Chapter 35
A client who is HIV positive has been diagnosed with Pneumoncystis pneumonia cause by P. jiroveci. What medication will the client take for the treatment of this infection? A. amphotericin B B. trimethoprim-sulfamethoxazole C. fluconazole D. nystatin
B
A client who is HIV positive is taking zidovudine. Which adverse effects should the nurse closley monitor for this client? A. numbness in the extremities and decreased cognition B. diarrhea and abdominal pain C. alterations in renal function D. pancreatitis
B
A client will be starting on antiretroviral therapy, and is concerned about being able to afford the therapy. The nurse can inform the client that the largest source of public funding for HIV/AIDS care is: A. AIDS drug assistance program B. medicaid C. medicare D. blue cross/blue shield
B
A has been diagnosed HIV positive. What will determine the initiation of antiretroviral drug therapy? Select all that apply. A. CD (T cell) count greater than 350/mm B. CD (T cell) count less than 350 /mm C. positive Western blot D. positive ELISA test
B
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? A. AIDS dementia complex (ADC) B. distal sensory polyneuropathy (DSP) C. candidiasis D. cytomegalovirus (CMV)
A
A client with a diagnosis of HIV presents with pharyngitis, rash on the palms and soles of the feet, and diarrhea. The nurse suspects the client is suffering from: A. acute retroviral syndrome (ARS) B. AIDS-related complex (ARC) C. AIDS dementia complex (ADC) D. distal sensory polyneuropathy (DSP)
A
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? A. testing the client for the presence of HIV B. having the client abstain from sexual activity for 6 weeks while the medication is working C. instructing the client to wear cotton underwear D. using a medicated douche in order to keep the vaginal pH normal
A
A public health nurse is given an informational presentation on HIV/AIDS at a nearby college.How would the nurse best define AIDS? A. acquired immunodeficiency syndrome (AIDS) is an infectious and potentially life-threatening disease that severely compromises the immune system B. acquired immunodeficiency syndrome is a rapidly fatal infection that profoundly weakens the immunue system C. acquired immunodeficiency syndrome is an infectious disease transmitted in blood and body fluids D. acquired immunodeficiency syndrome is a sexually transmitted disease
A
Which nursing action essential before an ELISA test is performed? A. perform a western blot test B. perform a polymerase chain reaction test C. obtain a written consent from the client D. provide the client with plenty of fluids
C
In the interest of public health, the CDC has developed HIV transmission prevention strategies. The strategies address the routes by which HIV can be transmitted and steps that can be taken to reduce or eliminate transmission. Which categories of risk are addressed by these strategies? Select all that apply. A. sharing eating utensils B. secual activity C. illegal drugs D. organ donation
B, C
Thr 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. A. urine B. vaginal secretions C. semen D. breast milk E. blood
B, C, D, E
A client has been diagnosed with HIV and has been placed on antiretroviral therapy. What does the nurse infrom the client will be required for determing the progression of the disease as well as guiding drug therapy? A. the western blot test will be monitored every 6 months to see if the virus is still present B. viral load and T4-cell counts will be performed every 2 to 3 months C. the client will be required to stop medication for 2 weeks and then have lab studies drawn to determine if the antiretroviral therapy has cured the disease D. more antiretroviral medication will be added every 2 to 3 months
B
A client has discussed therapy for HIV positive status. The goal of antiretroviral therapy is to: A. reverse the HIV positive status to a negative status B. eliminate the risk of AIDS C. keep the CD4 cell count about 350/mm3 and viral load undetectable D. treat mycobacterium avium complex
C
A client who is HIV/AIDS positive has orders for lab tests to be performed. What precations should the nurse observe whenever there is a risk of exposure to the blood and body fluids of an infected client? A. avoid cleaning up spilled urine and feces B. wear barrier garments for as ling as long as possible after leaving a client's room C. transport the specimens of body fluids in leak-proof containers D. avoid any physical contact with the client
C
A client with AIDS has been tested for cytomegalovirus (CMV) with positive titers. What severe complication should the nurse be alert for with cytomegalovirus? A. fatigue B. hearing impairment C. blindness D. diarrhea
C
A client reports "feeling under the weather" for several weeks and is having blood work done to try and determine the cause. The physician is including an ELISA test in the blood work. What would be the expected next step if the ELISA is positive? A. perform Western blot B. diagnose AIDS C. repeat Western blot D. repeat the ELISA test
D
