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Chapter 37: Management of Patients With HIV Infection and AIDS Essay

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A patient with HIV develops a nonproductive cough, shortness of breath, a fever of 101°F and an O2 saturation of 92%. What infection caused by Pneumocystis jiroveci does the nurse know could occur with this patient? You selected: Pneumocystis pneumonia
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Which blood test confirms the presence of antibodies to HIV? You selected: Enzyme-linked immunoabsorbent assay (ELISA) Correct Explanation: ELISA, as well as Western blot assay, identifies and confirms the presence of antibodies to HIV. The ESR is an indicator of the presence of inflammation in the body. The p24 antigen is a blood test that measures viral core protein. Reverse transcriptase is not a blood test. Rather, it is an enzyme that transforms single-stranded RNA into a double-stranded DNA.
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The client comes to the clinic to obtain the results from the test to determine if he is infected with HIV. The physician informs the client that he has a CD4 cell count of 300 cells/mm3 and a high viral load. What does the nurse anticipate the physician will discuss with the client? You selected: The initiation of antiretroviral therapy Correct Explanation: Based on randomized trials, nonrandomized trials, and observational studies, the current guideline is to initiate treatment if the client has a CD4 T-cell count less than 350 to 500 cells/mm3,whereas others will begin treatment with a CD4 cell count over 500 cells/mm3 based on expert opinions. Prophylactic antibiotic and antifungal drug therapy is not warranted at this time and can cause drug resistance strains to emerge.
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The nurse completes a history and physical assessment on a patient with AIDS who was admitted to the hospital with respiratory complications. The nurse knows to assess for the most common infection in persons with AIDS (80% occurrence). This is: You selected: Pneumocystis pneumonia. Correct Explanation: Pneumocystic pneumonia (PCP) is one of the first and most common opportunistic infections associated with AIDS. It may be present despite the absence of crackles. If untreated, PCP progresses to cause significant pulmonary impairment and respiratory failure.
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(see full question) A client with acquired immunodeficiency syndrome is admitted with Pneumocystis carinii pneumonia. During a bath, the client begins to cry and says that most friends and relatives have stopped visiting and calling. What should the nurse do? You selected: Listen and show interest as the client expresses feelings. Correct Explanation: The nurse should listen actively and nonjudgmentally as the client expresses feelings. Telling the client not to worry would provide false reassurance. A psychiatric consultation would be appropriate only after further assessment. Stating that the client’s friends aren’t true friends would discount the client’s feelings.
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The nurse receives a phone call at the clinic from the family of a patient with AIDS. They state that the patient started “acting funny” after complaining of headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member? You selected: “The patient may have cryptococcal meningitis and will need to be evaluated by the physician.” Correct Explanation: A fungal infection, Cryptococcus neoformans is another common opportunistic infection among patients with AIDS, and it causes neurologic disease. Cryptococcal meningitis is characterized by symptoms such as fever, headache, malaise, stiff neck, nausea, vomiting, mental status changes, and seizures.
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Nursing students are reviewing the pathophysiology of human immunodeficiency virus (HIV). They demonstrate understanding of the information when they state which of the following as containing the genetic viral material? You selected: Ribonucleic acid (RNA) Correct Explanation: HIV is a retrovirus that carries its genetic material in the form of RNA rather than DNA. HIV consists of a viral core containing the viral RNA, surrounded by an envelope consisting of protruding glycoproteins.
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The nurse teaches the patient that lowering his or her viral load will have what effect? You selected: A longer survival time Correct Explanation: The lower the patient’s viral load, the longer the survival time.
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(see full question) A patient had unprotected sex with an HIV-infected person and arrives in the clinic requesting HIV testing. Results determine a negative HIV antibody test and an increased viral load. What stage does the nurse determine the patient is in? You selected: Primary infection Correct Explanation: The period from infection with HIV to the development of HIV-specific antibodies is known as primary infection, or stage 1. Initially, there is a period during which those who are HIV positive test negative on the HIV antibody blood test, although they are infected and highly infectious, because their viral loads are very high.
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(see full question) A client taking abacavir (ABC) has developed fever and rash. What is the priority nursing action? You selected: Call the health care provider to report. Correct Explanation: Fever and a rash could be indicative of a hypersensitivity reaction. Hypersensitivity reactions are also known as anaphylactic reactions and often involve skin rashes, fever, and bronchopulmonary issues such as bronchial constriction. The health care provider should be notified immediately and the medication stopped. Interventions need to be taken to assure that the patient’s airway is not compromised. Administering Tylenol and documentation and treating the rash are not the priority, and would be completed after the patient was stabilized.
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(see full question) A nurse is preparing an in-service presentation about human immunodeficiency virus (HIV) for a group of new graduate nurses. As part of the presentation, the nurse is planning to describe the events that occur once HIV enters the host cell. Which of the following would the nurse describe as the first step? You selected: Uncoating Incorrect Correct response: Attachment Explanation: Once HIV enters the host cell, attachment occurs in which the glycoproteins of HIV bind with the host’s uninfected CD4+ receptor and chemokine coreceptors. This is followed by uncoating, in which HIV’s viral core is emptied into the CD4+ T cell. Cleavage and budding occur as the last steps.
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(see full question) During assessment of a patient with Kaposi’s sarcoma, the nurse knows to look for the initial sign of: You selected: Deep purple cutaneous lesions. Correct Explanation: Localized cutaneous lesions may be the first manifestation of this HIV-related malignancy, which appears in 90% of patients as immune function deteriorates. Other symptoms develop over time as the lesions increase in size and spread to other locations.
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(see full question) The nurse is administering an injection to a client with AIDS and, when finished, attempts to recap the needle and sustains a needlestick to the finger. What is the priority action by the nurse? You selected: Report the incident to the supervisor Correct Explanation: Because post exposure protocols can reduce the risk of HIV infection if initiated promptly, nurses must immediately report any needlestick or sharp injury to a supervisor. Obtaining counseling will occur after all other procedures are adhered to. The lab will draw blood from the client if required for documentation and other blood transmitted disorders.
