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. Distended jugular veins may indicate fluid overload or congestive heart failure, not an allergic reaction.
B. Generalized urticaria, or hives, is a classic sign of an allergic transfusion reaction, presenting as an itchy rash or welts on the skin.
C. Bilateral flank pain is more indicative of a hemolytic reaction, particularly due to kidney involvement, rather than an allergic reaction.
D. A blood pressure of 184/92 mm Hg may suggest hypertension or a reaction, but it is not specific to allergic transfusion reactions, which are characterized by skin symptoms like urticaria.
Correct Answer is D
Explanation
A. Milk and cheese are low in iron content and are not recommended for increasing iron levels in clients with iron-deficiency anemia.
B. Whole grain breads may contain some iron but are not as high in iron as other food sources.
C. Fresh fruits do not provide significant amounts of iron and are not a good source for addressing iron deficiency.
D. Red meat and organ meat are excellent sources of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant sources, making them the best choice for increasing iron intake in clients with iron-deficiency anemia.