Chapter 55, Care of the Patient with HIV/AIDS

Which factors have been linked to increased mortality and morbidity from human immunodeficiency virus (HIV)? 1. Higher socioeconomic status 2. Lack of access to adequate care 3. Receiving care in a hospital with extensive experience in caring for HIV-infected patients 4. Being treated by a primary health care provider with extensive experience in caring for HIV-infected patients

Lack of access to adequate care. The course of HIV disease varies from person to person and can be influenced by several factors. One factor that has been linked to increased mortality and morbidity from HIV is lack of access to adequate care. Other factors for increased mortality and morbidity from HIV are receiving care in a hospital that has little experience in caring for HIV-infected patients; being from a lower socioeconomic status; and receiving treatment from a primary health care provider who has had little experience in caring for HIV-infected patients.

A nurse is providing education to a patient newly diagnosed with human immunodeficiency virus (HIV). The patient demonstrates an understanding of the disease by stating the disease progression will be monitored with which laboratory value? 1. CD4 cells 2. HIV antibodies 3. T lymphocytes 4. B lymphocytes

CD4 cells. HIV disease progression is tracked by the number of CD4 cells left in the body. HIV antibodies, T lymphocytes, and B lymphocytes are not used.

A nurse caring for a patient newly diagnosed with human immunodeficiency virus (HIV) is providing education on ways to delay the progression of HIV. When asked about social habits, the patient reveals that she uses intravenous drugs, smokes 50 cigarettes per day, and uses condoms with her multiple sex partners. Which initial goal would be most appropriate for this patient to promote a healthy lifestyle and delay disease progression? 1. Limit sexual partners to one person 2. Abstain from use of recreational drugs 3. Begin taking an oral contraceptive drug 4. Decrease cigarettes smoked per day to 20

Decrease cigarettes smoked per day to 20. Decreasing cigarettes smoked per day from 50 to 20 is an attainable goal that improves the health and immune system of the patient. Although limiting sexual partners to one, abstinence from recreational drug use, and prevention of pregnancy are important, these goals are not as attainable and as important to improving the immune system and maintaining health.

The nurse is counseling a group of patients before human immunodeficiency virus (HIV) antibody testing. Which nursing intervention is a part of the pretest counseling? 1. Discuss the importance of partner notification with the patients. 2. Remind the patients that treatments are availablefor this disease. 3. Educate the patients to avoid the future risk of exposure to infections. 4. Review the patients' health habits that can improve the immune system.

Educate the patients to avoid the future risk of exposure to infections. During the pretest counseling, the nurse educates patients about decreasing or avoiding future risk of exposure to HIV. Reminding the patients about the availability of treatments to treat the disease, reviewing the health habits that can improve the immune system, and discussing the importance of partner notification is a part of posttest counseling.

The nurse is caring for a patient with human immunodeficiency virus (HIV) who reports diarrhea due to gastrointestinal infection. Which nursing interventions would help prevent complications related to diarrhea? Select all that apply. 1. Encourage high-fiber foods. 2. Assess for skin impairment. 3. Encourage a high-protein diet. 4. Discourage the intake of fruit juices. 5. Advise the patient to drink Gatorade.

Assess for skin impairment. Encourage a high-protein diet. Advise the patient to drink Gatorade. A patient with HIV who is suffering from diarrhea may have impaired skin integrity due to dehydration and malnutrition. So, the nurse should assess the patient for skin impairments. A high-protein diet helps replenish the nutrition lost from the body caused by the diarrhea. A patient with diarrhea is at risk for fluid and electrolyte imbalance. Therefore, the nurse should advise the patient to drink Gatorade, which provides energy and prevents dehydration. High-fiber foods are encouraged for patients with constipation. The intake of fruit juices should be encouraged for the patient with diarrhea.

Which nursing interventions would be helpful to delay the progression of disease in a patient with human immunodeficiency virus (HIV)? Select all that apply. 1. Encourage the patient to quit smoking. 2. Encourage the patient to eat vegetables. 3. Encourage the patient to exercise regularly. 4. Support the patient in reducing stress levels. 5. Encourage the patient to be on a low-protein diet.

Encourage the patient to quit smoking. Encourage the patient to exercise regularly. Support the patient in reducing stress levels. Maintaining health and promoting immunity may delay the progression of HIV. The patient should be encouraged to stop smoking, as smoking may worsen pulmonary complications. Regular exercise helps maintain the patient's muscle mass. Stress levels may disturb the patient's metabolic functions. In a patient with HIV, stress levels should be reduced to promote well-being. The patient should be advised to not eat vegetables, as vegetables can cause gastroenteritis. A patient with HIV should be encouraged to maintain a high-protein diet to promote cell repair.

A patient visits the clinic after a possible exposure to human immunodeficiency virus (HIV) and would like more information on how she will be tested for HIV. The nurse correctly responds that which test will be used first? 1. Western blot test 2. Rapid plasma reagin test 3. Sexually transmitted infection screening 4. Enzyme-linked immunosorbent assay (ELISA)

Enzyme-linked immunosorbent assay (ELISA). ELISA is performed first for HIV. If a positive result is obtained, the Western blot test is performed, which is a more specific test. The rapid plasma reagin test is used for syphilis. Sexually transmitted infection screening may be done in conjunction, but it is not used initially for assessing for contraction of HIV.

The nurse educator is teaching nursing students the effective ways to avoid transmission of human immunodeficiency virus (HIV) through syringes and needles. What instructions should the nurse include in the teachings? Select all that apply. 1. Look for oral or topical drug treatment opportunities. 2. Encourage the use of injectable drugs for the patients. 3. Use sterile needles and equipment for injecting the drugs. 4. Clean the shared syringe with clean water, followed by alcohol. 5. Clean the shared syringe with sodium hypochlorite 5.25% (Clorox) bleach.

Look for oral or topical drug treatment opportunities. Use sterile needles and equipment for injecting the drugs. Clean the shared syringe with sodium hypochlorite 5.25% (Clorox) bleach. Oral drugs should be promoted instead of injectables, whenever possible. Nurses should ensure that they use sterile needles and equipment while injecting drugs to avoid transmission of HIV. If the syringe is shared, reduced risk-preventive measures, such as cleaning the syringe with sodium hypochlorite 5.25% (Clorox) bleach twice, should be carried out. Injectable drugs should not be encouraged for patients, as they may increase the transmission of HIV. Cleaning a syringe with water and alcohol is not a strong enough solution to sterilize the syringe, which means the virus may still linger or live on it.

Which cells may inhibit leukocyte migration inhuman immunodeficiency virus (HIV)? 1. B cells 2. Mast cells 3. Neutrophils 4. Natural killer (NK) cells

Mast cells Mast cells may inhibit leukocyte migration in HIV. B cells are involved in the humoral response to HIV and produce a variety of antibodies against the virus. HIV affects neutrophils and causes neutropenia. HIV affects NK cells, making them functionally defective.

