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A patient who seeks health care for vague symptoms of fatigue and headaches has HIV testing and is found to have a positive enzyme immunoassay (EIA) for HIV antibodies. In discussing the test results with the patient, the nurse informs the patient that
a.the enzyme immunoassay test will need to be repeated to verify the results.
b. a viral culture will be done to determine the progress of the disease.
c. it will probably be 10 or more years before the patient develops AIDS.
d. the Western blot test will need to be done to determine whether AIDS has developed.
- Correct Answer: A
- Rationale: After an initial positive EIA test, the EIA is repeated before more specific testing such as the Western blot is done. Viral cultures are not part of HIV testing. Because the nurse does not know how recently the patient was infected, it is not appropriate to predict the time frame for AIDS development. The Western blot tests for HIV antibodies, not for AIDS.
Four years after seroconversion, an HIV-infected patient has a CD4+ cell count of 800/µl and a low viral load. The nurse teaches the patient that
a. the patient is at risk for development of opportunistic infections because of CD4+
b. the patient is in a clinical and biologic latent period, during which very few viruses are being replicated.
c. anti-HIV antibodies produced by B cells enter CD4+ cells infected with HIV to stop replication of viruses in the cells.
d. the body currently is able to produce an adequate number of CD4+ cells to replace those destroyed by viral activity.
- Correct Answer: D
- Rationale: The patient is the early chronic stage of infection, when the body is able to produce enough CD4+ cells to maintain the CD4+ count at a normal level. The risk for opportunistic infection is low because of the normal CD4+ count. Although the viral load in the blood is low, intracellular reproduction of virus still occurs. Anti-HIV antibodies produced by B cells attack the viruses in the blood, but not intracellular viruses.
A patient who tested positive for HIV 3 years ago is admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP). Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC), the patient is diagnosed as having
a. early chronic infection.
b. HIV infection.
d. intermediate chronic infection.
- Correct Answer: C
- Rationale: Development of PCP pneumonia meets the diagnostic criterion for AIDS. The other responses indicate an earlier stage of HIV infection than is indicated by the PCP infection.