A nurse is caring for a client who is on anti-retroviral therapy (ART), which includes indinavir sulfate (Crixivan), a protease inhibitor, for the treatment of HIV. Which client statement demonstrates that teaching was effective?
"If I don't take my medication as scheduled, the virus may become resistant to treatment."
"If I don't take my medication as scheduled, it may cause my RNA to convert to DNA."
"If I don't take my medication as scheduled, it may prevent the HIV from being assembled."
"If I don't take my medication as scheduled, my CD4 lymphocyte count may increase."
The Correct Answer is A
A. This statement accurately reflects the importance of adherence to ART; if medication is missed, the virus may replicate unchecked, leading to drug resistance, which is a significant concern in HIV treatment.
B. This statement is incorrect because the conversion of RNA to DNA is a normal part of the HIV life cycle and is not directly prevented by taking medication on time.
C. While protease inhibitors do help prevent the assembly of new virions, the primary concern when missing doses is the risk of resistance rather than assembly prevention.
D. This statement is misleading; while effective ART can lead to an increase in CD4 counts over time, missing doses would not directly cause an increase in CD4 lymphocyte counts.
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Correct Answer is B
Explanation
A. A quantitative RNA assay is used to measure the amount of HIV RNA in the blood and is not used for confirmatory diagnosis after a positive ELISA.
B. The Western blot analysis is the standard confirmatory test for HIV following a positive ELISA result, as it specifically detects the presence of antibodies to HIV proteins.
C. A viral load test assesses the level of virus in the blood but does not confirm the diagnosis of HIV.
D. The CD4+ T-cell count is used to assess immune function in individuals with HIV but is not a confirmatory test for the diagnosis of the virus.
Correct Answer is B
Explanation
A. Over-hydration is not a trigger for a sickle cell crisis; in fact, adequate hydration helps prevent sickling of the cells.
B. Dehydration is a significant trigger for sickle cell crises, as it can lead to increased blood viscosity and sickling of red blood cells.
C. Non-steroidal anti-inflammatory drugs (NSAIDs) are often used to manage pain associated with sickle cell crises, but they do not trigger a crisis.
D. Vaccinations are important for preventing infections in individuals with sickle cell anemia but are not associated with triggering a sickle cell crisis.