The nurse is monitoring the effectiveness or antiretroviral therapy (ART) for a patient with human immunodeficiency virus (HIV). What laboratory study results indicates the medications are effective?

Increased viral load

Decreased neutrophil count

Decreased white blood cell count

Increased CD4-T-cell count

Answer and Explanation

The Correct Answer is D

A) "Increased viral load":
An increased viral load would indicate that the HIV virus is actively replicating in the body. This suggests that the antiretroviral therapy (ART) is not effective, as it has failed to suppress the viral replication. The goal of ART is to lower the viral load to undetectable levels, indicating that the virus is well controlled.

B) "Decreased neutrophil count":
. A decreased neutrophil count (neutropenia) is not directly related to the effectiveness of ART in managing HIV. Neutropenia can occur due to various causes, such as certain medications (including some ART medications), infections, or other underlying conditions. While neutropenia could be a side effect of ART, it does not directly reflect the effectiveness of HIV treatment. Monitoring CD4-T-cell counts and viral load is a better indicator of ART effectiveness.

C) "Decreased white blood cell count":
. A decreased white blood cell count (leukopenia) is also not an indicator of ART effectiveness. While some ART medications may lead to a decrease in white blood cell count, especially in the early stages of treatment, a decrease in the white blood cell count is not a measure of how well the therapy is controlling HIV. The effectiveness of ART is primarily assessed by the viral load and CD4-T-cell count.

D) "Increased CD4-T-cell count":
. CD4-T-cell count is a critical marker for monitoring the immune system's function in patients with HIV. CD4-T-cells are a type of T lymphocyte (white blood cell) that are targeted and destroyed by the HIV virus. A higher CD4-T-cell count indicates that the immune system is recovering and functioning better, which is a sign that the ART is effective in controlling the virus. Ideally, ART should result in a higher CD4-T-cell count and lower viral load, showing that the treatment is effectively suppressing the virus and preserving the immune system.

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Correct Answer is A

Explanation

A. Troponins I & T:
Troponins I and T are the most specific biomarkers for myocardial damage. These proteins are released into the bloodstream when the heart muscle is injured, such as during a myocardial infarction (MI). Troponins remain elevated for a prolonged period (typically up to 1-2 weeks) after myocardial injury, making them highly sensitive for detecting both acute and recent myocardial damage. Because of their high specificity for heart muscle, they are considered the gold standard for diagnosing acute myocardial infarction.

B. Creatine Kinase:
Creatine kinase (CK) is an enzyme found in the heart, brain, and skeletal muscle. While CK-MB (the heart-specific isoenzyme) can be elevated in cases of myocardial damage, it is less specific than troponins because it can also be elevated due to skeletal muscle injury or other conditions. CK-MB levels rise more rapidly than troponins but return to baseline within 48-72 hours, making it less useful for detecting myocardial damage over a longer period.

C. C-Reactive Protein (CRP):
C-Reactive Protein (CRP) is an acute-phase reactant produced by the liver in response to inflammation or tissue injury. While CRP levels can be elevated in various inflammatory conditions, including atherosclerosis, it is not specific to myocardial damage. Elevated CRP is associated with increased risk for cardiovascular events but does not provide specific information about acute myocardial injury, making it less helpful for diagnosing myocardial infarction.

D. Myoglobin:
Myoglobin is an oxygen-binding protein found in both skeletal and cardiac muscle. While it is an early marker that rises rapidly after muscle injury, it lacks specificity for myocardial damage because it is also released from skeletal muscle. Myoglobin levels peak quickly (within 1-4 hours of injury) and return to baseline within 24 hours, so it is not as useful for diagnosing a myocardial infarction or monitoring long-term cardiac injury.

A. You will need to return in 48-72 hours to have the test read B. A positive skin test will mean you need to have a follow up a chest x-ray C. "induration of greater than or equal to 10 millimeters means you have been exposed D. "induration of greater than or equal to 10 millimeters means you have active tuberculosis

Correct Answer is D

Explanation

A. You will need to return in 48-72 hours to have the test read:
This statement is correct. The purified protein derivative (PPD) skin test, also known as the tuberculin skin test (TST), must be read within 48-72 hours after administration. If the test is not read within this timeframe, the results may not be valid, and the test may need to be repeated. The test evaluates the presence of induration (swelling) at the injection site, which indicates a delayed-type hypersensitivity reaction to the tuberculosis antigen.

B. A positive skin test will mean you need to have a follow-up chest x-ray:
This statement is correct. A positive PPD skin test indicates exposure to Mycobacterium tuberculosis (the bacteria that causes tuberculosis). However, a positive result does not necessarily mean the person has active tuberculosis. A follow-up chest x-ray is typically recommended to determine whether active TB disease is present. The chest x-ray helps to assess for signs of active infection, such as lung lesions.

C. "Induration of greater than or equal to 10 millimeters means you have been exposed":
This statement is correct. In the context of a PPD skin test, induration (raised area of the skin) of 10 millimeters or more is generally considered a positive result, indicating exposure to tuberculosis. However, the exact threshold for what is considered positive can vary based on individual risk factors. A positive test means the person has been exposed to the tuberculosis bacteria, but it does not confirm active disease.

D. "Induration of greater than or equal to 10 millimeters means you have active tuberculosis":
This statement is incorrect. A positive PPD skin test result indicates exposure to Mycobacterium tuberculosis, but it does not confirm active tuberculosis (TB) infection. The induration reflects prior exposure or latent infection. To determine if the individual has active TB, additional diagnostic tests such as a chest x-ray, sputum cultures, and possibly a molecular test are required. A positive PPD result does not differentiate between latent TB infection and active TB disease.

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The nurse is monitoring the effectiveness or antiretroviral therapy (ART) for a patient with human immunodeficiency virus (HIV). What laboratory study results indicates the medications are effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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