The nurse is teaching safe and effective sex methods to a couple. The nurse finds that the couple participates in anal sex and uses a diaphragm for contraception. The male partner is circumcised and refrains from having oral sex. Which of the couple's actions would increase the risk of sexually transmitted infections (STIs)? 1. Using a diaphragm 2. Refraining from oral sex 3. Undergoing circumcision 4. Participating in anal sex

Participating in anal sex. Most couples participate in anal intercourse instead of vaginal intercourse to prevent conception. Practicing anal sex increases the risk of human immunodeficiency virus and STIs, as the rectal mucosa is less lubricated and may be easily worn out. Therefore, the nurse should advise the couple to avoid participating in anal sex. Using a diaphragm and condoms helps prevent the risk of infections, as it prevents the contact of semen with other body fluids. Oral sex increases the risk of STIs, as a virus may be transmitted if the partner's oral mucosa is damaged. Therefore, refraining from oral sex is a good method. According to research, circumcision reduces the risk of STIs.

The nurse is conducting a study to compare the characteristics of the patients who have contracted zoonotic infections. Which patient should the nurse include in the study? 1. Patient with rabies infection 2. Patient with salmonella infection 3. Patient with enterococcal infection 4. Patient with streptococcal infection

Patient with rabies infection. A zoonotic organism is able to cross from an animal species to humans. Rabies is an infection that is usually acquired from infected dogs and cats and therefore it is a zoonotic infection. Enterococcal and salmonella infection are food borne infection. Streptococcal infection is usually an air borne infection.

A patient with human immunodeficiency virus (HIV) who is administered stavudine (Zerit) reports numbness and impaired proprioception. The nurse finds that the patient also has hypesthesia. What could be the reason behind the onset of these symptoms? 1. Hypoglycemia 2. Hyperlipidemia 3. Stress due to HIV 4. Peripheral neuropathy

Peripheral neuropathy. Peripheral neuropathy can be related to HIV itself or, more frequently, the side effects of many anti-HIV medications, such as stavudine (Zerit). Symptoms include numbness, hypesthesia (diminished sensitivity to stimulation), or anesthesia, and loss of sense of vibration and position (proprioception). Hypoglycemia, hyperlipidemia, and stress due to HIV do not cause these symptoms in patients with HIV who have been administered stavudine (Zerit).

The nurse is caring for a patient with human immunodeficiency virus (HIV). Which nursing intervention would help promote good nutrition in the patient? 1. Provide a high-protein diet. 2. Provide a high-residue diet. 3. Provide raw fruits in the diet. 4. Provide raw meats in the diet.

Provide a high-protein diet. A protein-rich diet helps develop the immune system and promote cell and tissue repair. Therefore, to promote good nutrition for patients with HIV, patients should be advised to consume a protein-rich diet. Patients should not be advised to follow a high-residue diet, as the digestive function is reduced. Patients should not consume raw fruits and meats, as these foods may cause food poisoning due to the patient's low immunity levels.

The nurse is caring for a patient with human immunodeficiency virus (HIV). While observing the diagnostic reports, the nurse finds that the patient has anemia. Which food items should the nurse include in the patient's diet to increase red blood cell (RBC) count? Select all that apply. 1. Raisins 2. Cereals 3. Bananas 4. Organ meats 5. Apricot nectar

Raisins Organ meats Patients with anemia should be encouraged to consume foods rich in iron, such as raisins and organ meats, in order to increase their RBC count. Patients with constipation are encouraged to eat cereals, as cereals contain fiber, which helps relieve constipation. Patients with diarrhea should be encouraged to eat bananas and apricot nectar, as these foods have high potassium content, which replenishes the patient's potassium levels after experiencing diarrhea.

What is the most common mode of transmission of human immunodeficiency virus (HIV)? 1. Injection drug use 2. Sexual transmission 3. Occupational exposure 4. Receiving blood or blood products

Sexual transmission. Sexual transmission remains the most common mode of HIV transmission in the world today and is responsible for the majority of the world's total acquired immune deficiency syndrome (AIDS) cases. Sexual activity provides the potential for exchange of semen, cervicovaginal secretions, and blood. Although the majority of HIV transmissions in the United States occur in men who have sex with me (MSM) via receptive anal intercourse, heterosexual transmission via anal intercourse is becoming increasingly prevalent. HIV transmission may occur by exposure to contaminated blood through the accidental or intentional sharing of injection equipment and paraphernalia. Such equipment includes syringes, needles, filters, and cooking devices. Injection drug users represent the second highest exposure category. In the United States, transfusion of infected blood and blood components and transplantation of infected tissues accounts for 1% of total adult and adolescent AIDS cases and 2% of pediatric AIDS cases. The risk of contracting HIV from a blood transfusion is estimated to be 1 in 400,000. In 1985, blood banks implemented procedures to screen all donated units of blood and blood products for HIV and to screen donors who might be at risk for HIV infection. As of December 2000, there had been 58 documented cases of occupationally acquired HIV or AIDS infection, with another 138 cases of possible occupational transmission (by the end of 2003, the total cumulative number of cases of AIDS in the United States was listed at 929,985). The overall risk of acquiring HIV after a percutaneous exposure is approximately 0.3%

The nurse is caring for a patient with human immunodeficiency virus (HIV). Which nursing interventions help prevent atelectasis? Select all that apply. 1. Include yogurt in the patient's diet. 2. Recommend daily showering or bathing. 3. Provide the patient with a protein-rich diet. 4. Teach the patient routine coughing exercises. 5. Encourage the patient to perform deep-breathing exercises.

Teach the patient routine coughing exercises. Encourage the patient to perform deep-breathing exercises. Atelectasis is defined as the collapse or closure of the lung, resulting in a reduced or absent gas exchange. This condition occurs in patients with HIV. Encouraging the patient to perform deep-breathing and coughing exercises to promote airway clearance can prevent atelectasis. The patient with dysphagia is encouraged to consume yogurt to promote good nutrition. Showering or using a basin bath on a daily basis is recommended to promote good patient hygiene, but does not prevent atelectasis. A protein-rich diet is recommended to increase immunity and provide strength to a patient; however, itis not particularly given to prevent atelectasis.

Which drug does the primary health care provider prescribe for a patient with human immunodeficiency virus (HIV)? 1. Dronabinol (Marinol) 2. Zidovudine (Retrovir) 3. Pravastatin (Pravachol) 4. Rosiglitazone (Avandia)

Zidovudine (Retrovir) Zidovudine (Retrovir) is used to treat HIV. Dronabinol (Marinol) is given to stimulate appetite in patients who have anorexia. Pravastatin (Pravachol) is an anticholesterol drug that is given to treat hyperlipidemia. Rosiglitazone (Avandia) is an oral hypoglycemic agent given to treat diabetes.