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(see full question) An older adult widowed woman informs the nurse that she notices vaginal dryness now that she has become sexually active again. She is not using barrier protection because it makes the dryness worse. What education should the nurse provide to the patient? You selected: Vaginal dryness is common in postmenopausal women, and there are creams that can be used, but she should use a latex condom. Correct Explanation: Other than abstinence, consistent and correct use of condoms (Chart 37-3) is the only effective method to decrease the risk of sexual transmission of HIV infection. When latex male condoms are used consistently and correctly during vaginal or anal intercourse, they are highly effective in preventing the sexual transmission of HIV (CDC, 2011d). Nonlatex condoms made of natural materials such as lambskin are available for people with latex allergy but will not protect against HIV infection
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A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find? You selected: Hypokalemia Correct Explanation: Electrolyte imbalances such as decreased sodium, potassium, calcium, magnesium, and chloride typically result from profuse diarrhea. A urine specific gravity of 1.010 would indicate dilute urine. The client with severe diarrhea most likely would be dehydrated, leading to a high urine specific gravity. Proteinuria may suggest renal dysfunction and would not be associated with severe diarrhea unless the client was developing renal failure.
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The nurse is collecting objective data for a client with AIDS at the clinic. The nurse observes white plaques in the client’s oral cavity, on the tongue, and buccal mucosa. What does the nurse understand this finding indicates? You selected: Candidiasis Correct Explanation: Candidiasis is a yeast infection caused by the Candida albicans microorganisms. It may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in folds of the skin. It is often called thrush when located in the mouth. Inspection of the mouth, throat, or vagina reveals areas of white plaque that may bleed when mobilized with a cotton-tipped swab. Kaposi’s sarcoma is a purple lesion and is an opportunistic cancer. Hairy leukoplakia is also an indication of oral cancer. Coccidiomycosis causes diarrhea in the immunosuppressed client.
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A client diagnosed with HIV asks the nurse how the doctor can know what their viral load is. What should the nurse respond? Correct response: The doctor can have a polymerase chain reaction test run. Explanation: The p24 antigen test and polymerase chain reaction test measure viral loads. They are used to guide drug therapy and follow the progression of the disease.
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A client with suspected HIV has had two positive enzyme-linked immunosorbent assay tests. What diagnostic test would be run next? You selected: Western Blot Correct Explanation: The enzyme-linked immunosorbent assay (ELISA) test, an initial HIV screening test, is positive when there are sufficient HIV antibodies; it also is positive when there are antibodies from other infectious diseases. The test is repeated if results are positive. If results of a second ELISA test are positive, the Western blot is performed. A positive result on Western blot confirms the diagnosis; however, false-positive and false-negative results on both tests are possible. A polymerase chain reaction gives the viral load of the client. The T4/T8 ratio determines the status of T lymphocytes.
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(see full question) A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority? Correct response: Risk for injury
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A client has undergone diagnostic testing for human immunodeficiency virus (HIV) using the enzyme immunoassay (EIA) test. The results are positive and the nurse prepares the client for additional testing to confirm seropositivity. The nurse would prepare the client for which test? You selected: Western blot assay Correct Explanation: A positive EIA test indicates seropositivity. To confirm this, a Western blot assay would be done. The OraSure test uses saliva to perform an EIA test. The p24 antigen test and nucleic acid sequence-based amplification test are used to test viral load and evaluate response to treatment. However, the reverse transcriptase-polymerase chain reaction (RT-PCR) and nucleic acid sequence-based tests have replaced the p24 antigen test. The RT-PCR tests may be used to confirm a positive EIA result
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The nurse practitioner who is monitoring the patient’s progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is: You selected: Chronic diarrhea. Correct Explanation: Chronic diarrhea is believed related to the direct effect of HIV on cells lining the intestine. Although all gastrointestinal manifestations of AIDS can be debilitating, the most devastating is chronic diarrhea. It can cause profound weight loss and severe fluid and electrolyte imbalances.
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(see full question) A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection? You selected: Trimethoprim-sulfamethoxazole (Bactrim, Septra) Correct Explanation: To prevent and treat Pneumocystis pneumonia, trimethoprim-sulfamethoxazole (Bactrim, Septra) is prescribed. The other medications are antifungals and used to treat candidiasis.
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(see full question) A patient receiving antiretroviral therapy is complaining of “not urinating enough.” What is the nurse’s best action? You selected: Assess BUN and creatinine.
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A client with AIDS is brought to the clinic by his family. The family tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms? Correct response: AIDS dementia complex (ADC) Explanation: ADC, a neurologic condition, causes the degeneration of the brain, especially in areas that affect mood, cognition, and motor functions. Such clients exhibit forgetfulness, limited attention span, decreased ability to concentrate, and delusional thinking. DSP is characterized by abnormal sensations, such as burning and numbness in the feet and later in the hands. Candidiasis is a yeast infection that may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in the folds of the skin. CMV infects the choroid and retinal layers of the eye, leading to blindness, and can also cause ulcers in the esophagus, colitis, diarrhea, pneumonia, and encephalitis.
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The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluids does the nurse inform them will transmit the virus? Select all that apply. You selected: • Blood • Semen • Vaginal secretions • Breast milk Correct Explanation: There are only four known body fluids through which HIV is transmitted:blood, semen, vaginal secretions, and breast milk. HIV may be present in saliva, tears, and conjunctival secretions, but transmission of HIV through these fluids has not been implicated, HIV is not found in urine, stool, vomit, or sweat.
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A client is beginning highly active antiretroviral therapy (HAART). The client demonstrates an understanding of the need for follow up when he schedules a return visit for viral load testing at which time? You selected: 6 weeks Correct Explanation: Viral load tests are measured immediately before initiating antiretroviral therapy and then again in 2 to 8 weeks. In most clients, adherence to a regimen of potent antiretroviral agents should result in a large decrease in the viral load by 2 to 8 weeks. Therefore, a return visit at 6 weeks would be in this time frame. By 16 to 20 weeks, the viral load should continue to decline, dropping below detectable levels.
