The nurse is preparing a teaching plan for a group of well-educated clients who were found to be HIV positive within the last year. The nurse should explain that the human immunodeficiency virus (HIV) acts in which way to suppress the immune system?
Increase in B-lymphocytes and IgM.
Destruction of helper T-cells and CD4 cells.
Deficiency of cytotoxic T cells.
Proliferation of suppressor T-cells.
The Correct Answer is B
Choice A rationale
An increase in B-lymphocytes and IgM is not how HIV suppresses the immune system. B-lymphocytes are responsible for producing antibodies, and IgM is a type of antibody. HIV primarily affects T-lymphocytes, specifically helper T-cells (CD4 cells), rather than B-lymphocytes.
Choice B rationale
The destruction of helper T-cells and CD4 cells is the primary mechanism by which HIV suppresses the immune system. HIV targets and infects these cells, leading to their depletion. Helper T-cells play a crucial role in coordinating the immune response, and their loss results in a weakened immune system, making the body more susceptible to infections and diseases.
Choice C rationale
A deficiency of cytotoxic T cells is not the primary mechanism by which HIV suppresses the immune system. Cytotoxic T cells (CD8 cells) are involved in directly killing infected cells, but the main impact of HIV is on helper T-cells (CD4 cells), which are essential for orchestrating the immune response.
Choice D rationale
The proliferation of suppressor T-cells is not how HIV suppresses the immune system. Suppressor T-cells (regulatory T cells) help regulate and control the immune response, but HIV primarily affects helper T-cells (CD4 cells), leading to their destruction and a weakened immune system.
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Correct Answer is D
Explanation
Choice A rationale
Counting the apical and radial pulses simultaneously is important for assessing pulse deficits, but it is not the most critical assessment for a client receiving hydromorphone.
Choice B rationale
Measuring the client’s capillary glucose level is important for clients with diabetes, but it is not directly related to the administration of hydromorphone.
Choice C rationale
Observing for edema around the ankles is important for assessing fluid retention, but it is not the most critical assessment for a client receiving hydromorphone.
Choice D rationale
Auscultating the client’s bowel sounds is crucial because hydromorphone is a potent opioid analgesic that can slow peristalsis and frequently causes constipation. Monitoring bowel sounds helps prevent complications such as bowel obstruction. .
Correct Answer is A
Explanation
Choice A rationale
Corneal abrasion is a contraindication for the use of ophthalmic ketorolac. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that can delay healing and increase the risk of further damage to the cornea.
Choice B rationale
Chemical burns are not a primary contraindication for ophthalmic ketorolac. However, the treatment of chemical burns typically involves other specific interventions, and the use of ketorolac should be carefully considered.
Choice C rationale
Radiation exposure is not a direct contraindication for the use of ophthalmic ketorolac. The medication is used to reduce inflammation and pain, which may be beneficial in managing symptoms related to radiation exposure.
Choice D rationale
A foreign body in the eye is not a primary contraindication for ophthalmic ketorolac. However, the foreign body should be removed, and the eye should be thoroughly examined before administering any medication.