A male client with acquired immune deficiency syndrome (AIDS) and Pneumocystis carinii pneumonia has a CD4+ T cell count of 200 cells/microliter. The client asks the nurse why he keeps getting these massive infections. Which pathophysiologic mechanism should the nurse describe in response to the client's question?

Correct Answer: D

Rationale: The correct answer is D) Inadequate numbers of T lymphocytes are available to initiate cellular immunity and macrophages. In individuals with AIDS and a low CD4+ T cell count, the body's ability to mount an effective immune response is compromised. T lymphocytes play a crucial role in coordinating the immune response by activating other immune cells, such as macrophages, to destroy pathogens. With low T cell counts, the body's ability to fight off infections is severely impaired, leading to recurrent and severe infections like Pneumocystis carinii pneumonia. Option A is incorrect because bone marrow suppression primarily affects the production of white blood cells, not their ability to phagocytize organisms. Option B is incorrect because while exposure to environmental agents can contribute to infections, the primary issue in AIDS is the immune system's failure due to T cell depletion. Option C is incorrect because B cells are involved in the humoral immune response, which is separate from the cellular immune response primarily affected in AIDS. In an educational context, understanding the pathophysiologic mechanisms underlying infections in clients with AIDS is crucial for nurses caring for these individuals. By grasping how T cell depletion impacts the immune response, nurses can provide effective education and support to clients, helping them better manage their condition and prevent complications.

Correct Answer: C

Rationale: The correct answer is C. In osteoarthritis, the breakdown of cartilage in the joints leads to chondrocyte injury, which results in the destruction of joint cartilage and the production of osteophytes. This process causes joint inflammation and pain. Choice A is incorrect because osteoarthritis primarily involves the articular cartilage rather than the synovial membrane. Choice B is incorrect as it describes the degeneration of cartilage but does not explain the specific pathophysiological process contributing to pain in osteoarthritis. Choice D is incorrect as the formation of uric acid crystals is characteristic of gout, not osteoarthritis.

Correct Answer: D

Rationale: The correct answer is D. An elevated serum creatinine level indicates kidney damage, which significantly increases the risk of complications from hypertension. High blood pressure can damage the kidneys over time, leading to impaired kidney function. Choices A, B, and C do not directly correlate with increased risk of complications related to hypertension. Choice A focuses on obesity and overeating, Choice B on anemia and alcohol consumption, and Choice C on a diet high in sodium and nitrates, none of which are as directly related to hypertension complications as kidney damage.

Correct Answer: C

Rationale: The correct answer is C. Decreasing the number of cigarettes smoked per day is not sufficient for CAD prevention. Smoking cessation is crucial in reducing the risk of CAD. While increasing physical activity, eating a low-fat diet, and monitoring blood pressure regularly are all positive behaviors for CAD prevention, quitting smoking should be emphasized due to its significant impact on cardiovascular health.

Correct Answer: C

Rationale: The middle-aged female with a broken humerus who is unable to follow commands and is crying requires immediate action. These symptoms indicate a possible head injury or severe emotional distress that need urgent attention. Choice A is not as urgent since a minor laceration can be addressed after more critical cases. Choice B, although having a dislocated shoulder, is stable, as the client is calm. Choice D presents with minor injuries that can wait while more critical cases are addressed.