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(see full question) A client with HIV will be started on a medication regimen of three medications. Which medication will be given that will interfere with the virus’s ability to make a genetic blueprint. What drug will the nurse instruct the client about? You selected: Reverse transcriptase inhibitors Correct Explanation: Reverse transcriptase inhibitors are drugs that interfere with the virus’ ability to make a genetic blueprint. A protease inhibitor is a drug that inhibits the ability of virus particles to leave the host cell. The integrase inhibitors are a class of drug that prevents the incorporation of viral DNA into the host cell’s DNA. Hydrea is a drug that is used as an adjunct therapy that tries to halt the progression of AIDS
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Which of the following options should the nurse encourage to replace fluid and electrolyte losses in a patient with AIDS? You selected: Liquids Correct Explanation: The nurse should encourage patients with AIDS to have liquids to help in replacing fluid and electrolyte losses. Gluten and sucrose may increase the complication of malabsorption. Large doses of iron and zinc should be avoided because they can impair immune function.
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(see full question) A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis? You selected: Stool specimen for ova and parasites Correct Explanation: A stool specimen for ova and parasites will give a definitive diagnosis. The organism is spread by the fecal-oral route from contaminated water, food, or human or animal waste. Those infected can lose from 10 to 20 L of fluid per day. Losing this magnitude of fluid quickly leads to dehydration and electrolyte imbalances.
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Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy? Correct response: CD4 counts Explanation: The most important consideration in decisions to initiate antiretroviral therapy is CD4 counts.
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A female client comes to the clinic and tells the nurse, “I think I have another vaginal infection and I also have some wartlike lesions on my vagina. This is happening quite often.”What should the nurse consult with the physician regarding? You selected: Testing the client for the presence of HIV
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Diagnosis of Kaposi’s sarcoma (KS) is made by which of the following? You selected: Biopsy Correct Explanation: Diagnosis of KS is made by biopsy of the suspected lesions. Prognosis depends on the extent of the tumor, the presence of other symptoms of HIV infection, and the CD4+ count.
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Which of the following indicates that a client with HIV has developed AIDS? You selected: Herpes simplex ulcer persisting for 2 months Correct Explanation: A diagnosis of AIDS cannot be made until the person with HIV meets case criteria established by the Centers for Disease Control and Prevention. The immune system becomes compromised. The CD4 T-cell count drops below 200 cells and develops one of the opportunistic diseases, such as Pneumocystis carinii pneumonia, candidiasis, cytomegalovirus, or herpes simplex.
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A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay with positive results twice. What is the next step for the nurse to explain to the patient for confirmation of the diagnosis? You selected: Perform a Western blot test for confirmation of diagnosis.
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(see full question) A patient is diagnosed with pneumocystis pneumonia (PCP). What medication does the nurse anticipate educating the patient about for treatment? Correct response: TMP-SMZ (Bactrim) Explanation: TMP-SMZ (Bactrim, Cotrim, Septra) is the treatment of choice for PCP; it is as effective as parenteral pentamidine isethionate (Pentacarinat) and more effective than other regimens.
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Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm? Correct response: CDC category A: HIV asymptomatic Explanation: More than 500 CD4+ T lymphocytes/mmindicates CDC category A: HIV asymptomatic. The period from infection with HIV to the development of antibodies to HIV is known as primary infection and 200 to 499 CD4+ T lymphocytes/mm indicates CDC category B:
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The development of a positive HIV antibody test following initial infection generally occurs in which timeframe? You selected: 6 weeks Incorrect Correct response: 4 weeks Explanation: Development of a positive HIV antibody test generally occurs within 4 weeks and with few exceptions by 6 months
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A patient taking amprenavir (APV, Agenerase) complains of “getting fat.” What is the nurse’s best action? Correct response: Teach the patient about medication side effects. Explanation: The patient needs to be aware of the potential for fat redistribution. Exercise, diet, and counseling will not change the outcome of this side effect.
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A patient is infected with HIV after sharing needles with another intravenous (IV) drug abuser. Upon infection with HIV, the immune system responds by making antibodies against the virus, usually within how many weeks after infection? You selected: 1 to 2 weeks Incorrect Correct response: 3 to 12 weeks Explanation: When a person is infected with HIV, the immune system responds by producing antibodies against the virus, usually within 3 to 12 weeks after infection.
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A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection? You selected: Amphotericin B (Fungizone) Incorrect Correct response: Trimethoprim-sulfamethoxazole (Bactrim, Septra) Explanation: To prevent and treat Pneumocystis pneumonia, trimethoprim-sulfamethoxazole (Bactrim, Septra) is prescribed. The other medications are antifungals and used to treat candidiasis.
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The nurse identifies a nursing diagnosis of ineffective airway clearance related to pneumocystis pneumonia and increased bronchial secretions for a client with AIDS. Which of the following would be appropriate for the nurse to include in the client’s plan of care? You selected: Assist with chest physiotherapy every 2 to 4 hours. Correct Explanation: The nurse should include interventions such as assisting with and/or performing chest physiotherapy every 2 to 4 hours to prevent stasis of secretions, assist the client to attain the semi- or high Fowler’s position to facilitate breathing and airway clearance, allow for frequent rest periods to prevent excessive fatigue, and maintain a fluid intake of at least 3 liters per day unless contraindicated
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(see full question) A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client? You selected: Using volume expanders in case blood is needed. Incorrect Correct response: Bank autologous blood. Explanation: Signing the refusal form does not give the client any information about the options that are available and place the client at risk. Banking autologous blood that is self-donated is the safest option for the client. Directed donor blood may be no safer than blood collected from public donors. Those who support this belief say that directed donors may not reveal their high-risk behaviors that put the potential recipient at risk for blood-borne pathogens such as HIV.
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When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by ____. You selected: HIV-1 is more prevalent than HIV-2 subtypes Correct Explanation: Two HIV subtypes have been identified: HIV-1 and HIV-2. HIV-1 mutates easily and frequently, producing multiple substrains that are identified by letters from A through O. HIV-2 is less transmittable, and the interval between initial infection with HIV-2 and development of AIDS is longer. HIV-1 is more prevalent in the United States and in the rest of the world. Western Africa is the primary site of infection with HIV-2. There is no cure for HIV/AIDS; hence, no cure rate. The virus is thought to be a mutation of a simian virus. Transmission of the virus is not a characteristic.