The nurse is educating a patient with human immunodeficiency virus (HIV) on methods to reduce the risk of infection transmission. What should the nurse include in the teaching? Select all that apply. 1. "You should not share a razor." 2. "You should use a condom for safe sex." 3. "You should never donate blood to others." 4. "You can donate liver or kidneys if required." 5. "You can donate semen for artificial insemination."

"You should not share a razor." "You should use a condom for safe sex." "You should never donate blood to others." Patients should be encouraged to use a condom in order to practice safe sex and avoid the transmission of HIV. Patients with HIV should be instructed to not donate blood. Patients with HIV should be instructed not to share razors, as razors may contain blood and could spread the disease. HIV-infected patients should be instructed not to donate organs or semen for artificial insemination, as they are routes for passing on the infection on to others.

A pregnant woman with human immunodeficiency virus (HIV) requests information on ways to prevent transmission of the virus to her baby. The nurse should respond with which information? 1. "Zidovudine (azidothymidine or AZT) therapy can reduce vertical transmission to 2%." 2. "Zidovudine (azidothymidine or AZT) therapy can eliminate vertical transmission of the virus." 3. "Zidovudine (azidothymidine or AZT) can be used after the first trimester to reduce vertical transmission." 4. "Although zidovudine (azidothymidine or AZT) therapy is effective at reducing viral transmission, it causes serious birth defects.

"Zidovudine (azidothymidine or AZT) therapy can reduce vertical transmission to 2%." Zidovudine (azidothymidine or AZT) therapy administered to the mother can reduce vertical transmission to 2% without causing serious defects in the baby. It does not eliminate the transmission, but it drastically decreases it.

The nurse is caring for a postpartum patient with human immunodeficiency virus (HIV). What should the nurse suggest to the patient to prevent the spread of infection to the newborn? 1. Avoid kissing the newborn. 2. Avoid hugging the newborn. 3. Avoid breastfeeding the newborn. 4. Avoid providing kangaroo care to the newborn.

Avoid breastfeeding the newborn. HIV is transmitted through blood, semen, cervicovaginal secretion, and breast milk. Therefore, to prevent the transmission of infection to the newborn, the nurse should suggest that the patient avoids breastfeeding the newborn. HIV does not spread through saliva, urine, or feces. Therefore, the nurse need not advise the patient to avoid kissing the newborn. HIV is not transmitted through skin-to-skin contact. Therefore, the nurse should not tell the patient to avoid hugging and providing kangaroo care to the newborn.

Which statement is true regarding pharmacologic therapy for human immunodeficiency virus (HIV)? 1. Combination drug therapy is now the standard of care. 2. Zidovudine (AZT) is the only medication approved to treat HIV disease. 3. Antiretroviral medications and prophylactic interventions have demonstrated limited success in treating opportunistic infections. 4. When a medication for treatment of HIV is prescribed to be taken three times a day, it is acceptable for the patient to be flexible with the schedule, as long as three doses are taken during waking hours.

Combination drug therapy is now the standard of care. Combination drug therapy is now the standard of care. A single dose (monotherapy) is no longer recommended because of the likelihood of the development of viral and therapeutic resistance. "Cocktails" are more effective than single-drug therapy. This is referred to as highly active antiretroviral therapy (HAART). A number of opportunistic diseases and debilitating problems associated with HIV can be delayed or prevented through the use of antiretroviral medications and prophylactic interventions. Prophylactic medications have contributed to the decreased morbidity and mortality associated with HIV infection during the past several years. A medication that is prescribed three times a day (tid) should be given as close to every 8 hours as possible, not three times while the patient is awake. When medications are not given regularly, the drug levels in the blood fall low enough to allow HIV to develop resistance. Zidovudine was the first drug approved to treat HIV but is no longer the only approved medication. Today there are 18 approved anti-HIV medications available, and many more are being developed and researched.

A nurse is providing education to a patient recently diagnosed with human immunodeficiency virus (HIV). Which instruction would the nurse include to help the patient delay the progress of the disease? 1. Conserve energy by avoiding exercise 2. Report any changes to the oral mucosa 3. Consume a diet that promotes lean muscle mass and an ideal body weight 4. Take double the recommended daily allowance of all vitamins and minerals

Consume a diet that promotes lean muscle mass and an ideal body weight. In general, the patient who has just learned that he or she is HIV positive still feels well, and education should focus on improving and maintaining the health of the immune system. The nurse should instruct the patient to consume a diet that will promote lean muscle mass and an ideal body weight. The patient should maintain a regular exercise regimen and consume the recommended daily allowance of vitamins and minerals. Although the patient should report any changes to the oral mucosa, this is not an intervention to slow the progress of the disease.

The nurse is caring for a patient with acquired immune deficiency syndrome (AIDS). What opportunistic fungal infection would the nurse expect to observe in this patient? 1. Tuberculosis 2. Toxoplasmosis 3. Histoplasmosis 4. Cryptosporidiosis

Histoplasmosis. Histoplasmosis is an opportunistic fungal infection that can be observed in a patient with AIDS. Tuberculosis is an opportunistic bacterial infection that can be observed in a patient with AIDS; it is caused by Mycobacterium tuberculosis. Toxoplasmosis and cryptosporidiosis are opportunistic protozoal infections that can be observed in a patient with AIDS.

A nurse is caring for a patient with advanced human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) who is experiencing wasting. The nurse anticipates the patient's body will exhibit which change? 1. Loss of muscle 2. Increase in fatty tissue 3. Decrease in bone density 4. Thinning of the dermis and epidermis

Loss of muscle. Wasting is the loss of lean muscle while fatty tissue is maintained. It is not an increase in fatty tissue, decrease in bone density, or thinning of the dermis and epidermis.

A pregnant patient learns she has human immunodeficiency virus (HIV) and asks the nurse if she can transmit the virus to her fetus. The nurse should base her response on an understanding of which mechanism of transmission? 1. Vertical transmission 2. Transient transmission 3. Incidental transmission 4. Accidental transmission

Vertical transmission. Vertical transmission is the transmission of the virus from the mother to the fetus. Horizontal transmission would be the transmission of the virus through sexual contact. Incidental and transient transmission do not exist.

The nurse is educating a male teenager about the prevention of human immunodeficiency virus (HIV).Which instructions given by the nurse would help promote safe sex? Select all that apply. 1. "Use oil-based lubricants when using condoms." 2. "Put on the condom as soon as erection occurs." 3. "Pull the condom snug against the tip of the penis." 4. "Limit the number of partners for sexual intercourse." 5. "Avoid sexual contact that involves the exchange of semen."

"Put on the condom as soon as erection occurs." "Limit the number of partners for sexual intercourse." "Avoid sexual contact that involves the exchange of semen." HIV is a sexually transmitted virus. To avoid contracting HIV, it is necessary to practice safe sex. This can be achieved by putting on the condom as soon as erection occurs. In order to prevent HIV, it is advised to limit the number of sexual partners, as well as avoid sexual contact that involves the exchange of semen. Not leaving space at the tip of the condom may cause the condom to break and increase the risk of HIV transmission. Water-based lubricants should be used for the condom.