According to the WHO, how many adults in sub-Saharan Africa are infected with HIV? A. 10 million B. 15 million C. 5 million D. 20 million
D
It is important for a nurse to refer an HIV positive clients to support groups and resources because: A. it is mandatory, as per the state health guidelines, to refer HIV positive clients to support groups B. support groups and resources provide better emotional and psychological support to HIV positive clients C. after a point in time, management of HIV positive clients is not practical for the nurse D. support groups and resources provide information about new HIV drug development and clinical drug trials to clients
D
When learning about HIV/AIDS, the students should be able to differentiate the two subtypes of virus by which characteristic? A. the fact that it is a mutated virus originally thought to be bovine in nature B. means of transmission C. cure rate D. HIV-1 is more prevalent than HIV-2 subtypes
D
A client is considering beginning sexual relations and wants to know the best way to be protected from a sexually transmitted infection and HIV. What is the best response by the nurse? A. "Using condom (latex) and spermicidal jelly is one of the most effective ways to decrease the risk of transmission of an STI and HIV." B. "Douching immediately after intercourse will be the most effective way to kill bacteriaand viruses." C. "Using a lamb skin condom will be the most effective way to decrease transmission of STIs and HIV." D. "Using a diaphragm with spermicidal jelly will also kill the bacteria and viruses that transmit STIs and HIV."
A
A client on antiretroviral drug therapy admits to skipping medication doses, sometimes for days at a time. What can occur when medications are not taken as prescribed? A. the client is risking the development of drug resistance and drug failure B. the funding for the medications will cease if the client is not taking them correctly C. the client will have to take the drugs intravenously to ensure compliance
A
The nurse has four clients that come to the clinic for healthcare. Which client has the highest risk factor for HIV infection? A. a 34 year old female who has donated blood on several occasions B. a 26 year old inmate who receives tattoos in prison C. a 22 year old heterosexual male who has had one relationship for 2 years D. a 46 year old female who has been in a monogamous relationship for 9 years
B
The nurse is preparing to start an IV for a client who is combative. What precautionary measure should the nurse take in order to avoid a needlestick? A. have the patient placed in restraints B. ask for assistance C. refuse to start the IV D. give the client a sedative prior to starting the IV
B
A client is adminstered foscarnet to treat a case of CMV retinitis. Which adverse effects should the nurse closely monitor in the client? Select all that apply. A. emboli B. hypotension C. numbness in extremities D. dyspnea
C
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? A. Kaposi's sarcoma B. hairy leukoplakia C. candidiasis D. coccifiomycosis
C
A client comes to the clinic to obtain HIV test results. The physician states that the client that has a CD4 cell count of 300 cells/mm3 and a high viral load. What will the physician discuss with the client? A. follow-up testing to determine whether therapy is warranted at this time B. initiation of antibiotic therapy to prevent the development of an opportunistic infection C. administration of an antifungal medication to prevent the development of an opportunistic fungal infection D. initiation of an antiretroviral therapy
D
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? A. sign a refusal of blood transfusion form so the client will not receive the transfusion B. using volume expanders in case blood is needed C. ask people to donate blood D. bank autologous blood
D
A young mother of two has been diagnosed as being HIV positive. Her HIV specialist has started her on antiretroviral therapy without a CD (T-cell) count because she: A. is pregnant B. none of the options is correct C. has the money for treatment D. has aches and pains
A
The nurse adminsiters an injection to a client with AIDS. When finished, the nurse attempts to recap the needle and sustains a needlestick to the finger. What is the priority action by the nurse? A. obtain counseling B. fill out a risk management report C. report the incident to the supervisor D. call the lab to draw the nurse's blood
C
The nurse is gathering data from lab 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? A. the client has another infection present that is causing a decrease in the T4-cell count B. the client's T4-cell count has decreased due to the pneumocystis pneumonia C. the client has converted from HIV infection to AIDS D. the client has advanced HIV infection
C
A client requires a blood transfusion for anemia and is concerned about the risk of contracting acquired immune deficiemcy syndrome (AIDS). What is the best response by the nurse? A. "You don't want to die, do you?" B. "The blood is screened very carefully, the risk is 1 in 2,000,000." C. "If you don't have the transfusion, you are taking a greater risk." D. "It is always a possibility."
