An HIV-positive client who has been started on highly active antiretroviral therapy (HAART) came back for a follow-up checkup. Which of the following will be the most helpful in determining the response to the therapy?

Correct Answer: C

Rationale: The most helpful test in determining the response to highly active antiretroviral therapy (HAART) in an HIV-positive client is the viral load test. This test measures the amount of HIV in a person's blood, indicating how well the medication is working to suppress the virus. A decrease in the viral load over time signifies a positive response to the treatment, while an increase may indicate treatment failure or drug resistance development. Monitoring the viral load is crucial in managing HIV and making informed decisions about the continuation or modification of the antiretroviral therapy regimen. Rapid HIV antigen tests, Western Blot analysis, and white blood cell count do not directly assess the response to HAART in the same way that viral load testing does.

Correct Answer: D

Rationale: The placenta is not a site for drug metabolism. Drug metabolism primarily occurs in the liver, gastrointestinal tract (GIT), skin, and kidney. The placenta serves as a barrier between the mother and fetus and is involved in nutrient and waste exchange but does not play a significant role in drug metabolism processes.

Correct Answer: C

Rationale: Antacids or antidiarrheals should be avoided for at least 4 hours after taking digoxin. These medications can interfere with the absorption of digoxin in the body, thereby reducing its effectiveness. By spacing out the administration of these medications, the risk of decreased digoxin absorption and potential impact on its therapeutic effects can be minimized. It is important for patients to follow this guidance to ensure optimal effectiveness of digoxin therapy.

Correct Answer: C

Rationale: The nurse's priority action in this situation is to contact the prescriber because LMWHs like enoxaparin should not be given to a patient with an epidural catheter due to the increased risk of bleeding. Giving LMWH to a patient with an epidural catheter can lead to epidural hematoma, a serious complication that can result in permanent paralysis. It is important to clarify this order with the prescriber to ensure patient safety and prevent potential harm.

Correct Answer: A

Rationale: Atropine, a muscarinic antagonist, causes bronchodilation by relaxing bronchial smooth muscle, a true statement used in asthma or COPD. It produces mydriasis (pupil dilation), not miosis (constriction), making that false, as it blocks parasympathetic tone. It's highly lipid-soluble, crossing the blood-brain barrier, so that's false. It doesn't block acetylcholine (ACh) reuptake (there's no such mechanism) but competitively inhibits muscarinic receptors, so that's incorrect. It reduces, not increases, salivary secretions. Bronchodilation is a primary therapeutic effect, reflecting atropine's anticholinergic action, critical for respiratory applications and distinguishing it from sympathomimetics.