Chapter 32: Management of Patients With HIV Infection and AIDS

A client with AIDS is exhibiting shortness of breath, cough, and fever. The nurse most likely would suspect infection with which of the following?

Pneumocystis jiroveci pg. 1010

A client taking abacavir has developed fever and rash. What is the priority nursing action?

Report to the health care provider. pg. 1007

A client with HIV will be started on a medication regimen of three medications. What drug will the nurse instruct the client about?

Reverse transcriptase inhibitors p. 998, 1006.

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?

Ribonucleic acid (RNA) pg. 1003

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?

Stool specimen for ova and parasites pg. 1011

Antiretroviral medications should be offered to clients with T-cell counts less than

350 cells/mm3. pg. 1006

Which assessment finding(s) are likely to cause noncompliance with antiretroviral treatment? Select all that apply.

Active substance abuse pg. 1006

When do most perinatal HIV infections occur?

After exposure during delivery pg. 1000

A client who has AIDS reports having diarrhea after every meal, and wants to know what can be done to stop this symptom. What should the nurse advise?

Avoid fibrous foods, lactose, fat, and caffeine. pg. 1023

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?

Bank autologous blood. pg. 890

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?

Disclosure of the client's condition pg. 1025

A client suspected of having HIV has blood drawn for a screening test. What is the first test generally run to see if a client is, indeed, HIV positive?

ELISA pg. 1005

Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS?

Liquids pg.

The nurse is gathering data from laboratory studies for a client who has HIV. The clients T4-cell count is 200/mm³, and the client has been diagnosed with pneumocystis pneumonia. What does this indicate to the nurse?

The client has converted from HIV infection to AIDS. pg. 1010

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?

Trimethoprim-sulfamethoxazole pg. 1013

What test will the nurse assess to determine the client's response to antiretroviral therapy?

Viral load pg. 1005

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?

"The patient may have cryptococcal meningitis and will need to be evaluated by the physician." pg. 1012

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? (Select all that apply.)

- Active substance abuse - Depression - Lack of social support pg. 1006

A client comes in to get an EIA test done because the physician suspects AIDS. Which nursing action is essential before an EIA test is performed?

. Obtaining a general consent for medical care from the client pg. 1005

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?

6 weeks pp. 1005-1006.

A client with AIDS has become forgetful with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms

AIDS dementia complex (ADC) pg. 1012

When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following?

Antibodies to HIV are not present in his blood. pg. 1005

A patient receiving antiretroviral therapy is complaining of "not urinating enough." What is the nurse's best action?

Assess BUN and creatinine. pg. 1006

Which is usually the most important consideration in the decision to initiate antiretroviral therapy?

CD4+ counts pg. 1006

A client with AIDS is brought to the clinic by their family. The family. The family tells the nurse that the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms?

HIV encephalopathy pg. 1012

When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by which characteristic?

HIV-1 is more prevalent than HIV-2 subtypes pg. 1004

Which condition is an early manifestation of HIV encephalopathy?

Headache pp. 1011-1012.

A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find?

Hypokalemia pg. 1015

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?

Inform the patient that it would be beneficial to test for HIV. pg. 1005

Which substance may be used to lubricate a condom?

K-Y jelly pg.

The nurse teaches the client that reducing the viral load will have what effect?

Longer survival pg. 1005

The nurse advises a patient who has received a negative test result from his HIV antibody test that he:

May be infected but antibodies are not currently present. pg. 1005

Which characteristic has NOT been implicated as a factor for noncompliance with antiretroviral treatment?

Past substance abuse pg. 1006

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:

Pneumocystis pneumonia. pg. 1010

A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority?

Risk for injury pg. 1012

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.

Semen Breast milk Blood Vaginal secretions pg. 1021

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?

Side effects of drug therapy pg. 1024

Cryptococcus meningitis is suspected in a client with HIV. Which of the following would be consisted with cryptococcus meningitis? Select all that apply?

Stiff neck and seizures pg. 1012

The nurse is teaching the client with HIV about therapy. Which elements are essential for the nurse to include in the teaching plan? Select all that apply.

The CD4 count is the major indicator of immune function and guides therapy. Antiretroviral therapy targets different stages of the HIV life cycle. pg. 1006

A nurse is implementing appropriate infection control precautions for a client who is positive for human immunodeficiency virus (HIV). The nurse demonstrates a need for a review of transmission routes by identifying which body fluid as a means of transmission?

Urine pg.

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?

Viral load and T4-cell counts will be performed every 2 to 3 months pg. 1006

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?

Western blot assay pg. 1005

A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay (ELISA) with positive results twice. The next step for the nurse to explain to the client for confirmation of the diagnosis is to perform a:

Western blot test for confirmation of diagnosis. pg. 1005

The nurse has four clients that come to the clinic for healthcare. Which client has the highest risk factor for HIV infection?

a 26-year-old inmate who receives tattoos in prison p. 1000-1001.

Kaposi sarcoma (KS) is diagnosed through

biopsy. pg. 1011

A nurse is collecting objective data for a client with AIDS. The nurse observes white plaques in the client's oral cavity, on the tongue, and buccal mucosa. What does this finding indicate?

candidiasis pg. 1016

The lower the patient's viral load,

the longer the survival time. pg. 1006

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?

Assist with chest physiotherapy every 2 to 4 hours. pg. 1018

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:

Chronic diarrhea. pp. 1010-1011.

A patient has received the results of his HIV antibody test, which is positive. The nurse explains that this result means that:

He has been infected and has produced antibodies. pg. 1005

Which of the following indicates that a client with HIV has developed AIDS?

Herpes simplex ulcer persisting for 2 months pg. 999

A client who is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication will the client take for the treatment of this infection?

trimethoprim-sulfamethoxazole pg. 1013

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.

• 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. pg. 1020