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(see full question) When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following? Correct response: Antibodies to HIV are not present in his blood. Explanation: A negative test result indicates that antibodies to HIV are not present in the blood at the time the blood sample for the test is drawn. A negative test result should be interpreted as demonstrating that if infected, the body has not produced antibodies (which take from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged. The test result does not mean that the patient is immune to the virus, nor does it mean that the patient is not infected. It just means that the body may not have produced antibodies yet. When antibodies to HIV are detected in the blood, the test is interpreted as positive.
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The term used to define the balance between the amount of HIV in the body and the immune response is which of the following? Correct response: Viral set point
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(see full question) The nurse is reviewing the medical record of a client who is positive for human immunodeficiency virus (HIV). The nurse notes that the client is classified as HIV asymptomatic based on which CD4+ T lymphocyte count? You selected: Greater than 500/mm3 Correct Explanation: A client is classified as HIV asymptomatic when the CD4+ T lymphocyte count is greater than 500/mm3. A person is considered HIV symptomatic when the CD4+ count is 200 to 499/mm3. A person is considered to have aquired immunodeficiency syndrome (AIDS) when the CD4+ count is less than 200/mm3.
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(see full question) A patient presents to a clinic on May 1 and tells the nurse practitioner that he had a 1-month sexual relationship with a friend who did not disclose that he was HIV positive. The relationship ended last week. The nurse tells the patient that after infection with HIV, the immune system responds by making antibodies against the virus; therefore the patient should expect this to happen by: You selected: June 5
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) A client who is HIV positive is receiving highly active antiretroviral therapy (HAART) that includes a protease inhibitor (PI). The client comes to the clinic for a follow-up visit. Assessment reveals lipoatrophy of the face When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean that and arms. The client states, “I’m thinking the side effects of the drug are worse than the disease. Look what’s happening to me.” The nurse would most likely identify which nursing diagnosis as the priority? Correct response: Disturbed body image related to loss of fat in the face and arms Explanation: The client is experiencing lipoatrophy, which results in a localized loss of subcutaneous fat in the face (manifested as sinking of the cheeks, eyes, and temples), arms, legs, and buttocks. These changes as well as his statement about the side effects of the drug being worse than the disease indicate that he is concerned about how he appears to others. Therefore, the nursing diagnosis of disturbed body image would be the priority. Deficient knowledge, risk for infection, and risk for impaired liver function may be applicable; however, they are not concerns at this time.
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(see full question) A patient is on ART for the treatment of HIV. What does the nurse know would be an adequate CD4 count to determine the effectiveness of treatment for a patient per year? You selected: 50 mm3 to 150 mm3 Correct Explanation: An adequate CD4 response for most patients on ART is an increase in CD4 count in the range of 50 mm3 to 150 mm3 per year, generally with an accelerated response in the first 3 months
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A client has been diagnosed with HIV and has been placed on antiretroviral therapy. What does the nurse inform the client will be required for determining the progression of the disease as well as guiding drug therapy? You selected: Viral load and T4-cell counts will be performed every 2 to 3 months
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The period from infection with HIV to the development of antibodies to HIV is known as which of the following? Correct response: Primary infection Explanation: Primary infection is the period from the infection with HIV to the development of antibodies to HIV. The viral load test measures plasma HIV RNA levels. Viral set point is the balance between the amount of HIV in the body and the immune response. Anergy is the absence of an immune response
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(see full question) A client with AIDS is brought to the clinic by his family. The family tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms? You selected: AIDS dementia complex (ADC) Correct Explanation: ADC, a neurologic condition, causes the degeneration of the brain, especially in areas that affect mood, cognition, and motor functions. Such clients exhibit forgetfulness, limited attention span, decreased ability to concentrate, and delusional thinking. DSP is characterized by abnormal sensations, such as burning and numbness in the feet and later in the hands. Candidiasis is a yeast infection that may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in the folds of the skin. CMV infects the choroid and retinal layers of the eye, leading to blindness, and can also cause ulcers in the esophagus, colitis, diarrhea, pneumonia, and encephalitis.
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When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean that Correct response: his body has not produced antibodies to the AIDS virus. Explanation: A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn. A negative test result should be interpreted as demonstrating that if infected, the body has not produced antibodies (which takes from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged. The test result does not mean that the patient is immune to the virus, nor does it mean that the patient is not infected. It just means that the body may not have produced antibodies yet. When antibodies to the AIDS virus are detected in the blood, the test is interpreted as positive.
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When do most perinatal HIV infections occur? You selected: After exposure during delivery Correct Explanation: Mother-to-child transmission of HIV-1 may occur in utero or through breastfeeding, but most perinatal infections are thought to occur after exposure during delivery.
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(see full question) A patient being treated for HIV/AIDS has a decreased appetite, almost to the point of anorexia. What is the nurse’s best action? You selected: Ask his family to bring in food that he enjoys. Incorrect Correct response: Administer megestrol acetate (Megace). Explanation: Appetite stimulants are successfully used in patients with AIDS-related anorexia. The anorexia is compounded by medications that cause nausea and vomiting. The anorexia has a physiologic cause, and this must be addressed. Bringing in favorite foods or making favorite foods may have little or no effect on the patient’s appetite; it is physiologically rather than psychologically based.
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Which of the following is an early manifestation of HIV encephalopathy? You selected: Headache Correct Explanation: An early manifestation of HIV encephalopathy is a headache. Later stages include hyperreflexia, a vacant stare, and hallucinations.
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(see full question) A public health nurse is giving an informational presentation on HIV/AIDS at a nearby college. How would the nurse best define AIDS? You selected: Acquired immunodeficiency syndrome is a fatal infection that profoundly weakens the immune system. Correct Explanation: Acquired immunodeficiency syndrome (AIDS) is an infectious and eventually fatal disorder that profoundly weakens the immune system.
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(see full question) A client diagnosed with HIV asks the nurse how the doctor can know what their viral load is. What should the nurse respond? You selected: The doctor can have a polymerase chain reaction test run. Correct Explanation: The p24 antigen test and polymerase chain reaction test measure viral loads. They are used to guide drug therapy and follow the progression of the disease.
