HIV

What bodily fluid does not pose a transmission risk for HIV? A. Semen B. Breast milk C. Saliva D. Blood

C. Saliva

The nurse administers 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. Report the incident to the supervisor B. Call the lab to draw the nurse's blood C. Obtain counseling D. Fill out a risk management report

A. Report the incident to the supervisor 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.

The nurse practitioner who is monitoring the patient's progress of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is: A. Anorexia B. Chronic diarrhea C. Nausea and vomiting D. Oral candida

B. Chronic diarrhea Chronic diarrhea is believed to be 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 the chronic diarrhea. It can cause profound weight loss and severe fluid and electrolyte imbalances

Which type of pneumonia is common in patients with active HIV infection? A. Aspiration pneumonia B. Community-acquired pneumonia C. Hospital-acquired pneumonia D. Atypical pneumonia E. Interstitial pneumonia

B. Community-acquired pneumonia

Which condition is an early manifestation of HIV encephalopathy? A. Hyperreflexia B. Headache C. Vacant stare D. Hallucinations

B. Headache Early manifestations of HIV encephalopathy include headache, memory deficits, difficulty concentrating, progressive confusion, psychomotor slowing, apathy, and ataxia. Later stages include hyperreflexia, a vacant stare, and hallucinations.

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. A. Semen B. Urine C. Breast Milk D. Blood E. Vaginal Secretions

A, C, D, E 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

A client with acquired immune deficiency syndrome (AIDS) reports diarrhea after every meal. What is the nurse's best response? A. Avoid residue, lactose, fat, and caffeine B. Encourage large, high-fat meals C. Reduce Food intake D. Increase the intake of iron and zinc

A. Avoid residue, lactose, fat, and caffeine Diarrhea may subside when the client avoids residue, lactose, fat, and caffeine. Although eating may seem to cause diarrhea, the client must understand that limiting the intake of food to control diarrhea only exacerbates wasting. The client will tolerate a low-fat high-carbohydrate, soft or liquid diet better than large, high-fat meals. The client should be advised to avoid large doses of iron and zinc because they can impair the functioning of the immune system

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? A. Sharing the diagnosis with a support group B. Caring for a client who can kill other people C. Disclosure of the client's condition D. Caring for a client with an infectious terminal disease

C. Disclosure of the client's condition 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

Which is usually the most important consideration in the decision to initiate antiretroviral therapy? A. CD4+ counts B. HIV RNA C. Western blotting assay D. Enzyme-linked Immunosorbent Assay (ELISA)

A. CD4+ counts The most important consideration in decisions to initiate antiretroviral therapy is CD4+ counts.

Which of the following is an appropriate treatment regimen for an HIV-positive patient with tuberculosis? A. Rifampin, isoniazid, pyrazinamide ± ethambutol or streptomycin B. Rifampin, isoniazid ± pyrazinamide C. Rifampin, pyrazinamide ± streptomycin D. Rifampin and isoniazid E. Rifampin, isoniazid, and ethambutol

A. Rifampin, isoniazid, pyrazinamide ± ethambutol or streptomycin

Which of the following statements is TRUE about infants with HIV? A. They tend to have more rapidly progressing and more severe disease. B. Encephalopathy in untreated patients typically occurs around 4 years of age. C. They rarely present with opportunistic infections. D. It may be fatal in untreated patients by the age of 15. E. They rarely present with failure to thrive.

A. They tend to have more rapidly progressing and more severe disease.

A nurse is reviewing treatment options with parents of an infant born with severe combined immunodeficiency disease (SCID). The nurse recognizes that the parents understand the teaching based on which statement? A. "We can ask our family members to donate blood for stem cell harvesting." B. "The only treatment option is thymus gland transplantation." C. "We could have our 10-year-old daughter tested, as the ideal stem cell donor is a human leukocyte antigen-identical sibling." D. "Hematopoietic stem cell transplantation cannot be performed until the age of 5 years."