B
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? A. reduce food intake B. avoid fibrous foods, lactose, fat, and caffeine C. increase intake of iron and zinc D. consume large, high-fat meals
B
A healthcare worker has been exposed to the blood of an HIV positive client and is awaiting the results of an HIV test. In the meantime, what precautions must the healthcare worker take to prevent the spread of infection? A. limit interactions with people who are not HIV infected B. follow the same sexual precautions as someone who has been diagnosed with AIDS C. quit their job and get admitted to a hospital or a cancer treatment center D. limit interactions with people who are already HIV infected
B
A client will be having a hysterectomy and wants her daughter to provide directed donor blood. What factor would eliminate her daughter from donating the blood? A. the daughter weighs 124 lb B. the daughter is negative for HIV C. the daughter is 15 years of age D. the physician has been notified of the procedure
C
A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay with positive results twice. The next step for the nurse to explain to the patient for confirmation of teh diagnosis is to perform a: A. T4-cell count for confirmation of diagnosis B. p24 antigen test for confirmation of diagnosis C. western blot test for confirmation of diagnosis D. polymerase chain reaction test for confirmation of diagnosis
C
A male client is having sexual relations with another male as well as using methamphetamine, and has contracted HIV. The nurse is concerned that this client: A. will remain HIV positive for a longer period of time B. is a drug addict and needs to stop using C. may develop AIDS in a shorter period of time D. may infect other people because of his drug use
C
A client with a history of IV drugs use is HIV-positive. The client has been following an antiretroviral medication regimen faithfully and is doing well, attending college to get a social work degree, and focused on a nright future. In regular CD counts, what factor will indicate that this client has progressed from HIV to AIDS? A. CD count > 100/mm B. CD count < 100 / mm C. CD count > 200/mm D. CD count < 200/mm
D
A client with cytomegalovirus infection reports difficulty seeing. The physician determines that the client is developing CMV retinitis. What medication does the nurse anticipate the client will receive for this? A. zidovudine B. fluconazole C. azithromycin D. foscarnet
D
Traditionally, HIV infecitons has been a danger for specific populations groups who engaged in risky behaviors. Recently, incidence has spread to groups who are not typically thought to be in danger of contracting HIV. Which population group in the US has HIV infection rates eight times higher than whites? A. asians B. no option is correct C. hispanics D. african americans
D
A client tells the nurse, "You know I have AIDS. I still cannot afford to tell my employer because they will probably cancel my health insurance, then what would I do?" What is the best response by the nurse? A. "An employer cannot cancel your currently active health insurance on the basis of AIDS." B. "I just would not tell them. It is none of their business." C. "You have to tell them, it is not your right to allow them exposure to you. What if you give it to someone?" D. "I understand your dilemma, but I think you should tell them. I would want to know."
A
A client who recently had sexual contact with a partner who is HIV positive has developed flulike symptoms such as a low grade fever, headache, and muscle pain. What does the nurse suspect this client is experiencing? A. acute retroviral B. influenza C. pneumocystis pneumonia D. AIDS
A