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(see full question) Postexposure prophylaxis (PEP) medications should be started within __________ after exposure, but no longer than __________, to offer any benefit. It must be taken for __________. You selected: 1 hour; 72 hours; 4 weeks Correct Explanation: Prophylaxis needs to start immediately after exposure. After 72 hours, no benefit is offered because of the rapid increases in viral load upon initial infection
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Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy? You selected: CD4 counts Correct Explanation: The most important consideration in decisions to initiate antiretroviral therapy is CD4 counts.
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(see full question) A client with AIDS comes to the clinic reporting difficulty swallowing. He says, “It hurts so much when I swallow.” Inspection reveals creamy white patches in the client’s mouth. Which of the following would the nurse suspect? You selected: Candidiasis Correct Explanation: The client’s complaints and physical examination suggest oral candidiasis. Wasting syndrome involves involuntary weight loss greater than 10% of the client’s baseline body weight and either chronic diarrhea for more than 10 days or chronic weakness and documented intermittent or constant fever in the absence of any concurrent illness that could explain these findings. Cryptococcus neoformans is a fungal infection that affects the neurologic system. Clostridium difficile is a common cause of chronic diarrhea in clients with AIDS.
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The nurse advises a patient who has received a negative test result from his HIV antibody test that he: You selected: Does not have the infection. Incorrect Correct response: May be infected but antibodies are not currently present. Explanation: A negative test result indicates that antibodies to HIV are not present in the blood at the time of the testing. This means either the patient has not been infected or, if infected, that the body has not yet produced antibodies. Refer to Box 37-5 in the text
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(see full question) A client receiving atazanavir (ATV, Reyataz) requires what priority intervention? You selected: Increased fluids Incorrect Correct response: Cardiac assessment Explanation: This medication may cause prolongation of the PR interval and first degree AV block. Patients with underlying conduction deficits may develop problems. A cardiac assessment will assist in determining if the patient has underlying problems that could be exacerbated by this drug therapy.
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A client on antiretroviral drug therapy is discussing with the nurse that sometimes he “forgets to take his meds for a few days.” What should the nurse inform the client can occur when the medications are not taken as prescribed? You selected: The client is risking the development of drug resistance and drug failure. Correct Explanation: Clients who neglect to take antiretroviral drugs as prescribed risk development of drug resistance. When drug levels are not adequately maintained, viral replication and mutations increase.
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A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority? You selected: Risk for injury
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A patient taking amprenavir (APV, Agenerase) complains of “getting fat.” What is the nurse’s best action? You selected: Teach the patient about medication side effects. Correct Explanation: The patient needs to be aware of the potential for fat redistribution. Exercise, diet, and counseling will not change the outcome of this side effect.
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(see full question) A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection? You selected: Trimethoprim-sulfamethoxazole (Bactrim, Septra) Correct Explanation: To prevent and treat Pneumocystis pneumonia, trimethoprim-sulfamethoxazole (Bactrim, Septra) is prescribed. The other medications are antifungals and used to treat candidiasis.
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emale client with human immunodeficiency virus (HIV) receives family-planning counseling. Which statement about safer sex practices for persons with HIV is accurate? You selected: A latex condom with spermicide provides the best protection against HIV transmission during sexual intercourse. Correct Explanation: A latex condom with spermicide provides the best protection against HIV transmission during sexual intercourse.
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A patient with HIV has been on antiretroviral therapy (ART) for 6 months. The patient comes to the clinic with home medications and the nurse observes that there are too many pills in the container. What does the nurse know about the factors associated with nonadherence to ART? • Active substance abuse • Depression • Lack of social support
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(see full question) Which of the following has not been implicated as a factor for noncompliance with antiretroviral treatment? Correct response: Past substance abuse Explanation: Past substance abuse has not been implicated as a factor for noncompliance with antiretroviral treatment. Factors associated with nonadherence include active substance abuse, depression, and lack of social support.
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When assisting the patient to interpret a negative HIV test result, what does the nurse tell the patient this result means? Correct response: His body has not produced antibodies to the AIDS virus. Explanation: A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn. A negative test result should be interpreted as demonstrating that, if infected, the body has not produced antibodies (which takes from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged.
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There are many ethical issues in the care of clients with HIV or HIV/AIDS. What is an ethical issue healthcare providers deal with when caring for clients with HIV/AIDS? You selected: Caring for a client with an infectious terminal disease Incorrect Correct response: Disclosure of the client’s condition Explanation: Despite HIV-specific confidentiality laws, clients infected with AIDS fear that disclosure of their condition will affect employment, health insurance coverage, and even housing. Since healthcare providers do not share a client’s diagnosis with a support group, option A is incorrect. Caring for a client with an infectious terminal illness that can be transmitted to other people is a concern for healthcare providers but it is not an ethical issue
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Question 13: (see full question) A nurse is working in a support group for clients with acquired immunodeficiency syndrome (AIDS). Which point is most important for the nurse to stress? You selected: Following safer-sex practices Correct Explanation: It’s essential for clients with AIDS to follow safer-sex practices to prevent transmission of the human immunodeficiency virus. Although it’s helpful if clients with AIDS avoid using recreational drugs and alcohol, it’s more important that I.V. drug users use clean needles and dispose of used needles for purposes of avoiding transmission. Whether the client with AIDS chooses to tell anyone about the diagnosis is his decision; there is no legal obligation to do so.
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(see full question) Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm? You selected: Primary infection (acute HIV infection or acute HIV syndrome) Incorrect Correct response: CDC category A: HIV asymptomatic Explanation: More than 500 CD4+ T lymphocytes/mmindicates CDC category A: HIV asymptomatic. The period from infection with HIV to the development of antibodies to HIV is known as primary infection and 200 to 499 CD4+ T lymphocytes/mm indicates CDC category B: HIV symptomatic. Less than 200 CD4+ T lymphocytes/mm3 indicates CDC category C: AIDS
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Question 15: (see full question) A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client? You selected: Bank autologous blood. Correct Explanation: Signing the refusal form does not give the client any information about the options that are available and place the client at risk. Banking autologous blood that is self-donated is the safest option for the client.