C. "We could have our 10-year-old daughter tested, as the ideal stem cell donor is a human leukocyte antigen-identical sibling." Treatment options for SCID include stem cell and bone marrow transplantation. Hematopoietic stem cell transplantation is the definitive therapy for SCID; the best outcome is achieved if the disease is recognized and treated early in life. The ideal donor is a human leukocyte antigen-identical sibling.

A client on antiretroviral drug therapy informs the nurse about sometimes forgetting to take the medication for a few days. What should the nurse inform the client can occur when the medications are not taken as prescribed? A. The funding for the medications will cease if the client is not taking the meds correctly B. The client is risking the development of drug resistance and drug failure C. The client will have to take the drugs intravenously to ensure compliance D. The client will have to take higher doses of the antiviral medication

B. The client is risking the development of drug resistance and drug failure 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. Funding will not cease for noncompliance. The medications are not all available in IV form. Taking a higher dose of the medication if missed does not resolve drug resistance

Which assessment finding(s) are likely to cause noncompliance with antiretroviral treatment? Select all that apply A. Active substance abuse B. Depression C. Past substance abuse D. Lack of social support

A, B, D Psychosocial barriers such as depression and other mental illnesses, neurocognitive impairment, low health literacy, low levels of social support, stressful life events, high levels of alcohol consumption and active substance use, homelessness, poverty, nondisclosure of HIV serostatus, denial, stigma, and inconsistent access to medications affect adherence to ART. Past substance abuse has not been implicated as a factor for noncompliance with antiretroviral treatment.

The nurse is caring for a client with an autoimmune disease. What is a characteristic of autoimmune disorders? A. Progressive tissue damage without any verifiable etiology B. Absence of a triggering event C. Profound fatigue with no identifiable cause D. Affects only older adults and infants less than 3 months

A. Progressive tissue damage without any verifiable etiology Diseases are considered autoimmune disorders and are characterized by unrelenting, progressive tissue damage without any verifiable etiology. In many autoimmune disorders, there tends to be a triggering event, such as an infection, trauma, or introduction of a drug that integrates itself into the membranes of the host's cells. Although older adults face a greater risk of developing autoimmune disorders, persons belonging to any age-group can be affected. Chronic fatigue syndrome is primarily characterized by profound fatigue with no identifiable cause, and this is not a characteristic of autoimmune disorders

Which term defines the balance between the amount of HIV in the body and the immune response? A. Viral set point B. Window period C. Primary infection stage D. Viral clearance rate

A. Viral set point The viral set point is the amount of virus in the body after the initial immune response subsides is referred to as the viral set point, which results in an equilibrium between HIV levels and the immune response that may be elicited. During the primary infection period, the window period occurs because 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.

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? A. Western blot assay B. OraSure test C. p24 antigen capture assay D. Nucleic acid sequence-based amplification

A. Western blot assay 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

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. Candidiasis C. Hairy leukoplakia D. Coccidioidomycosis

B. Candidiasis 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 opportunistic cancer. Hairy leukoplakia is also an indication of oral cancer. Coccidioidomycosis causes diarrhea in the immunosuppressed client

When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by which characteristic? A. Means of transmission B. HIV-1 is more prevalent than HIV-2 subtypes C. The fact that it is a mutated virus originally thought to be bovine in nature D. Cure rate

B. HIV-1 is more prevalent than HIV-2 subtypes 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

A client with HIV develops a onproductive cough, shortness of breath, a fever of 101 F and an O2 sat of 92%. What infection caused by Pneumocystis Jiroveci does the nurse know could occur with this client? A. Mycobacterium avium complex (MAC) B. Pneumocystis Pneumonia C. Tuberculosis D. Community-acquired pneumonia

B. Pneumocystis Pneumonia The most common life threatening infection in those living with acquired immune deficiency syndrome (AIDS) is Pneumocystis Pneumonia (PCP), cause by P. jiroveci. Without prophylactic therapy, most people infected with HIV will develop PCP. The clinical presentation of PCP in HIV infection is generally less acute than in people who are immunosuppressed as a result of other conditions. Clients with HIV infection initially develop nonspecific signs and symptoms, such as nonproductive cough, fever, chills, shortness of breath, dyspnea, and occasionally chest pain. Arterial oxygen concentrations in clients who are breathing room air may be mildly decreased, indicating minimal hypoxemia.

