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ATI ADULT MEDICAL SURGICAL NURSING – UNIT 12 Immune & Infectious
Disorders 120 Questions with Rationales
SECTION 1: IMMUNE SYSTEM ASSESSMENT & HIV/AIDS
1. A nurse is caring for a client with HIV. Which laboratory value
is most important to monitor for immune function?
A. CD4+ T-cell count
B. Platelet count
C. Serum creatinine
D. Hemoglobin
Answer: A
Rationale: The CD4+ T-cell count is the primary indicator of
immune function in HIV; lower counts indicate increased risk for
opportunistic infections.
2. A client with HIV has a CD4+ count of 180 cells/mm³. The
nurse should recognize that the client is at risk for:
A. Opportunistic infections
B. Anemia only
C. Hypertension
D. No increased risk
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Answer: A
Rationale: A CD4+ count below 200 cells/mm³ indicates severe
immunosuppression and high risk for opportunistic infections.
3. Which of the following is a common opportunistic infection in
clients with a CD4+ count below 50 cells/mm³?
A. Pneumocystis jirovecii pneumonia
B. Streptococcal pharyngitis
C. Influenza
D. Urinary tract infection
Answer: A
Rationale: PCP is an opportunistic infection that typically occurs
when CD4+ counts fall below 200, especially below 50.
4. A client with HIV is prescribed antiretroviral therapy (ART).
The primary goal of ART is to:
A. Cure HIV infection
B. Suppress viral replication and preserve immune function
C. Prevent all opportunistic infections without other measures
D. Increase CD4+ count immediately to normal
Answer: B
Rationale: ART suppresses viral load and slows disease
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progression; it does not cure HIV but improves immune
function and reduces transmission.
5. Which of the following indicates effective ART?
A. Decreased viral load and increased CD4+ count
B. Increased viral load
C. No change in CD4+ count
D. Development of opportunistic infections
Answer: A
Rationale: Effective ART results in viral suppression
(undetectable or low viral load) and immune recovery (rising
CD4+).
6. A client with HIV is started on trimethoprim-
sulfamethoxazole (TMP-SMX). The purpose is to prevent:
A. Pneumocystis jirovecii pneumonia
B. Tuberculosis
C. Candidiasis
D. Toxoplasmosis only
Answer: A
Rationale: TMP-SMX is used as prophylaxis for PCP when CD4+
count is below 200.
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7. Which of the following is a common side effect of TMP-SMX?
A. Rash and bone marrow suppression
B. Constipation only
C. Hypertension
D. Hyperglycemia
Answer: A
Rationale: TMP-SMX can cause rash, GI upset, and bone
marrow suppression; monitor CBC and for allergic reactions.
8. A client with HIV and a CD4+ count of 100 is prescribed
azithromycin weekly. The purpose is to prevent:
A. Mycobacterium avium complex (MAC)
B. Pneumocystis jirovecii pneumonia
C. Cytomegalovirus retinitis
D. Cryptococcal meningitis
Answer: A
Rationale: Azithromycin (or clarithromycin) prophylaxis is used
to prevent MAC when CD4+ count is below 50–100.
9. Which of the following is a sign of HIV-associated wasting
syndrome?
A. Involuntary weight loss >10% with diarrhea or fever
B. Weight gain and edema
ATI ADULT MEDICAL SURGICAL NURSING – UNIT 12 Immune & Infectious
Disorders 120 Questions with Rationales
SECTION 1: IMMUNE SYSTEM ASSESSMENT & HIV/AIDS
1. A nurse is caring for a client with HIV. Which laboratory value
is most important to monitor for immune function?
A. CD4+ T-cell count
B. Platelet count
C. Serum creatinine
D. Hemoglobin
Answer: A
Rationale: The CD4+ T-cell count is the primary indicator of
immune function in HIV; lower counts indicate increased risk for
opportunistic infections.
2. A client with HIV has a CD4+ count of 180 cells/mm³. The
nurse should recognize that the client is at risk for:
A. Opportunistic infections
B. Anemia only
C. Hypertension
D. No increased risk
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Answer: A
Rationale: A CD4+ count below 200 cells/mm³ indicates severe
immunosuppression and high risk for opportunistic infections.
3. Which of the following is a common opportunistic infection in
clients with a CD4+ count below 50 cells/mm³?
A. Pneumocystis jirovecii pneumonia
B. Streptococcal pharyngitis
C. Influenza
D. Urinary tract infection
Answer: A
Rationale: PCP is an opportunistic infection that typically occurs
when CD4+ counts fall below 200, especially below 50.
4. A client with HIV is prescribed antiretroviral therapy (ART).
The primary goal of ART is to:
A. Cure HIV infection
B. Suppress viral replication and preserve immune function
C. Prevent all opportunistic infections without other measures
D. Increase CD4+ count immediately to normal
Answer: B
Rationale: ART suppresses viral load and slows disease
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progression; it does not cure HIV but improves immune
function and reduces transmission.
5. Which of the following indicates effective ART?
A. Decreased viral load and increased CD4+ count
B. Increased viral load
C. No change in CD4+ count
D. Development of opportunistic infections
Answer: A
Rationale: Effective ART results in viral suppression
(undetectable or low viral load) and immune recovery (rising
CD4+).
6. A client with HIV is started on trimethoprim-
sulfamethoxazole (TMP-SMX). The purpose is to prevent:
A. Pneumocystis jirovecii pneumonia
B. Tuberculosis
C. Candidiasis
D. Toxoplasmosis only
Answer: A
Rationale: TMP-SMX is used as prophylaxis for PCP when CD4+
count is below 200.
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7. Which of the following is a common side effect of TMP-SMX?
A. Rash and bone marrow suppression
B. Constipation only
C. Hypertension
D. Hyperglycemia
Answer: A
Rationale: TMP-SMX can cause rash, GI upset, and bone
marrow suppression; monitor CBC and for allergic reactions.
8. A client with HIV and a CD4+ count of 100 is prescribed
azithromycin weekly. The purpose is to prevent:
A. Mycobacterium avium complex (MAC)
B. Pneumocystis jirovecii pneumonia
C. Cytomegalovirus retinitis
D. Cryptococcal meningitis
Answer: A
Rationale: Azithromycin (or clarithromycin) prophylaxis is used
to prevent MAC when CD4+ count is below 50–100.
9. Which of the following is a sign of HIV-associated wasting
syndrome?
A. Involuntary weight loss >10% with diarrhea or fever
B. Weight gain and edema
