decline in cognitive, behavioral and motor functions. The nurse identifies these symptoms are most likely related to the onset of which complication?

Human Immunodeficiency virus encephalopathy

Beta-cell lymphoma

Kaposi sarcoma

Wasting syndrome

Answer and Explanation

The Correct Answer is A

A. Human Immunodeficiency virus encephalopathy:
Human Immunodeficiency Virus (HIV) encephalopathy, also known as HIV-associated neurocognitive disorder (HAND), is a common neurological complication of HIV/AIDS. It occurs due to the direct effects of HIV on the central nervous system (CNS), leading to cognitive impairment, behavioral changes, and motor dysfunction. The progressive decline in cognitive, behavioral, and motor functions described in the patient is characteristic of HIV encephalopathy. Therefore, this choice is the most likely explanation for the patient's symptoms.

B. Beta-cell lymphoma:
Beta-cell lymphoma, also known as primary central nervous system lymphoma (PCNSL), is a rare but serious complication of HIV/AIDS. It involves the development of malignant lymphomas within the CNS. While PCNSL can cause neurological symptoms, such as cognitive decline and motor dysfunction, it typically presents with focal neurological deficits and signs of increased intracranial pressure, which are not mentioned in the scenario. Therefore, beta-cell lymphoma is less likely to be the cause of the patient's symptoms compared to HIV encephalopathy.

C. Kaposi sarcoma:
Kaposi sarcoma is a type of cancer caused by human herpesvirus 8 (HHV-8) infection, which commonly affects individuals with HIV/AIDS. While Kaposi sarcoma can involve the CNS and potentially lead to neurological symptoms, such as headaches and focal neurological deficits, the progressive decline in cognitive, behavioral, and motor functions described in the scenario is not typically associated with Kaposi sarcoma. Therefore, this choice is less likely to explain the patient's symptoms compared to HIV encephalopathy.

D. Wasting syndrome:
Wasting syndrome, also known as cachexia, is a syndrome characterized by unintentional weight loss, weakness, and muscle atrophy. While wasting syndrome is a common complication of advanced HIV/AIDS, it primarily affects body composition and nutritional status rather than causing progressive decline in cognitive, behavioral, and motor functions. Therefore, wasting syndrome is less likely to be the cause of the patient's symptoms compared to HIV encephalopathy.

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Correct Answer is B

Explanation

A. Changes in peristalsis: Changes in peristalsis, which refers to the rhythmic contraction and relaxation of the gastrointestinal tract muscles, are not typically associated with target organ damage in hypertension. While hypertension can indirectly affect gastrointestinal function through its impact on other organ systems, such as the kidneys and cardiovascular system, alterations in peristalsis are more commonly attributed to gastrointestinal disorders or neurological conditions rather than hypertension-induced target organ damage.

B. Decreased urine output: In a patient diagnosed with hypertension, decreased urine output may indicate the development of target organ damage, particularly renal damage. Hypertension can lead to chronic kidney disease (CKD) over time, which is characterized by a gradual decline in kidney function. Decreased urine output may be a sign of impaired renal function, reduced glomerular filtration rate (GFR), or the presence of proteinuria. These changes indicate that the kidneys are no longer effectively filtering waste products and regulating fluid balance, suggesting the onset of renal damage as a consequence of long-standing hypertension.

C. Decreased insulin resistance: Hypertension is not directly linked to changes in insulin resistance. However, hypertension and insulin resistance are often comorbid conditions that share common risk factors, such as obesity, sedentary lifestyle, and unhealthy diet. While poorly controlled hypertension and insulin resistance can contribute to the development of cardiovascular disease and other complications, a decrease in insulin resistance would not typically be considered an indicator of target organ damage in hypertension.

D. Hypercholesterolemia: Hypercholesterolemia, or high levels of cholesterol in the blood, is a risk factor for cardiovascular disease, including atherosclerosis and coronary artery disease. While hypertension and hypercholesterolemia frequently coexist and contribute to the progression of vascular damage, the presence of hypercholesterolemia alone does not necessarily indicate target organ damage specific to hypertension. However, elevated cholesterol levels can exacerbate vascular changes and increase the risk of cardiovascular events in individuals with hypertension.

A. Oral candidiasis and nausea B. Genital ulcer and vomiting C. Memory deficit and apathy D. Progressive dyspnea and fever

Correct Answer is D

Explanation

A. Oral candidiasis and nausea: Oral candidiasis (thrush) and nausea are common manifestations in patients with AIDS, particularly when the CD4 count is low. While these symptoms require intervention, they are not typically considered emergent or immediately life-threatening.

B. Genital ulcer and vomiting: Genital ulcers and vomiting can occur in patients with AIDS due to various opportunistic infections and conditions. While these symptoms may warrant intervention, they are not typically indicative of an immediate life-threatening situation.

C. Memory deficit and apathy: Memory deficits and apathy can occur in patients with AIDS, particularly as the disease progresses. While these cognitive and behavioral changes may impact the patient's quality of life and require intervention, they are not typically considered emergent or immediately life-threatening.

D. Progressive dyspnea and fever: Progressive dyspnea (difficulty breathing) and fever are concerning findings in a patient with AIDS, especially with a CD4 count less than 200. These symptoms may indicate the presence of opportunistic infections such as Pneumocystis jirovecii pneumonia (PCP), which can rapidly progress and lead to respiratory failure and death if not promptly treated. Therefore, these assessment findings require immediate intervention to assess for and manage potential respiratory compromise and systemic infection.

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Naxlex Comprehensive Predictor Exams

The nurse is assessing a patient diagnosed with hypertension several years ago. What assessment finding may indicate that target organ damage is now occurring?

Correct Answer is B

Explanation

The nurse is caring for a patient diagnosed with acquired immunodeficiency syndrome (AIDS) whose most recent laboratory values reveal a CD4 level less than 200. Which assessment findings require immediate intervention?

Correct Answer is D

Explanation

The nurse admits a patient with a history of human immunodeficiency virus (HIV). Patient reports severe diarrhea, vomiting for the past 6 days. Which action will the nurse perform first?

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The nurse is caring for a patient who has been taking metoprolol as a second medication to control hypertension. The nurse will assess for which side effect?

The nurse is assessing a patient diagnosed with hypertension several years ago. What assessment finding may indicate that target organ damage is now occurring?

The nurse is assessing a patient who is complaining of blurred vision. The patient's blood pressure reading is 195/130, the heart rate is 95 beats per minute. Which assessment finding by the nurse is consistent with a diagnosis of hypertensive emergency?

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