When administering intravenous immunoglobulin (IVIG), what is the most important action for the nurse to take? A. Administer the infusion at a rate of 5 to 10 mL per minute. B. Premedicate the client with acetaminophen and diphenhydramine 30 minutes before starting. C. Review the chart to obtain information about the client's height and weight. D. Assess the client for nausea, vomiting, and hematuria indicative of a severe reaction.

B. Premedicate the client with acetaminophen and diphenhydramine 30 minutes before starting When administering intravenous immunoglobulin (IVIG), the nurse should premedicate the client with acetaminophen and diphenhydramine 30 minutes before starting the infusion to prevent anaphylaxis and infuse IVIG at a rate of 3 mL/minute. The nurse needs to obtain the client's height and weight before treatment to verify that the dose is accurate. Checking the client's chart for height and weight would be inappropriate. The nurse also needs to assess the client for signs and symptoms of adverse effects, including flank and back pain, shaking chills, dyspnea, tightness in the chest, headache, fever, and local reactions at the infusion site. Complaints of a tickle or lump in the throat as the precursor to laryngospasm that precedes bronchospasm is a key warning sign of an anaphylactic reaction

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? A. Maintain the client in a supine or side-lying position B. Encourage client to ambulate frequently in the halls C. Assist with chest physiotherapy every 2-4 hours D. Limit fluid intake to 1.5 - 2 liters per day

C. Assist with chest physiotherapy every 2-4 hours The nurse should include interventions such as assisting with and/or performing chest physiotherapy every 2 - 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

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? A. Deficient knowledge related to the effects of the disease B. Risk for infection related to the immune system dysfunction C. Disturbed body image related to loss of fat in the face and arms D. Risk for impaired liver function related to drug therapy effects

C. Disturbed body image related to loss of fat in the face and arms 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.

Which blood test confirms the presence of antibodies to HIV? A. Erythrocyte sedimentation rate (ESR) B. P24 Antigen C. Reverse Transcriptase D. Enzyme-linked Immunosorbent Assay (ELISA)

D. Enzyme-linked Immunosorbent Assay (ELISA) ELISA and Western Blotting identify and confirm the presence of antibodies to HIV. ESR is an indicator of the presence of inflammation in the body. The p24 antigen test 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 double-stranded DNA

A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority? A. Bathing or hygiene self-care deficit B. Ineffective cerebral tissue perfusion C. Complicated grieving D. Risk for injury

D. Risk for injury In a client with AIDS, central nervous system (CNS) deterioration can lead to AIDS-related dementia. This type of dementia impairs cognition and judgment, placing the client at risk for injury. Although Bathing or hygiene self-care deficit and Complicated grieving may be relevant in AIDS, these diagnoses don't take precedence in a client with AIDS-related dementia. Because CNS deterioration results from infection, Ineffective cerebral tissue perfusion isn't applicable.

A client is scheduled to receive an intravenous immunoglobulin (IVIG) infusion. The client asks the nurse about the infusion's administration and its adverse effects. Which condition should the nurse instruct this client to report immediately? A. Mouth sores B. Sneezing C. Constipation D. Tickle in the throat

D. Tickle in the throat Continually assess the client for adverse reactions; be especially aware of complaints of a tickle or lump in the throat, which could be the precursor to laryngospasm that precedes bronchoconstriction

When does HIV become diagnosed as AIDS?

