ART Provider Treatment Planning & Patient Care 2

Question 1

A patient with HIV initiating ART has a baseline CD4 count of 180 cells/µL. Which additional prophylaxis should the provider prioritize?

Accepted Answer

Trimethoprim-sulfamethoxazole for Pneumocystis pneumonia

Answer

TMP-SMX prophylaxis is indicated when CD4 count falls below 200 cells/µL to prevent Pneumocystis jirovecii pneumonia.

Question 2

When counseling a patient newly starting ART, which adherence strategy is most evidence-based for long-term viral suppression?

Accepted Answer

Using a daily pill organizer combined with mobile phone reminders

Answer

Combining organizational tools like pill organizers with electronic reminders has strong evidence for improving ART adherence and sustaining viral suppression.

Question 3

A patient on a tenofovir-based regimen presents with rising creatinine and decreased phosphate. What is the most appropriate next step?

Accepted Answer

Evaluate for tenofovir-associated nephrotoxicity and consider regimen switch

Answer

Rising creatinine with hypophosphatemia on tenofovir suggests proximal tubular dysfunction (Fanconi syndrome), warranting evaluation and possible switch to TAF or an alternative agent.

Question 4

Which viral load result indicates confirmed virologic failure requiring regimen reassessment in a patient on ART for 12 months?

Accepted Answer

Two consecutive values above 200 copies/mL

Answer

Confirmed virologic failure is defined as two consecutive viral load measurements above 200 copies/mL, requiring resistance testing and regimen evaluation.

Question 5

A pregnant patient with HIV is in her first trimester. Which ART component is specifically recommended to be avoided due to potential neural tube defect risk at conception?

Accepted Answer

Dolutegravir (DTG) at the time of conception

Answer

Early data raised concern about dolutegravir use at conception and neural tube defects, though risk estimates have since been revised; guidelines still require counseling and informed consent.

(ART) Certified Art Provider Practice Test

(ART) Certified Art Provider Practice Test

ART Provider Treatment Planning & Patient Care 2