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(see full question) A patient had unprotected sex with an HIV-infected person and arrives in the clinic requesting HIV testing. Results determine a negative HIV antibody test and an increased viral load. What stage does the nurse determine the patient is in? You selected: Primary infection Correct Explanation: The period from infection with HIV to the development of HIV-specific antibodies is known as primary infection, or stage 1. Initially, there is a period during which those who are HIV positive test negative on the HIV antibody blood test, although they are infected and highly infectious, because their viral loads are very high.
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(see full question) You are caring for a client who has a diagnosis of HIV. Part of this client’s teaching plan is educating the client about his or her medications. What is essential for the nurse to include in the teaching of this client regarding medications? You selected: Side effects of drug therapy
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(see full question) A client who is HIV positive has been prescribed antiretroviral drugs. The nurse explains the action of each antiretroviral drug and develops a schedule for the client’s self-administration, including strong emphasis about rigidly adhering to the dosage, time and frequency of the administration of the drugs. Why is it important to adhere to the schedule of drug dosing developed for this client? You selected: To avoid resistance to the drugs
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Which of the following are antidepressants used in the treatment of AIDS? Select all that apply. Correct response: • Tofranil • Norpramin • Prozac Explanation: Antidepressants such as Tofranil, Norpramin, and Prozac may be used, because these medications also alleviate the fatigue and lethargy that are associated with depression.
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(see full question) The nurse receives a phone call at the clinic from the family of a patient with AIDS. They state that the patient started “acting funny” after complaining of headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member? Correct response: “The patient may have cryptococcal meningitis and will need to be evaluated by the physician.” Explanation: A fungal infection, Cryptococcus neoformans is another common opportunistic infection among patients with AIDS, and it causes neurologic disease. Cryptococcal meningitis is characterized by symptoms such as fever, headache, malaise, stiff neck, nausea, vomiting, mental status changes, and seizures
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(see full question) A nurse is preparing a presentation about HIV for a local community group. Which of the following would the nurse include in the presentation about HIV transmission? Select all that apply. Correct response: • The risk of acquiring HIV through the transfusion of blood products is almost nonexistent. • The amount of HIV contained in body fluids on exposure is associated with the risk for infection. • HIV can be found in seminal fluid, vaginal secretions, and breast milk. • Sharing of infected equipment used to inject drugs increases the risk for infection. Explanation: HIV-1 is transmitted in body fluids that contain free virons and infected CD+4 T cells. These fluids include blood, seminal fluid, vaginal secretions, amniotic fluid, and breast milk. The amount of HIV and infected cells in the body fluid is associated with the probability that the exposure will result in infection. Blood and blood products can transmit HIV to recipients; however, the risk associated with transfusions have been virtually eliminated as the result of intensive donor screening. Mother-to-child transmission may occur in utero, at the time of delivery, or through breastfeeding. Most perinatal infections are thought to occur during delivery. Sharing infected equipment during drug injections increases a person’s risk for acquiring HIV.
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Question 7: (see full question) A client with AIDS is experiencing pain secondary to Kaposi’s sarcoma. The nurse would most likely expect the client to describe the pain as which of the following? You selected: Crushing, widespread pressure Incorrect Correct response: Sharp, throbbing pressure Explanation: The pain associated with Kaposi’s sarcoma is typically described as sharp, throbbing pressure and heaviness. Pain related to peripheral neuropathy frequently is described as burning, numbness, and “pins and needles.” Dull, cramping pain and crushing widespread pressure are not associated with Kaposi’s sarcoma.
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(see full question) A nurse is preparing to administer an antiretroviral medication to a client who is positive for HIV. The nurse identifies the drug as a nucleoside reverse transcriptase inhibitor (NRTI). Which drug might this be? You selected: Delavirdine (Rescriptor) Incorrect Correct response: Lamivudine (Epivir) Explanation: Lamivudine (Epivir) is an antiretroviral agent that belongs to the class of NRTIs. Delavirdine (Rescriptor), etravirine (Intelence), and nevirapine (Viramune) are examples of non-nucleoside reverse transcriptase inhibitors (NNRTIs).
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(see full question) A client with human immunodeficiency virus undergoes intradermal anergy testing using Candida and mumps antigen. During the 3 days following the tests, there is no induration or evidence of reaction at the intradermal injection sites. The most accurate conclusion the nurse can make is: You selected: the client has antibodies to the antigens. Incorrect Correct response: the client is immunodeficient and won’t have a skin response. Explanation: Anergy testing determines the level of immune response an individual has to common microbes. A normal response is a local skin reaction to all the antigens injected intradermally. Absence of a response within 3 days suggests the individual is immunodeficient and can’t produce a normal immune response. It doesn’t imply nonexposure to the antigens, which are environmentally prevalent. A positive skin reaction demonstrates presence of antibodies to the antigens. An expected reaction to the antigens isn’t considered an allergic or hypersensitive reaction
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(see full question) During assessment of a patient with Kaposi’s sarcoma, the nurse knows to look for the initial sign of: You selected: Deep purple cutaneous lesions. Correct Explanation: Localized cutaneous lesions may be the first manifestation of this HIV-related malignancy, which appears in 90% of patients as immune function deteriorates. Other symptoms develop over time as the lesions increase in size and spread to other locations.
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(see full question) A client who is HIV positive is receiving highly active antiretroviral therapy (HAART) that includes a protease inhibitor (PI). The client comes to the clinic for a follow-up visit. Assessment reveals lipoatrophy of the face and arms. The client states, “I’m thinking the side effects of the drug are worse than the disease. Look what’s happening to me.” The nurse would most likely identify which nursing diagnosis as the priority? Correct response: Disturbed body image related to loss of fat in the face and arms Explanation: The client is experiencing lipoatrophy, which results in a localized loss of subcutaneous fat in the face (manifested as sinking of the cheeks, eyes, and temples), arms, legs, and buttocks. These changes as well as his statement about the side effects of the drug being worse than the disease indicate that he is concerned about how he appears to others. Therefore, the nursing diagnosis of disturbed body image would be the priority. Deficient knowledge, risk for infection, and risk for impaired liver function may be applicable; however, they are not concerns at this time.