When the CD4+ T-cell count falls below 200 cells/mcl

HIV Prevention

Safe sex (condoms, abstinence),

Based on the nurse's base knowledge of primary immunodeficiencies, how would the nurse complete this statement? Primary immunodeficiencies: A. Develop early in life after protection from maternal antibodies decreases. B. occur most commonly in the aged population. C. Develop as a result of treatment with antineoplastic agents. D. disappear with age.

A. Develop early in life after protection from maternal antibodies decreases. These disorders may involve one or more components of the immune system. Primary immunodeficiencies are seen primarily in infants and young children. Primary immunodeficiencies are rare disorders with genetic origins. Without treatment, infants and children with these disorders seldom survive to adulthood.

A client with severe combined immunodeficiency is to receive a hematopoietic stem cell transplant. What would the nurse expect to be started? A. Antibiotic therapy B. Immunosuppressive agents C. Chest physiotherapy D. Anticoagulation

B. Immunosuppressive agents For a client undergoing a hematopoietic stem cell transplant, immunosuppression is started to ensure engraftment of depleted bone marrow. Antibiotic therapy may or may not be indicated. Chest physiotherapy would be appropriate for clients with ataxia-telangiectasis who have chronic lung disease. Anticoagulation would not be used.

A client receiving antiretroviral therapy reports "not urinating enough." What is the nurse's best action? A. Encourage the client to drink more fluids. B. Administer fluids 100 mL/hour IV. C. Assess blood urea nitrogen and creatinine. D. Assess liver function tests.

C. Assess blood urea nitrogen and creatinine. Adverse effects associated with antiretroviral therapy include potential nephrotoxicity. Assessing blood urea nitrogen and creatinine for clients who have decreased urination is appropriate. The other answers will not assist the nurse in determining the client's problem, which should be assessed before intervention are administered.

Which of the following is the most common HIV-related malignancy? A. Kaposi's Sarcoma B. B-cell Lymphoma C. Cervical Carinoma D. Pancreatic Carinoma

A. Kaposi's Sarcoma Kaposi's sarcoma is the most common HIV-related malignancy and involves the endothelial layer of blood and lymphatic vessels. Kaposi's sarcoma, certain types of B-cell lymphomas, and invasive cervical carcinoma are included in the CDC classification of AIDS-related malignancies

What type of cell does HIV take over? A. Memory T cells B. CD4 T cells C. NK T cells D. CD8 T cells

B. CD4 T cells

What is the most common glomerular disease in HIV? A. Membranous glomerulonephritis B. Minimal change disease C. Focal segmental glomerulosclerosis D. Diffuse proliferative glomerulonephritis E. Membranoproliferative glomerulonephritis

C. Focal segmental glomerulosclerosis

A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find? A. Urine specific gravity of 1.010 B. Hypernatremia C. Hypokalemia D. Proteinuria

C. Hypokalemia 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

The most common infection in persons with AIDS (80% occurrence) is: A. Cytomegalovirus B. Legionnaire's disease C. Mycobacterium tuberculosis D. Pneumocystis pneumonia

D. Pneumocystis pneumonia Pneumocystis pneumonia can affect 80% of all people infected with HIV

Western Blot Test

Identified HIV in blood and urine

HIV Pathophysiology

- HIV attaches to cells with CD4+ (primarily Helper T Cells) via Glycoprotein (GP)120, - Hijacks the cell via the nucleus, causing it to replicate the HIV

A nurse is preparing to give a client an infusion of gamma globulin. The nurse knows to stop the infusion if the client experiences which symptoms? Select all that apply. A. Flank pain B. Shaking chills C. Tightness in the chest D. Hunger E. Fatigue

A, B, C Adverse reactions can include reports of flank and back pain, shaking chills, dyspnea, and tightness in the chest, as well as headache, fever, and local reaction at the infusion site.