What does the nurse teach a patient about condom use to prevent sexually transmitted diseases? 1. "Use only natural-membrane condoms." 2. "Do not use oil-based lubricants for lubrication." 3. "Do not leave any space at the tip of the condom." 4. "Unroll the condom and place it on the erect penis."

"Do not use oil-based lubricants for lubrication." The nurse should teach patients not to use oil-based lubricants, such as petroleum jelly, for lubrication, because they can damage the condom. Water-based lubricants are safe to use. Latex or polyurethane condoms should be used rather than natural-membrane condoms, because they are more durable. The condom must be unrolled onto the erect penis by holding the tip of the condom, and space should be left at the tip to collect the semen.

An occupational health nurse is providing education to an employee who has been exposed to human immunodeficiency virus (HIV) and will begin postexposure antiviral therapy. Which statement, if made by the employee, indicates a need for further teaching regarding healthy practices during postexposure antiviral therapy? 1. "I should be sure to drink plenty of fluids each day." 2. "I should eat a balanced diet and exercise regularly." 3. "I should practice universal precautions at all times." 4. "I should use only acetaminophen (Tylenol) for minor aches."

"I should use only acetaminophen (Tylenol) for minor aches." Postexposure antiviral therapy is hepatotoxic, so the employee should avoid medications such as Tylenol, which are also hepatotoxic. The patient would be correct to eat a balanced diet, exercise regularly, drink plenty of fluids, and practice universal precautions at all times.

The nurse is caring for a patient with human immunodeficiency virus (HIV) who is experiencing bouts of diarrhea. Which dietary instruction does the nurse give to the patient to prevent complications? Select all that apply. 1. Increase the intake of peas. 2. Increase the intake of bananas. 3. Increase the intake of dried beans. 4. Increase the intake of apricot nectar. 5. Increase the intake of margarine foods.

Increase the intake of bananas. Increase the intake of apricot nectar. Diarrhea causes loss of electrolytes in the body. Therefore, the nurse should instruct the patient to increase the intake of bananas and apricot nectar. Both are rich sources of potassium and help maintain potassium levels in the body. The nurse should not instruct the patient to increase the intake of peas, dried beans, and margarine foods because these foods worsen the symptoms of diarrhea.

A nurse who is caring for a patient with human immunodeficiency virus (HIV) is splashed in the face and eyes with blood while inserting an intravenous (IV) line. The nurse immediately notifies occupational health and is told that the risk for contracting HIV is what percentage? 1. 9% 2. 3% 3. 0.3% 4. 0.09%

0.09% An individual who has infected blood or secretions come in contact with his or her mucous membranes has a 0.09% chance of contracting HIV. An injury from a needle contaminated with HIV-positive blood leads to a 0.3% chance of contracting HIV. The values 3% and 9% are not associated with contracting HIV.

A patient with human immunodeficiency virus (HIV) comes to the clinic because of frequent pneumocystitis. The nurse suspects that the patient's CD4 cell count will be below which level? 1. 500/mm³ 2. 800/mm³ 3. 5000/mm³ 4. 10,000/mm³

500/mm³ When the patient's CD4 count falls below 500/mm³, the patient's immune system starts to fail and chronic infections are noted.

A patient with acquired immunodeficiency syndrome (AIDS) and wasting syndrome is experiencing chronic diarrhea. The nurse should order which meal for the patient's dinner? 1. Fried chicken tenders with macaroni and cheese and raw vegetables 2. Ham and cheese sandwich on whole-grain bread with fresh fruit salad 3. Grilled chicken breast, oven roasted potatoes, and canned green beans 4. Fettuccine Alfredo with chicken and whole-wheat pasta with a chef's salad

Grilled chicken breast, oven roasted potatoes, and canned green beans. The nurse should provide a lactose-free meal that is low in fat, low in fiber, and high in potassium. Grilled chicken breast, oven-roasted potatoes, and canned green beans are low in fiber, high in potassium, and without dairy products. Macaroni and cheese, fettuccine Alfredo, and the ham and cheese sandwich are high in fat and contain dairy products. Raw vegetables, fresh fruit, and whole-grain bread and pasta are high in fiber.

After observing the diagnostic reports of a patient infected with human immunodeficiency virus (HIV), the primary health care provider prescribes fluvastatin (Lescol). What reason does the nurse expect behind the prescription? 1. Increased glucose levels 2. Decreased protein levels 3. Increased cholesterol levels 4. Decreased triglyceride levels

Increased cholesterol levels. Fluvastatin (Lescol) is a statin drug prescribed to prevent cardiovascular disease in patients with HIV who have elevated cholesterol levels.Increased glucose levels may occur due to diabetes. Decreased protein or triglyceride levels may occur due to malnutrition. Fluvastatin (Lescol) is neither prescribed for increased glucose levels nor for decreased protein levels. It is also not prescribed for decreased levels of triglycerides.

A nurse works in a clinic that has a patient population composed largely of individuals with or at risk for human immunodeficiency virus (HIV). The nurse knows which characteristic of HIV promotes the transmission of the virus? 1. The virus affects the individual's ability to make sound decisions. 2. Many individuals do not experience symptoms of the disease for years. 3. Individuals with HIV are not contagious until they begin to experience symptoms. 4. The type of individuals with HIV are not concerned about preventing transmission.

Many individuals do not experience symptoms of the disease for years. HIV transmission is promoted by the fact that many individuals do not realize they have HIV because they do not experience symptoms. Although HIV can cause dementia in the late stages, it does not affect the individual's ability to make sound decisions. Individuals with HIV are contagious immediately. There is no certain "type" of individual with HIV.

A patient comes to the clinic with human immunodeficiency virus (HIV) seropositivity. The nurse understands that this patient has which manifestations? 1. Flulike symptoms 2. Weight loss, night sweats 3. Kaposi sarcoma, tuberculosis 4. Positive laboratory test result

Positive laboratory test result The patient with HIV seropositivity is infectious but shows no sign of disease. In the primary infectious period, flulike symptoms are present. Then the patient passes into the seropositivity stage. As the disease progresses the patient may experience weight loss, night sweats, and lymphadenopathy.

A nurse is caring for a patient with human immunodeficiency virus (HIV) who will begin highly active antiretroviral therapy (HAART). The nurse anticipates administering medications from which class(es)? Select all that apply. 1. Fusion inhibitor 2. Protease inhibitor 3. Integrase Inhibitor 4. Nucleotide reverse transcriptase inhibitor (NRTI) 5. Non-nucleoside reverse transcriptase inhibitor (NNRTI)

Protease inhibitor Nucleotide reverse transcriptase inhibitor (NRTI) Non-nucleoside reverse transcriptase inhibitor (NNRTI) HAART includes a protease inhibitor and two NNRTIs or NRTIs. Fusion inhibitors and integrase inhibitors are also medications used to treat HIV, but they are not included in HAART.

