The nurse is caring for a client with type 2 diabetes mellitus who reports frequent episodes of hypoglycemia. Which action should the nurse prioritize?

Choice A reason: HIV does not primarily cause a deficiency in antibody production. B-cells produce antibodies, but HIV targets CD4 T-cells, impairing their ability to activate B-cells. This indirectly reduces antibody effectiveness, but the primary mechanism is T-cell destruction, not a direct antibody production deficit, making this incorrect.

Choice B reason: HIV infects and destroys helper T-cells (CD4 cells), critical for coordinating immune responses. By reducing CD4 cell counts, HIV impairs activation of B-cells and cytotoxic T-cells, leading to immune suppression. This is the primary mechanism of AIDS-related immune deficiency, making it the correct explanation for HIV pathology.

Choice C reason: Proliferation of suppressor T-cells (regulatory T-cells) is not a primary HIV mechanism. HIV depletes CD4 cells, not suppressor T-cells, which modulate immune responses. While immune dysregulation occurs, the hallmark is CD4 destruction, not suppressor T-cell proliferation, making this an inaccurate description of HIV’s action.

Choice D reason: HIV does not increase B-lymphocyte numbers. It impairs B-cell function indirectly by destroying CD4 cells, which are needed to activate B-cells for antibody production. B-cell hyperactivity may occur in early HIV, but the primary immune suppression results from CD4 cell loss, not B-cell proliferation.

Choice A reason: A foreign body in the eye may cause irritation or damage but is not a contraindication for ketorolac, a nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation. The nurse would ensure removal of the foreign body first, but ketorolac can be used post-removal if indicated.

Choice B reason: Radiation exposure, such as from UV light, may cause photokeratitis but is not a specific contraindication for ophthalmic ketorolac. The medication reduces inflammation and pain, which may be beneficial in such cases. The nurse should assess for other ocular conditions, but radiation exposure alone does not preclude its use.

Choice C reason: Chemical burns require immediate irrigation and specific treatments based on the chemical involved. Ketorolac may reduce pain and inflammation post-irrigation, but it is not contraindicated. The nurse should prioritize burn management, but chemical burns do not inherently prohibit ketorolac use compared to corneal abrasions.

Choice D reason: Corneal abrasions are a contraindication for ophthalmic ketorolac, as NSAIDs can delay corneal healing and increase the risk of complications like corneal ulceration. The nurse must review the medical record to confirm the absence of abrasions, as ketorolac is typically used for postoperative pain, not traumatic corneal injuries.