Which of the following is NOT a class of drugs used in the treatment of HIV? A. Helicase inhibitors B. Nucleoside reverse transcriptase inhibitors C. Non-nucleoside reverse transcriptase inhibitors D. Protease inhibitors E. Fusion inhibitors

A. Helicase inhibitors

What is the approximate transmission rate of HIV in healthcare professional with percutaneous exposure? A. 1 in 3 B. 1 in 300 C. 1 in 3,000 D. 1 in 10 E. 1 in 100

B. 1 in 300

What type of HIV medication is Ritonavir? A. Binding and fusion B. Assembly, building, and maturation C. Replication D. Conversion and integration

B. Assembly, building, and maturation

A nurse is preparing an in-service presentation about primary immunodeficiencies. When describing these conditions, what would the nurse need to integrate into the presentation? A. Overall, these conditions more commonly affect females. B. Most cases are typically diagnosed in infancy. C. The conditions appear to predominate in males after adolescence. D. Primary immunodeficiencies are more common than secondary immunodeficiencies

B. Most cases are typically diagnosed in infancy. Most primary immunodeficiencies are diagnosed in infancy, with a male-to-female ratio of 5 to 1. A large fraction of primary immunodeficiencies are not diagnosed until adolescence or early adulthood when the gender distribution equalizes. Secondary immunodeficiencies are more common than primary immunodeficiencies

Which of the following populations has an increased risk of developing Burkitt lymphoma? A. Patients of low socioeconomic status B. Patients with HIV C. Health care professionals D. Coal miners E. Industrial workers

B. Patients with HIV

When preparing a client with acquired immunodeficiency syndrome (AIDS) for discharge to home, the nurse should be sure to include which instruction? A. "Put on disposable gloves before bathing." B. "Sterilize all plates and utensils in boiling water." C. "Avoid sharing such articles as toothbrushes and razors." D. "Avoid eating foods from serving dishes shared by other family members."

C. "Avoid sharing such articles as toothbrushes and razors." The human immunodeficiency virus (HIV), which causes AIDS, is most concentrated in the blood. For this reason, the client shouldn't share personal articles that may be blood-contaminated, such as toothbrushes and razors, with other family members. HIV isn't transmitted by bathing or by eating from plates, utensils, or serving dishes used by a person with AIDS

Which part of a cell does HIV use to replicate itself? A. rRNA B. tRNA C. DNA D. mRNA

C. DNA

Which type of HIV drug is Enfuvirtide? A. Protease inhibitor B. Non-nucleoside reverse transcriptase inhibitor C. Infusion inhibitor D. Integrase strand transfer inhibitor E. Nucleoside reverse transcriptase inhibitor

C. Infusion inhibitor

Which characteristic has NOT been implicated as a factor for noncompliance with antiretroviral treatment? A. Active substance abuse B. Depression C. Past substance abuse D. Lack of social support

C. Past substance abuse Factors associated with nonadherence include active substance abuse, depression, and lack of social support, as well as neurocognitive impairment, low health literacy, stressful life events, high levels of alcohol consumption, homelessness, poverty, nondisclosure of HIV serostatus, denial, stigma, and inconsistent access to medications. Past substance abuse has not been implicated as a factor for noncompliance with antiretroviral treatment

A widely used laboratory test that measures HIV-RNA levels and tracks the body's response to HIV infection is the: A. CD4/CD8 ratio B. EIA test C. Viral load test D. Western blot.

C. Viral Load Test Viral load test measures plasma RNA levels. CD4/CD8 ratio measures the number of CD4 T cells in the body. EIA test identifies antibodies directed specifically against HIV. Western blot is used to confirm seropositivity when the EIA result is positive.