After observing the urine screening test reports of a patient, the primary health care provider (PHP) decides to perform another test to confirm the presence of human immunodeficiency virus (HIV). Which test would the nurse expect the PHP to prescribe for this patient? 1. Radioimmunoprecipitation assay (RIPA) 2. Agglutination assay of the blood specimen 3. Western blotting technique for antibodies 4. Oral fluid test (swabbing of the cheek and gum)

Radioimmunoprecipitation assay (RIPA) RIPA is the confirmatory test performed for the detection of antibodies in response to HIV in a patient. Agglutination assay of the blood specimen, Western blotting technique for antibodies, and oral fluid test (swabbing of the cheek and gum) are screening tests done for the presence of HIV, but are not confirmatory tests.

A nurse is providing education to a group of high school students about human immunodeficiency virus (HIV). The students would demonstrate an understanding of the modes of transmission by identifying which route(s)? Select all that apply. 1. Vaginal sex 2. Being sneezed on 3. Using the same toilet 4. From mother to fetus 5. Sharing eating utensils 6. Sharing needles and syringes

Vaginal sex From mother to fetus Sharing needles and syringes HIV is transmitted through blood, cervicovaginal secretions, and semen. It can be transmitted through vaginal sex, vertically from mother to fetus, and when needles and syringes are shared. HIV is not transmitted from a sneeze, use of the same toilet, or shared eating utensils.

According to the Centers for Disease Control and Prevention (CDC), in 2010 what percentage of men who have sex with men (MSM) accounted for the total number of human immunodeficiency virus (HIV) infections in males 13 years old and older? 1. 23% 2. 56% 3. 78% 4. 95%

78% In 2010 the CDC reported that MSM constitute the biggest proportion of human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) patients, accounting for 78% of the total number of HIV infections in males 13 years old and older. The category labeled as men who have sex with men still accounts for the largest number of individuals with HIV and AIDS.

A patient is considering antiretroviral therapy (ART) for human immunodeficiency virus (HIV). What is the most important consideration about the patient when the primary health care provider is making a treatment choice? 1. Ability of the patient to pay for therapy 2. Ability of the patient to adhere to therapy 3. Ability of the patient to tolerate the side effects of therapy 4. Incompatibilities of the ART therapy with drugs the patient already takes

Ability of the patient to adhere to therapy. The most important consideration for whether or not to begin ART therapy is whether or not the patient will adhere to the treatment plan. If not, treatment failure and drug resistant organisms occur. Although side effects of therapy and the patient's ability to pay for therapy are important, they are not the most important considerations. The patient's current prescriptions can be changed to accommodate ART therapy.

The primary health care provider (PHP) prescribes an iron supplement to a patient with human immunodeficiency virus (HIV) to treat anemia. The nurse advises the patient to drink orange juice while taking the iron supplement. What could be the reason for this advice? 1. To increase the immunity of the patient 2. To facilitate absorption of the iron supplement 3. To maintain the blood sugar level of the patient 4. To prevent side effects from the iron supplement

To facilitate absorption of the iron supplement. The patient has been prescribed an iron supplement to treat anemia. Orange juice facilitates the absorption of iron supplements, resulting in an increased absorption of iron in the body. Therefore, the nurse advises the patient to drink orange juice when taking the iron supplement. Orange juice does not have immunomodulator activity, so it does not increase the immunity of the patient. Orange juice does not interact with iron supplements, so it does not prevent the side effects of the iron supplements. Orange juice does not have any effect on insulin function, so it does not help maintain blood sugar levels.

A nurse is teaching a group in the community about the history of the human immunodeficiency virus (HIV). A student indicates an understanding of the virus by stating which route as its mode of transmission? 1. Using the same toilet as an infected individual. 2. Using the same toothbrush as an infected individual. 3. Drinking from the same straw as an infected individual. 4. Using the same hypodermic needle as an infected individual.

Using the same hypodermic needle as an infected individual. HIV is transmitted through infected blood, semen, vaginal secretions, and breast milk. Therefore the virus is transmitted when using the same hypodermic needle as an infected individual. Although HIV has been found in saliva, no evidence of transmission has occurred unless the saliva has visible blood. Therefore, using the same toilet, toothbrush, and straw as an infected individual does not lead to transmission.

What statement is most accurate concerning acquired immunodeficiency syndrome (AIDS)? 1. The median time from AIDS diagnosis to death, without treatment, is 5 years. 2. As HIV disease progresses, there are more T-helper cells (CD4+) than T-suppressor cells (CD8+). 3. AIDS is used to describe the end stage, or terminal phase, of human immunodeficiency virus (HIV) infection. 4. A patient with AIDS usually has a normal white blood cell (WBC) count and purified protein derivative (PPD) test result.

AIDS is used to describe the end stage, or terminal phase, of human immunodeficiency virus (HIV) infection. AIDS is used to describe the end stage, or terminal phase, of HIV infection. Earlier phases of the disease include early infection (sometimes called the asymptomatic phase) and early symptomatic disease, when the patient begins to have the symptoms of fevers, night sweats, diarrhea, headaches, fatigue, and persistent generalized lymphadenopathy (PGL). The median time from AIDS diagnosis to death, without treatment, is 1.3 years. With treatment, however, the life span is unpredictable, and the disease can resemble a chronic illness in some patients. The normal ratio of T-helper (CD4+) to T-suppressor (CD8+) cells is 2:1. As HIV disease progresses, there is a gradual shift in this ratio, whereby there are more T-suppressor cells (CD8+) than T-helper cells (CD4+), because of the reduction in the T-helper cells. A patient with AIDS often has a decrease in the number of white blood cells. The person's reactivity to skin tests, such as PPD tuberculin, is decreased or absent. An individual is said to be anergic if no skin response is noted.

A nurse is caring for a patient in the end stages of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). The nurse knows care planning is based on which concept? 1. Allowing family members to say goodbyes 2. Managing symptoms and improving quality of life 3. Helping the patient regain health and independence 4. Preventing complications and increasing the length of the patient's life

Managing symptoms and improving quality of life. In the end stages of HIV/AIDS, care planning is centered on managing the patient's symptoms and improving his or her quality of life. Finding a cure, regaining health and independence, and increasing the length of the patient's life are not the primary goals of care.