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(see full question) A patient receiving antiretroviral therapy is complaining of “not urinating enough.” What is the nurse’s best action? Correct respons (see full question) The term used to define the balance between the amount of HIV in the body and the immune response is You selected: viral set point. Correct Explanation: The viral set point is the balance between the amount of HIV in the body and the immune response. During the primary infection period, the window period occurs since a person is infected with HIV but negative on the HIV antibody blood test. The period from infection with HIV to the development of antibodies to HIV is known as the primary infection stage. The amount of virus in circulation and the number of infected cells equals the rate of viral clearancee: Assess BUN and creatinine.
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(see full question) The term used to define the balance between the amount of HIV in the body and the immune response is You selected: viral set point. Correct Explanation: The viral set point is the balance between the amount of HIV in the body and the immune response. During the primary infection period, the window period occurs since a person is infected with HIV but negative on the HIV antibody blood test. The period from infection with HIV to the development of antibodies to HIV is known as the primary infection stage. The amount of virus in circulation and the number of infected cells equals the rate of viral clearance
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What test will the nurse assess to determine the patient’s response to antiretroviral therapy? You selected: Viral load
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HIV is harbored within which type of cell? You selected: Lymphocyte
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Which assessment finding is not likely to cause noncompliance with antiretroviral treatment? You selected: Lack of social support Incorrect Correct response: Past substance abuse
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Question 3: (see full question) A client is prescribed didanosine (Videx) as part of his highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client? You selected: “Be sure to take this drug about 1/2 hour before or 2 hours after you eat.” Correct Explanation: Didanosine should be taken 30 to 60 minutes before or 2 hours after meals. Other antiretroviral agents, such as abacavir, emtricitabine, or lamivudine can be taken without regard to meals. High-fat meals should be avoided when taking amprenavir. Atazanavir should be taken with food and not with antacids.
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(see full question) A patient is administered foscarnet to treat a case of cytomegalovirus (CMV) retinitis. Which of the following adverse effects should the nurse closely monitor in the patient? You selected: Electrolyte imbalances
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The development of a positive HIV antibody test following initial infection generally occurs in which timeframe? You selected: 6 weeks Incorrect Correct response: 4 weeks Explanation: Development of a positive HIV antibody test generally occurs within 4 weeks and with few exceptions by 6 months.
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(see full question) A female client comes to the clinic and tells the nurse, “I think I have another vaginal infection and I also have some wartlike lesions on my vagina. This is happening quite often.”What should the nurse consult with the physician regarding? You selected: Having the client abstain from sexual activity for 6 weeks while the medication is working Incorrect Correct response: Testing the client for the presence of HIV Explanation: Abnormal results of Papanicolaou tests, genital warts, pelvic inflammatory disease, and persistent vaginitis also may correlate with HIV infection. Wearing cotton underwear can help with the prevention of candidiasis but does not address the recurrent vaginal infection that may not be caused by a fungus. Abstaining from sexual intercourse does not address the recurrent vaginal infection. A medicated douche can alter the normal flora of the vaginal wall.
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(see full question) A woman infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV? You selected: Gynecologic problems Correct Explanation: In women with HIV, gynecologic problems, such as abnormal results of Papanicolaou tests, genital warts, pelvic inflammatory disease, and persistent vaginitis may be the focus of a majority of complaints. Acute retroviral syndrome (viremia) may be the chief complaint in one third to more than one half of those infected, not necessarily women. Its manifestations include rashes, muscle and joint pain, and weight loss.
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(see full question) There are many ethical issues in the care of clients with HIV or HIV/AIDS. What is an ethical issue healthcare providers deal with when caring for clients with HIV/AIDS? You selected: Disclosure of the client’s condition Correct Explanation: Despite HIV-specific confidentiality laws, clients infected with AIDS fear that disclosure of their condition will affect employment, health insurance coverage, and even housing. Since healthcare providers do not share a client’s diagnosis with a support group, option A is incorrect. Caring for a client with an infectious terminal illness that can be transmitted to other people is a concern for healthcare providers but it is not an ethical issue.
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(see full question) A patient in the clinic states, “My boyfriend told me he went to the clinic and was treated for gonorrhea.” While testing for the sexually transmitted infection (STI), what else should be done for this patient? Correct response: Inform the patient that it would be beneficial to test for HIV. Explanation: HIV screening is recommended for all persons who seek evaluation and treatment for STIs. HIV testing must be voluntary and free of coercion. Patients must not be tested without their knowledge. HIV screening after notifying the patient that an HIV test will be performed (unless the patient declines) is recommended in all health care settings. Specific signed consent for HIV testing should not be required. In most settings, general informed consent for medical care is considered sufficient.
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(see full question) People have different levels of risk for becoming infected with HIV. Which client is more at risk of becoming infected with HIV? You selected: A person having casual intercourse with multiple partners Correct Explanation: People who have casual intercourse with multiple partners are at a greater risk of acquiring HIV. Women who have never had intercourse are at the least risk because HIV spreads through body fluids, such as semen, vaginal secretions, and blood. The risks of women who have had deliveries after the age of 40 or men who use sildenafil (Viagra) before having intercourse are yet to be established.
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Question 19: (see full question) A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find? You selected: Hypokalemia Correct Explanation: Electrolyte imbalances such as decreased sodium, potassium, calcium, magnesium, and chloride typically result from profuse diarrhea. A urine specific gravity of 1.010 would indicate dilute urine. The client with severe diarrhea most likely would be dehydrated, leading to a high urine specific gravity. Proteinuria may suggest renal dysfunction and would not be associated with severe diarrhea unless the client was developing renal failure.
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(see full question) A client taking abacavir (ABC) has developed fever and rash. What is the priority nursing action? You selected: Call the health care provider to report. Correct Explanation: Fever and a rash could be indicative of a hypersensitivity reaction. Hypersensitivity reactions are also known as anaphylactic reactions and often involve skin rashes, fever, and bronchopulmonary issues such as bronchial constriction. The health care provider should be notified immediately and the medication stopped. Interventions need to be taken to assure that the patient’s airway is not compromised. Administering Tylenol and documentation and treating the rash are not the priority, and would be completed after the patient was stabilize
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(see full question) Which of the following nursing actions is essential before an EIA test is performed? You selected: Obtaining a written consent from the patient Incorrect Correct response: Obtaining a general consent for medical care from the patient Explanation: Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing. The Western blot test is performed if the results of the EIA test are positive. A polymerase chain reaction test, which measures viral loads, is used if diagnosis is confirmed as positive
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Question 5: (see full question) The balance between the amount of HIV in the body and the immune response is the You selected: viral set point. Correct Explanation: The balance between the amount of HIV in the body and the immune response is the viral set point.A viral load test measures the quantity of HIV RNA in the blood. The window period is the time from infection with HIV until seroconversion detected on HIV antibody test. Anergy is the loss or weakening of the body’s immunity to an irritating agent or antigen.