A client who is HIV positive is successfully treated for a stage 3 opportunistic illness. In which way will the client's care change when the CD4+T-lymphocyte count is 1500 cells/L? A. Care is at a stage 0 because the illness is undetectable B. Care can return to be for stage 1 of the disease C. Care is limited to stage 2 of the disease D. Care remains at the stage 3 of the disease

D. Care remains at the stage 3 of the disease HIV disease progression is classified from less to more severe; once a case is classified into a surveillance severity stage, it cannot be reclassified into a less severe stage even if the CD4+T-lymphocytes increase. Therefore, the client may have a CD4+ T-lymphocyte count of stage 1 disease, staging will remain at level 3. The client will not be restaged at levels 0, 1, 2

Enzyme-Linked Immunosorbent Assay (ELISA)

Serum antibody test to detect HIV Requires confirmation of a Western Blot Test to confirm a positive test

Primary Infection (Acute/Recent HIV infection)

The period between HIV infection and the development of HIV antibodies

The nurse is preparing a teaching plan for a client with an immunodeficiency. What aspect would the nurse emphasize as most important? A. Frequent and thorough handwashing B. Identifying the signs and symptoms of infection C. Adherence to prophylactic medication administration D. Incorporation of treatment regimens into daily patterns

A. Frequent and thorough handwashing Although identifying the signs and symptoms of infection, adherence to medication prophylaxis, and incorporation of treatment regimens into daily patterns are important, the most important aspect is frequent and thorough handwashing to prevent infection. If infection is prevented, signs and symptoms will not develop and medications would not necessarily be needed

What are the potential adverse effects of taking an HIV fusion inhibitor? Select all that apply. A. Injection site reactions B. Higher risk of pneumonia C. Hypersensitivity reactions inhibitor D. Myopathy E. Hematologic toxicity

A. Injection site reactions B. Higher risk of pneumonia C. Hypersensitivity reactions inhibitor

Which type of HIV drug is Zidovudine? A. Nucleoside reverse transcriptase inhibitor B. Non-nucleoside reverse transcriptase inhibitor C. Integrase strand transfer inhibitor D. Protease inhibitor

A. Nucleoside reverse transcriptase inhibitor

What can help prevent transmission of HIV? Select all that apply. A. Precautions during pregnancy B. External (male) condoms C. Internal (female) condoms D. Not sharing food utensils E. Taking HIV treatment drugs

A. Precautions during pregnancy B. External (male) condoms C. Internal (female) condoms E. Taking HIV treatment drugs

A client at the walk-in clinic reports exposure to human immunodeficiency virus (HIV). The client wants to know the precise sources through which the HIV infection is transmitted. What is the nurse's best response? A. Sweat B. Saliva C. Urine D. Semen

D. Semen The known body fluids through which HIV is transmitted are blood, semen, vaginal secretions, amniotic fluid, and breast milk. HIV may be present in saliva, tears, and conjunctival secretions, but the transmission of HIV through these fluids has not been implicated. HIV is not found in urine, stool, vomit, or sweat.

What treatment option does the nurse anticipate for the patient with severe combined immunodeficiency disease (SCID)? A. Bone Marrow Transplantation B. Antibiotics C. Radiation therapy D. Removal of the thymus gland

A. Bone Marrow Transplantation Treatment options for SCID include stem cell and bone marrow transplantation

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? A. Trimethoprim-sulfamethoxazole B. Nystatin C. Amphotericin B D. Fluconazole

A. Trimethoprim-sulfamethoxazole To prevent and treat Pneumocystis pneumonia, trimethoprim-sulfamethoxazole (Bactrim, Septra) is prescribed. The other medications are antifungals and used to treat candidiasis.

A diagnosis of wasting syndrome can be initially made when involuntary weight loss exceeds what percentage of baseline body weight? A. 10% B. 15% C. 20% D. 25%

C. 20% Wasting syndrome occurs when there is profound involuntary weight loss exceeding 10% of the baseline body weight

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. Diarrhea B. Hearing impairment C. Blindness D. Fatigue

C. Blindness Cytomegalovirus (CMV) can infect the choroid and retinal layers of the eye, leading to blindness. It does not lead to hearing impairment. Fatigue and diarrhea may occur but are not as critical as blindness.

A client taking Fosamprenavir reports "getting fat." What is the nurse's best action? A. Have the client increase exercise. B. Assess the client's diet. C. Teach the client about medication side effects. D. Arrange for a psychological counseling.