The nurse is caring for a patient with human immunodeficiency virus (HIV). Which findings suggest that the patient has early symptomatic disease? Select all that apply. 1. Recurrent infections 2. No reactivity to skin tests 3. CD4+ cell count of 400/mm3 4. Generalized lymphadenopathy 5. More CD4+ cells than CD8+ cells

Recurrent infections CD4+ cell count of 400/mm3 Generalized lymphadenopathy Early symptoms include recurrent infections and generalized lymphadenopathy due to compromised immunity. The early symptomatic phase of HIV occurs when the CD4+ cell count drops below 500/mm3. No reactivity to skin tests and the presence of more CD4+ cells than CD8+ cells indicate acquired immunodeficiency syndrome (AIDS).

Which statement is most accurate regarding diagnostic tests for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS)? 1. CD8+ cell monitoring is one of the laboratory parameters used to track the progression of HIV disease. 2. With HIV antibody testing, a seronegative test result indicates that the individual is free from HIV infection. 3. The ability to detect HIV viral load measurements in plasma is a significant advancement in the monitoring of HIV disease. 4. The enzyme-linked immunosorbent assay (ELISA) is considered to be more accurate than the Western blot for HIV antibody testing.

The ability to detect HIV viral load measurements in plasma is a significant advancement in the monitoring of HIV disease. Viral load or burden refers to a quantitative measure of HIV viral RNA in the peripheral circulation, or level of virus in the blood. The ability to detect HIV viral load measurements in plasma is a significant advancement in the monitoring of HIV disease. With HIV antibody testing, a seronegative test result does not indicate that the individual is free from HIV infection, because seroconversion may not yet have occurred. Transmission of the virus can still occur if the individual has HIV infection and engages in risky behaviors. The Western blot test is considered to be more accurate than the ELISA for HIV antibody testing. ELISA is the first test usually used to test for HIV; if the result is positive, the test is repeated. After a second positive ELISA result, Western blot is used to confirm the diagnosis, because this is a more specific confirming test. CD4+ cell monitoring is one of the laboratory parameters used to track the progression of HIV disease. As the disease progresses, there is a decrease in the number of CD4+ cells. The more significant the loss, the more severe immunosuppression becomes.

The primary health care provider prescribes a human immunodeficiency virus (HIV) diagnostic test for a patient. After observing the test results, the nurse suspects that the patient has an acute HIV infection. What findings in the report are consistent with the nurse's suspicion? 1. Decreased levels of CD4+cells 2. Decreased levels of neopterin 3. Decreased levels of cytotoxic T cells 4. Decreased levels of natural killer (NK) cells

Decreased levels of CD4+cells CD4+ cells are the major target of HIV. Progressive infection gradually destroys the available pool of CD4+ cells. So, the overall CD4+ cell count drops. Lower CD4+ cell counts leads to immunodeficiency in the patient. Increased levels of neopterin, cytotoxic T cells, and NK cells are observed in patients with HIV.

The nurse is caring for a male patient with human immunodeficiency virus (HIV). While checking the patient's body weight, the nurse finds that the body weight has decreased from 150 to 100 lb. What could be the reason behind this? 1. Decreased levels of activin 2. Decreased levels of neopterin 3. Decreased levels of testosterone 4. Decreased levels of cytotoxic T cells

Decreased levels of testosterone. Men with HIV have decreased levels of testosterone. Testosterone has two distinct biologic properties: virilizing activity (androgenic effect) and protein-building ability (anabolic effect). As testosterone is an anabolic hormone, a testosterone deficiency may cause a loss of body mass. Decreased levels of activin may not be observed in this patient. Increased levels of neopterin and cytotoxic T cells are observed in a patient with HIV.

Dysregulation and dysfunction of which cells contribute to the immune dysfunction in human immunodeficiency virus (HIV) disease? Select all that apply. 1. B cells 2. Platelets 3. Red cells 4. T-helper cells 5. CD4+ lymphocytes

T-helper cells CD4+ lymphocytes Immune dysfunction in HIV disease results primarily from dysregulation and dysfunction of the T-helper cells, also known as CD4+ lymphocytes. These cells are targeted because they have more CD4+ receptors on their surfaces than other cells. The CD4+ lymphocytes play a pivotal role in the ability of the immune system to recognize and defend against foreign invaders. CD4+ lymphocytes is another name for T-helper cells. The B cells actually function well during HIV infection. B cells make HIV-specific antibodies that are effective in reducing viral loads in the blood. Platelets and red cells do not contribute to the process.

A patient who recently learned she was infected with human immunodeficiency virus (HIV) demands that the nurse keep her status a secret. What is the best way for the nurse to respond? 1. "I promise I will keep your status a secret until you are ready to tell people." 2. "Your partners and your family deserve to know so they can protect themselves." 3. "You seem embarrassed. Why don't you want your partners and family to know?" 4. "Although I respect your need for privacy, I am required to share this information with my coworkers and with necessary health agencies."

"Although I respect your need for privacy, I am required to share this information with my coworkers and with necessary health agencies." The nurse should be honest about who will be told of the patient's HIV status while creating open lines of therapeutic communication. The nurse should not make promises he or she cannot keep. Telling the patient that her partners and family deserve to know is not therapeutic. The nurse should not presume the patient is embarrassed. Asking, "Why don't you want your partners and family to know?" does not create open lines of communication.

A nurse is assisting with the delivery of a baby born to a human immunodeficiency virus (HIV)-positive mother. The mother received zidovudine early in pregnancy and had good prenatal care. The nurse knows that which intervention should be employed to ensure the safety of the baby? 1. Initiating contact precautions until the baby's viral load is known 2. Bathing the baby before administering the routine vitamin K injection 3. Wearing gloves while handling the baby until the baby has been bathed 4. Inserting an intravenous (IV) line immediately to administer zidovudine within 2 hours of birth

Bathing the baby before administering the routine vitamin K injection. Because the mother received zidovudine early in pregnancy and had good prenatal care, it is possible that the virus has not yet been transmitted to the baby. The baby should be bathed well with soap and water before the skin is pierced to avoid introducing the virus into the baby's system. Gloves are always worn when caring for a baby before the baby is bathed for the first time; this protects the health care worker, not the baby. Contact precautions are not necessary for patients with HIV. Although zidovudine should be administered within 2 hours of birth, the baby should be bathed before an IV line is inserted.

The nurse knows which action is the correct way to prevent exposure to human immunodeficiency virus (HIV) while working in the health care industry? 1. Report all needle sticks to the occupational health department 2. Recap needles before disposing of them in appropriate receptacles 3. Employ universal precautions when coming in contact with all patients 4. Wear a gown, gloves, and mask when caring for a patient infected with HIV

Employ universal precautions when coming in contact with all patients. Universal precautions are designed to prevent the transmission of blood-borne diseases in the health care setting. It is not necessary to wear a gown, gloves, and mask when caring for a patient infected with HIV. Although one should report all accidental needle sticks to the occupational health department, this is not the most important action. Needles should never be recapped before disposal.