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Which of the following are modes of transmission for HIV? Select all that apply. Correct response: • Blood • Seminal fluid • Vaginal secretions • Amniotic fluid
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he nurse receives a phone call at the clinic from the family of a patient with AIDS. They state that the patient started “acting funny” after complaining of headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member? You selected: “The patient probably has pneumocystis pneumonia and will need to be evaluated by the physician.” Incorrect Correct response: “The patient may have cryptococcal meningitis and will need to be evaluated by the physician.” Explanation: A fungal infection, Cryptococcus neoformans is another common opportunistic infection among patients with AIDS, and it causes neurologic disease. Cryptococcal meningitis is characterized by symptoms such as fever, headache, malaise, stiff neck, nausea, vomiting, mental status changes, and seizures
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(see full question) A patient receiving antiretroviral therapy is complaining of “not urinating enough.” What is the nurse’s best action? You selected: Encourage the patient to drink more fluids. Incorrect Correct response: Assess BUN and creatinine.
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(see full question) Which of the following substances may be used to lubricate a condom? You selected: Baby oil Incorrect Correct response: K-Y jelly
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Which of the following microorganisms is known to cause retinitis in people with HIV/AIDS? Cytomegalovirus
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(see full question) A client is given a nursing diagnosis of social isolation related to withdrawal of support systems and stigma associated with AIDS. Which outcomes would indicate that the nurse’s plan of care was effective? Select all that apply. Correct response: • Client demonstrates beginning participation in events and activities. • Client identifies appropriate sources of assistance and support. • Client verbalizes feelings related to the changes imposed by the disease. Explanation: For the nursing diagnosis of social isolation, outcomes indicating effectiveness of care include demonstrating a beginning level of participation in activities and evenets, identifying appropriate sources for assistance and support, and verbalizing feelings related to the changes resulting from the disease. Demonstrating knowledge of safer sexual practices and practices to reduce transmission risk are more appopriate for a nursing diagnosis of deficient knowledge.
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A client is suspected of having an immune system disorder. The physician wants to perform a diagnostic test to confirm the diagnosis. What test might the physician order? You selected: T-and C-cell assays Incorrect Correct response: Enzyme-linked immunosorbent assay Explanation: T-cell and B-cell assays (or counts) and the enzyme-linked immunosorbent assay may be performed. A C-cell assay and plasmapherisis are distractors for this question. A complete chemistry panel is not a diagnostic test for an immune system disorder.
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Which category of HIV disease correlates with asymptomatic AIDS? You selected: A Correct Explanation: Each category denotes clinical progression of HIV infection in the patient from asymptomatic category A to “full-blown” AIDS category C
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A patient being treated for HIV/AIDS has a decreased appetite, almost to the point of anorexia. What is the nurse’s best action? You selected: Ask his family to bring in food that he enjoys. Incorrect Correct response: Administer megestrol acetate (Megace). Explanation: Appetite stimulants are successfully used in patients with AIDS-related anorexia. The anorexia is compounded by medications that cause nausea and vomiting. The anorexia has a physiologic cause, and this must be addressed. Bringing in favorite foods or making favorite foods may have little or no effect on the patient’s appetite; it is physiologically rather than psychologically based.
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When assisting the patient to interpret a negative HIV test result, what does the nurse tell the patient this result means? You selected: His body has not produced antibodies to the AIDS virus. Correct Explanation: A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn. A negative test result should be interpreted as demonstrating that, if infected, the body has not produced antibodies (which takes from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged. The test result does not mean that the patient is immune to the virus, nor does it mean that the patient is not infected. It just means that the body may not have produced antibodies yet. When antibodies to the AIDS virus are detected in the blood, the test is interpreted as positive.
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A nurse is caring for a client with human immunodeficiency virus (HIV). To determine the effectiveness of treatment the nurse expects the physician to order: You selected: enzyme-linked immunosorbent assay (ELISA). Incorrect Correct response: quantification of T-lymphocytes. Explanation: Quantification of T-lymphocytes is used to monitor the effectiveness of treatment for HIV. E-rosette immunofluorescence is used to detect viruses in general; it doesn’t confirm HIV infection. The ELISA test detects HIV antibody particles but may yield inaccurate results; a positive ELISA result must be confirmed by the Western blot test. The Western blot test — electrophoresis of antibody proteins — detects HIV antibodies when used in conjunction with the ELISA. It isn’t specific when used alone and doesn’t monitor the effectiveness of treatment.
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(see full question) Which assessment finding is not likely to cause noncompliance with antiretroviral treatment? Correct response: Past substance abuse Explanation: Past substance abuse has not been implicated as a factor for noncompliance with antiretroviral treatment. Factors associated with nonadherence include active substance abuse, depression, and lack of social support.
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(see full question) A nurse is teaching high school students about transmission of the human immunodeficiency virus (HIV). Which comment by a student warrants clarification by the nurse? You selected: “I won’t donate blood because I don’t want to get AIDS.” Correct Explanation: HIV is transmitted through infected blood, semen, and certain other body fluids. Although a transfusion with infected blood may cause HIV infection in the recipient, a person can’t become infected by donating blood. The other options reflect accurate understanding of HIV transmission.
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What intervention is a priority when treating a patient with HIV /AIDS? You selected: Assessing fluid and electrolyte balance Correct Explanation: Fluid and electrolyte deficits are a priority in monitoring patients with HIV/AIDS. Assessment of fluid loss and electrolyte imbalance is essential. Skin integrity should be monitored, but is a lower priority. Neurologic and psychological status should also be monitored, but this is not as high a priority as fluid and electrolyte imbalance.
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