The nurse is preparing a teaching plan for a group of clients who were found to be HIV positive within the last year. Members of the group express an interest in learning about the pathology of AIDS.
The nurse should explain that HIV acts in which way to suppress the immune system?
Proliferation of suppressor T-cells.
Deficiency of cytotoxic T-cells.
Increase in B-lymphocytes and IgM.
Destruction of helper T-cells and CD4 cells.
The Correct Answer is D
Choice A rationale:
Incorrect. Suppressor T-cells (also known as regulatory T-cells) play a role in regulating the immune response, but their proliferation is not the primary mechanism by which HIV suppresses the immune system. In fact, HIV can disrupt the function of suppressor T-cells, leading to an impaired ability to control immune responses.
Choice B rationale:
Incorrect. Cytotoxic T-cells (also known as CD8+ T-cells) are important for killing infected cells, but their deficiency is not the direct cause of immune suppression in HIV. However, HIV can indirectly lead to a deficiency of cytotoxic T-cells by disrupting their production and function.
Choice C rationale:
Incorrect. B-lymphocytes produce antibodies, and IgM is an early antibody produced in response to infection. However, an increase in B-lymphocytes and IgM is not characteristic of HIV infection. In fact, HIV can impair B-cell function, leading to decreased antibody production.
Choice D rationale:
Correct. HIV primarily targets and destroys helper T-cells (also known as CD4+ T-cells). These cells play a crucial role in coordinating the immune response by activating other immune cells, such as cytotoxic T-cells and B-cells. The depletion of helper T-cells leads to a progressive weakening of the immune system, rendering the body vulnerable to opportunistic infections and cancers.
Specific mechanisms of CD4+ T-cell destruction by HIV:
Direct infection and lysis: HIV can directly infect CD4+ T-cells and replicate within them, eventually leading to the death of the infected cells.
CD4+ T-cell apoptosis: HIV can induce programmed cell death (apoptosis) in CD4+ T-cells through various mechanisms, including the activation of pro-apoptotic pathways and the disruption of anti-apoptotic signals.
Immune dysregulation: HIV infection can also dysregulate the immune system, leading to chronic inflammation and immune activation. This can further contribute to CD4+ T-cell depletion and dysfunction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice D. Reported history of alcoholism.
Choice A rationale:
Employment as a construction worker is not directly relevant to the administration of terbinafine HCL. While it may affect the client’s overall health and risk of injury, it does not impact the medication’s safety or efficacy.
Choice B rationale:
A white blood cell count of 8,500/mm³ (8.5 x 10³/L) is within the normal range and does not indicate any immediate concern that would affect the administration of terbinafine HCL.
Choice C rationale:
Thick and yellow toenails are typical symptoms of a fungal toenail infection and are the reason for prescribing terbinafine HCL. This finding confirms the diagnosis but does not present a contraindication to the medication.
Choice D rationale:
A reported history of alcoholism is crucial to address because terbinafine HCL can cause liver toxicity. Clients with a history of alcoholism are at higher risk for liver damage, and this must be carefully evaluated before starting the medication.
Correct Answer is A
Explanation
Choice A rationale:
Hemoglobin A1C (HbA1C) is a blood test that reflects a person's average blood glucose levels over the past 2-3 months. It's considered the gold standard for diagnosing and monitoring diabetes.
An HbA1C level of 8.29% is significantly elevated above the reference range of 4-5.99%, indicating a high probability of diabetes.
The patient's HbA1C has also increased from 7.59% three months ago, suggesting a worsening of glycemic control.
Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels due to impaired insulin production or action, or both.
Common symptoms of diabetes include increased thirst, frequent urination, fatigue, blurred vision, and slow-healing wounds.
Early diagnosis and treatment of diabetes are crucial to prevent complications such as heart disease, stroke, kidney disease, nerve damage, and vision loss.
Choice B rationale:
Hypoglycemia refers to abnormally low blood glucose levels, typically below 70 mg/dL. It's often caused by excessive insulin or medication, missed meals, or strenuous exercise.
The patient's HbA1C level of 8.29% does not support a diagnosis of hypoglycemia.
Choice C rationale:
Hyperglycemia refers to abnormally high blood glucose levels, typically above 180 mg/dL. It can be caused by diabetes, stress, infection, or certain medications.
While the patient's HbA1C level does indicate hyperglycemia, it's specifically the pattern of elevated HbA1C over time that points to a diagnosis of diabetes mellitus, rather than transient hyperglycemia.
Choice D rationale:
Prediabetes is a condition where blood glucose levels are higher than normal, but not high enough to be classified as diabetes. People with prediabetes are at increased risk of developing diabetes.
The patient's HbA1C level of 8.29% is above the threshold for prediabetes, which is typically 5.7-6.4%.
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