The nurse is caring for a patient with human immunodeficiency virus (HIV). Which nursing interventions help promote good oral hygiene? Select all that apply. 1. Provide a soft toothbrush to the patient. 2. Provide sodium bicarbonate mouth rinse. 3. Provide magnesium peroxide mouth rinse. 4. Provide abrasive toothpaste to the patient. 5. Provide nonabrasive toothpaste to the patient.

Provide a soft toothbrush to the patient. Provide sodium bicarbonate mouth rinse. Provide nonabrasive toothpaste to the patient. A patient with HIV needs meticulous oral care. The nurse should provide a soft toothbrush to the patient to avoid causing the gums to bleed. Sodium bicarbonate neutralizes acids produced during food intake and prevents microbial infections in the mouth. Therefore, the nurse should provide sodium bicarbonate mouth rinse to the patient to use before and after meals and at bedtime. Another way to promote good oral hygiene is to advise the patient to use nonabrasive toothpaste, which prevents bleeding gums. Magnesium peroxide mouth rinse is not advised for oral hygiene, and patients with HIV should avoid using abrasive toothpastes, as such toothpastes can cause bleeding gums.

The nurse is caring for a patient who is on postexposure prophylaxis (PEP) regimen for human immunodeficiency virus (HIV). What side effects should the nurse monitor in the patient? Select all that apply. 1. Onset of pancreatitis 2. Onset of kidney stones 3. Onset of hypoglycemia 4. Onset of hyperglycemia 5. Onset of bile duct stones

Onset of pancreatitis Onset of kidney stones Onset of hyperglycemia Antiretroviral PEP regimen might prevent or inhibit systemic infection. The use of PEP regimens has been associated with the onset of pancreatitis, kidney stones, and hyperglycemia as a side effect. Hypoglycemia and bile duct stones are not reported in patients who are on postexposure prophylaxis (PEP) regimen for HIV.

The nurse is caring for a patient with human immunodeficiency virus (HIV). Which findings suggest that the patient has early symptomatic disease? Select all that apply. 1. Recurrent infections 2. No reactivity to skin tests 3. CD4+ cell count of 400/mm3 4. Generalized lymphadenopathy

Recurrent infections CD4+ cell count of 400/mm3 Generalized lymphadenopathy Early symptoms include recurrent infections and generalized lymphadenopathy due to compromised immunity.The early symptomatic phase of HIV occurs when the CD4+ cell count drops below 500/mm3. No reactivity to skin tests and the presence of more CD4+ cells than CD8+ cells indicate acquired immunodeficiency syndrome (AIDS).

The nurse is educating the family members of a patient with human immunodeficiency virus (HIV) about the risk of HIV transmission. Which routes of HIV transmission does the nurse discuss with the family members? Select all that apply. 1. Handshake 2. Air or water 3. Sharing needles 4. Sexual intercourse 5. Saliva, tears, or sweat

Sharing needles. Sexual intercourse. Sharing needles with a patient who has HIV can spread the HIV, as the virus is transmitted through blood. HIV also spreads through unprotected sex with a patient who has HIV, so the use of condoms is recommended. HIV cannot reproduce outside the human body. Therefore, it cannot be transmitted while shaking hands. Similarly, breathing the same air and sharing water with someone with HIV will also not transmit the disease.

A group of nursing students are discussing the transmission of the human immune deficiency (HIV) virus. Which statement about the transmission of the human immune deficiency (HIV) virus indicates effective learning? 1. "HIV is not present in tears." 2. "HIV can be spread by mosquitoes and insects." 3. "HIV can be transmitted via the parenteral route." 4. "The highest concentrations of HIV are in blood and vaginal fluids."

"HIV can be transmitted via the parenteral route." HIV can be spread via parenteral routes, such as the sharing of needles contaminated with infected blood, or by receiving contaminated blood products. HIV has been found in body fluids, such as the tears of infected patients, but there is no evidence that it transmits through tears. HIV cannot be transmitted by mosquitoes or other insects. The highest concentrations of HIV are found in blood and semen. Though vaginal fluids also have HIV, concentrations are less than blood and semen.

Which statement most accurately describes transmission of human immunodeficiency virus (HIV)? 1. HIV transmission occurs as a result of sexual preferences. 2. HIV transmission can occur via sharing food and/or utensils. 3. HIV can be transmitted via inanimate objects, such as toilet seats or computer keyboards. 4. HIV is transmitted from human to human via infected blood, semen, cervicovaginal secretions, and breast milk.

HIV is transmitted from human to human via infected blood, semen, cervicovaginal secretions, and breast milk. HIV transmission is dependent on the presence of the virus, the infectiousness of the virus, the susceptibility of the uninfected host, and any conditions that may put the person at risk. HIV is transmitted from human to human via infected blood, semen, cervicovaginal secretions, and breast milk. If these infected fluids are introduced into an uninfected person, the potential for HIV transmission exists. HIV transmission occurs as a result of sexual practices, not sexual preferences. HIV is generally transmitted by behaviors and not by casual contacts, such as hugging, dry kissing, shaking hands, or sharing food and utensils. HIV is an obligate virus, meaning that it must have a host organism to survive. HIV does not survive very long outside the human body; therefore it cannot be transmitted via inanimate objects.

What is the least virulent form of the human immunodeficiency virus (HIV) in the early stages? 1. HIV-1 2. HIV-2 3. Lymphadenopathy-associated virus (LAV) 4. Human T-cell lymphotropic virus type III (HTLV-III)

HIV-2 HIV-2 appears to be a less virulent form of the HIV virus, found primarily in western Africa and countries with historical or commercial ties to that geographic area. One study in Africa showed that women affected with HIV-2 did not develop acquired immunodeficiency syndrome (AIDS) during the 5-year period after infection, compared with 33% of those infected with HIV-1. HIV-1 is the more virulent strain of the HIV virus. It is found worldwide but is most prevalent in the United States and Europe. Human T-cell lymphotropic virus type III is the former name for HIV-1, named by an American scientist in 1984. It was renamed in 1986 to human immunodeficiency virus by the International Committee on Taxonomy of Viruses. Lymphadenopathy-associated virus was named in 1983 by researchers in France; it was believed to be the agent responsible for AIDS.

An adult patient comes to the clinic with white patches in the mouth that are diagnosed as oral thrush (candidiasis). The nurse knows this patient should be tested for which disease? 1. Hepatitis C virus (HCV) 2. Herpes simplex virus (HSV) 3. Haemophilus influenzae type B (HIB) 4. Human immunodeficiency virus (HIV)

Human immunodeficiency virus (HIV). Oral thrush is not an infection that occurs in patients with healthy immune systems. The patient should be tested for HIV. Testing for HSV, HIB, and HCV is not necessary.

A patient with advanced acquired immune deficiency syndrome (AIDS) requests information from the nurse regarding palliative care options. The nurse should respond with which information about palliative care? 1. Palliative care can hasten death. 2. Palliative care is only for patients with cancer. 3. Palliative care can improve the patient's life expectancy. 4. Palliative care can improve the quality of the patient's remaining time.