C. Teach the client about medication side effects. The client needs to be aware of the potential for fat redistribution. Exercise, diet, and counseling will not change the outcome of this side effect

The nurse is admitting a client to the unit with a diagnosis of ataxia-telangiectasia. The nurse would recognize that the client is exhibiting telangiectasia when assessing the presence of what? A. Peripheral edema B. Uncoordinated muscle movement C. Vascular lesions caused by dilated blood vessels D. A condition marked by development of urticaria

C. Vascular lesions caused by dilated blood vessels Telangiectasia is the term that refers to vascular lesions caused by dilated blood vessels. Ataxia refers to uncoordinated muscle movement and is a clinical manifestation of combined B-cell and T-cell deficiencies. Telangiectasia is not peripheral edema, vascular lesions, or urticaria

The nurse is teaching the client who has an immunodeficiency disorder how to avoid infection at home. Which statement indicates that additional teaching is needed? A. "I will wash my hands whenever I get home from work." B. "I will make sure to have my own toothbrush and tube of toothpaste at home." C. "I will avoid contact with people who are sick or who have recently been vaccinated." D. "I will be sure to eat lots of fresh fruits and vegetables every day."

D. "I will be sure to eat lots of fresh fruits and vegetables every day." The client should avoid eating raw fruits and vegetables. All foods should be cooked thoroughly and all leftover food should be refrigerated immediately to prevent infection.

Abnormal laboratory findings seen with AIDS include: A. Decreased CD4 and T cell count B. P24 antigen C. Positive EIA test D. All of the above

D. All of the above All of the answers are seen in AIDs patients. Decreased CD4 and T cell count can be seen in an AIDS patient, P24 antigen is seen in an AIDS patient, and positive EIA test is seen in an AIDS patient.

The client has discussed therapy for his HIV-Positive status. What does the nurse understand is the goal for antiretroviral therapy? A. Reverse the HIV+ status to a negative status B. Treat mycobacterium avium complex C. Eliminate the risk of AIDS D. Bring down the viral load to a virtually undetectable level

D. Bring down the viral load to a virtually undetectable level The goal of antiretroviral therapy is to bring the viral load to a virtually undetectable level. This level is no more than 500 to 50 copies, depending on the sensitivity of the selected viral load test. It is not possible to reverse the status to a negative, and it cannot eliminate the risk of AIDS but can help with prolonging the asymptomatic stage of HIV. Antiretroviral therapy does not treat mycobacterium avium complex

The home health nurse is assessing a client who is immunosuppressed. What is the most essential teaching for this client and the family? A. How to promote immune function through nutrition B. The importance of maintaining the client's vaccination status C. How to choose antibiotics based on the client's symptoms D. The need to report any slight changes in the client's health status

D. The need to report any slight changes in the client's health status They must be informed of the need for continuous monitoring for subtle changes in the client's physical health status and of the importance of seeking immediate health care if changes are detected. Nutrition is important, but infection control is the priority. Clients and families do not choose antibiotics independently. Vaccinations are often contraindicated in immunocompromised clients.

What is the most common tumor of the brain associated with HIV? A. Germ cell tumors B. Sellar region tumors C. Neuroepithelial tumors D. Meningeal tumors E. Primary CNS lymphoma

E. Primary CNS lymphoma

The most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is: A. Anorexia B. Chronic Diarrhea C. Nausea D. Vomiting

B: Chronic diarrhea occurs in up to 90% of patients with AIDS. Anorexia, nausea, and vomiting are not as incapacitating as chronic diarrhea.

Which assessment finding would the nurse expect to document for a client with ataxia-telangiectasis? A. Thrombocytopenia B. Eczema C. Thrush D. Vascular lesions

D. Vascular lesions Ataxia-telangiectasis is characterized by loss of muscle coordination and vascular lesions. Thrombocytopenia and eczema are associated with Wiskott-Aldrich syndrome. Thrush is a manifestation associated with severe combined immunodeficiency (SCID)