Palliative care can improve the quality of the patient's remaining time. The goal of palliative care is to improve the quality of the patient's remaining life. Palliative care does not hasten death or improve the patient's life expectancy and is not only for patients with cancer.

A person reports of having unwanted sexual intercourse with a patient who has human immunodeficiency virus (HIV). Two days after the intercourse, the patient approaches the primary health care provider (PHP) for treatment. What does the nurse expect the PHP to prescribe? 1. A 21-day supply of antiretroviral therapy 2. A 24-day supply of antiretroviral therapy 3. A 25-day supply of antiretroviral therapy 4. A 28-day supply of antiretroviral therapy

A 28-day supply of antiretroviral therapy. When a person is exposed to body fluids from a patient with HIV during a high-risk activity less than 72 hours before seeking treatment, the exposed person should receive a 28-day supply of antiretroviral therapy. A 21-, 24-, or a 25-day supply of antiretroviral therapy is not advised for this person, as the supply would not be sufficient because the packages do not provide enough drugs to act against the HIV.

The nurse is collecting data from a Hispanic patient with acquired immune deficiency syndrome (AIDS). The nurse finds that the patient is originally a resident of Germany, but has immigrated to the United States for employment. What should the nurse do in such a situation? 1. Provide care in accordance with the patient's European heritage. 2. Suggest that the patient bring a copy of the passport during each visit. 3. Suggest that the patient return to the country of origin for treatment. 4. Provide the patient with information about local AIDS support groups.

Provide the patient with information about local AIDS support groups. The nurse should provide appropriate care and help the patient get the right treatment, irrespective of the patient's financial and residential status. The nurse should inform the patient about local AIDS support groups, as the patient needs emotional support. As the patient is a Hispanic, the nurse should provide culturally competent care according to the patient's cultural preferences. Rather than asking the patient to submit a copy of his or her passport for care and treatment, the nurse should check to see whether the patient has health insurance. The nurse should not suggest that the patient should go back to Germany, as that demonstrates unprofessional and unethical behavior. The patient can take AIDS treatment in any part of the world.

A nurse is caring for a female patient with the human immunodeficiency (HIV) virus infection. Which statement about HIV infection regarding female patients is most significant? 1. Mean survival time is longer in female patients than in men. 2. Intravenous drug use is the major risk factor for HIV infection in women. 3. Recurrent vaginal candidiasis may be the first sign of the virus in female patients. 4. Women are the slowest-growing group with HIV infection and acquired immune deficiency syndrome (AIDS).

Recurrent vaginal candidiasis may be the first sign of the virus in female patients. Gynecologic problems and recurrent vaginal candidiasis may be the first signs of HIV infection in women. The World Health Organization (WHO) reported in 2010 that sexual exposure is the major risk factor for HIV infection in women, not intravenous drug use. Mean survival time is shorter in female patients. This may be due to late diagnosis and social or economic factors, which reduce access to medical care. Women are the fastest-growing group with HIV infection and AIDS.

The nurse is caring for a patient with a human immune deficiency (HIV) viral infection who has been prescribed stavudine (Zerit). What action does the nurse perform when caring for the patient? 1. Check the patient's serum phosphate levels. 2. Ensure HLA B5701 allele testing is performed. 3. Administer the drug 30 minutes before meals. 4. Monitor for numbness and tingling in toes or feet.

Monitor for numbness and tingling in toes or feet. The nurse should check for numbness and tingling in the patient's toes or feet, as peripheral neuropathy is a common side effect of stavudine. Patients taking didanosine (Videx EC) are given the drug 30 minutes before meals, because gastric acid destroys the drug's activity. Patients taking tenofovir (Viread) are checked for serum phosphate levels, because hypophosphatemia is a common side effect of the drug. HLA B5701 allele testing is performed in patients taking abacavir (Ziagen); patients who have a specific variation of the B5701 gene allele are at high risk for hypersensitivity reactions.

What factor increases the probability of vertical transmission of a human immunodeficiency virus (HIV) infection? 1. The baby is born at term. 2. The mother's viral load is low. 3. The mother has good nutritional status. 4. The mother is in the initial stage of the HIV infection.

The mother is in the initial stage of the HIV infection. If the mother is in the initial stage of the HIV infection, there is an increased chance of vertical transmission of the infection, because the initial and later stages of infection are the times when more of the virus is circulating in the mother's blood and body fluids. If the mother's viral load is low, there is a lower chance of vertical transmission of an HIV infection (although this is only one of numerous factors). A low viral load means that less of the virus is circulating in the mother's blood and body fluids. If the baby is born at term, there is a lower chance of vertical transmission of an HIV infection (although this is only one of numerous factors). Extreme prematurity increases the baby's risk of contracting the virus during the actual delivery. If the mother has good nutritional status, there is a lower chance of vertical transmission of an HIV infection (although this is only one of numerous factors).

A nurse in the community is providing education to a group of individuals in a homeless shelter who use intravenous (IV) drugs. Which instruction would be most effective at reducing the group members' risk for contracting human immunodeficiency virus (HIV)? 1. Abstain from the use of IV drugs immediately 2. Never share needles and syringes with another person 3. Always use a new syringe and needle for each injection 4. Before each use, fill each syringe with bleach twice, then with water twice

Always use a new syringe and needle for each injection. The most effective technique is to instruct patients to use a new syringe each time they inject. Ideally, these individuals would abstain from IV drug use, always use a new syringe and needle, or never share syringes and needles with another person. A group of individuals in a homeless shelter who already use IV drugs are not likely to be able to quit without treatment or to afford their own needles and syringes. It is suggested that if they can't obtain these, then they can be instructed to, at the very least, properly clean each syringe and needle before each use. This is harm-reduction education, and it has not been shown to rid the syringes of infectious organisms.

The nurse recommends human immunodeficiency virus (HIV) testing for a patient. Which risk factors the nurse might have found in this patient? Select all that apply. 1. Engaging in anal intercourse 2. Working as a prostitute 2 years ago 3. Being in a monogamous relationship 4. Testing positive for a chlamydial infection 5. Sharing needles when using intravenous drugs

Engaging in anal intercourse Working as a prostitute 2 years ago Testing positive for a chlamydial infection Sharing needles when using intravenous drugs The HIV virus is transmitted through blood and body fluids, including semen and vaginal secretions. Patients who have high-risk behaviors should be tested for HIV. Patients with a history of prostitution have frequent exposure to semen and vaginal secretions. Patients with other sexually transmitted diseases, like chlamydia, are at higher risk for HIV infection. Since HIV is spread through blood and body fluids, sharing needles when injecting drugs also increase the patient's risk. Patients who engage in anal intercourse, whether male or female, are at high risk for contracting HIV. Patients in a monogamous relationship have only one sexual partner and are therefore at low risk of acquiring HIV.