Quiz 16: Withdrawal & HIV/AIDS
A nursing student sustains a needlestick from a hollow-bore needle while attempting to establish a peripheral IV catheter. What should the student do first?
Throuroughly scrub and flush the puncture site
What is the best rationale for the nurse to be familiar with the HIV infectious viral particle process?
To educate HIV patients about the importance of adhering to a medication schedule
The patient with HIV has pain and burning along sensory nerve tracts, and the nurse observes fluid-filled blisters with crusts. Which question is the nurse most likely to ask to assist the health care provider in making the diagnosis of shingles caused by the varicella zoster virus?
"Did you have chickenpox during childhood?"
A young male has just been diagnosed as HIV positive. He tells the nurse that he suspects contracting the virus from a female several weeks ago and that he had sex with his girlfriend several days ago. What is the nurse's best response?
"Even in the early phase, it is possible to pass the HIV virus; both women should be notified"
The health care provider prescribed an integrase inhibitor drug for the patient with HIV. The patient asks the nurse how this drug works. What is the nurse's best response?
"It prevents viral DNA from integrating into your DNA"
The nurse is teaching a group of college students about preventing HIV infection through sexual contact. Which statement made by one of the students indicates effective teaching?
"Mutually monogamous sex with a noninfected partner is the best method to prevent HIV infection"
The HIV positive patient tells the nurse that his HIV positive negative partner will be using preexposure prophylaxis emtricitab. Which statement indicates to the nurse the need for additional teaching about this drug?
"Once we start using emtricitab I will no longer need to use a condom"
A nurse is planning to provide discharge teaching to the family of a client with AIDS. Which statement should the nurse include in the teaching plan?
"Wash used dishes in hot, soapy water"
The UAP comes to the nurse crying and upset because "Some of the patient's spit got on my arm when I was helping him with oral hygiene, and he is HIV positive." What is the nurse's best response?
"Wash your arm; saliva is not infectious with HIV unless it is bloody"
A patient comes into the walk-in clinic and tells the nurse that he would like to be admitted to an alcohol rehabilitation program. Which question is the most important to ask?
"When was the last time you had a drink?"
A client asks the nurse, "Should I tell my partner that I just found out I'm HIV positive?" What is the nurse's most appropriate response?
"You are having difficulty deciding what to say"
Rank the safety of sexual practices, with 1 being the safest practice and 6 being the least safe
1. Abstinence 2. Monogamy 3. Mutual masturbation with latex gloves 4. Vaginal sex with male condom use 5. Oral sex without condom 6. Unprotected anal sex
Which person should be advised to have periodic screening for HIV?
A 23-year-old man who plans to enjoy serial monogamy for a few years
A client with a history of alcohol abuse says to the nurse, "Drinking is a way out of my depression." Which strategy probably is most effective for the client at this time?
A self-help group
The patient with HIV/AIDS appears emaciated and has diarrhea, anorexia, mouth lesions, and persistent weight loss. What condition does the nurse suspect this patient is developing?
AIDS wasting syndrome
Al though there is a wide range of time from the beginning of HIV infection to the development of AIDS, which patient is most likely to develop AIDS very quickly?
Adult male who is transfused with HIV-contaminated blood
The patient with HIV/AIDS develops manifestations of TB. What type of precautions does the nurse institute at this time?
Airborne precautions
A client who was in an automobile collision is admitted to the hospital with multiple injuries. Approximately 14 hours after admission, the client begins to experience signs and symptoms of withdrawal from alcohol. Which of these signs and symptoms should the nurse relate to alcohol withdrawal? SATA
Anxiety Diaphoresis Psychomotor agitation
The nurse is caring for a patient with AIDS who has been admitted for treatment of exacerbation of cryptosporidiosis. What is the priority assessment for this patient?
Assess for signs of dehydration and monitor electrolytes
A nurse discusses the philosophy of Alcoholics Anonymous (AA) with the client who has a history of alcoholism. What need must self-help groups such as AA meet to be successful?
Belonging
A pregnant women who is HIV positive arrives at the labor and delivery unit in active labor. The patient tells the nurse that she has been consistently taking her antiretroviral therapy but did not have access to prenatal care. Which situation is the labor and delivery team most likely to prepare for?
Birth of a premature infant who is likely to have a low birth weightq
Which lab results are expected to decrease in a patient who has untreated HIV/AIDS? SATA
CD4+ WBC Lymphocytes
The nurse has identified a patient who may be a candidate for substance addiction treatment. Which health care team member should the nurse contact to increase the likelihood of a successful long-term outcome?
Call a social worker who can locate an immediately available treatment program
The nurse reads in the chart that the patient has Candida stomatitis. Which concept is the nurse most likely to consider in planning interventions for this patient?
Comfort
A patient who has HIV/AIDS and TB was recently started on the cART regimen. The TB symptoms worsen and the nurse informs the health care provider, who makes the diagnosis of IRIS. Which therapy is the provider most likely to order to treat IRIS?
Corticosteroids
The health care provider tells the nurse that the patient is considered Stage 1 according to the CDC case definition for HIV disease. What would the nurse expect to find when assessing the patient?
No s/s of AIDS-defining illness
Which age-related change increases the likelihood that the older adult will develop the infection after an HIV exposure?
Decline in the overall efficiency of the immune system
A patient is diagnosed with pneumocystis jiroveci pneumonia. Which s/s does the nurse expect to find when assessing the patient?
Dyspnea, tachypnea, persistent dry cough, and fever
What is the most important means of preventing HIV spread or transmission?
Education
The patient with HIV/AIDS tells the nurse that food tastes funny and it is difficult to swallow. What is the nurse's priority action at this time?
Examine mouth and throat for white plaques or inflammation
A patient is an IV drug user who regularly shares needles and syringes with friends. What information does the nurse provide to decrease the patient's risk of HIV through shared needles and syringes after each use?
Fill and flush needle and syringe with water, then fill syringe with bleach, shake approximately 30-60 seconds, and rinse with water
What is the most common route for health care providers to be exposed to the HIV virus?
Getting stuck with a contaminated needle
A nurse is caring for a client with a diagnosis of AIDS. The IV infiltrates and needs to be restarted. What is necessary to protect the nurse when restarting the IV? SATA
Gloves Hand hygiene
A client who abused intravenous drugs was diagnosed with HIV several years ago. The nurse explains that the diagnostic criterion for AIDS has been met when the client:
Has a CD4+ T lymphocyte level of less than 220 cells/mL
Which statements about the transmission of HIV are true? SATA
Those with recent HIV infection and high viral load are very infectious Those with end-stage HIV and no drug therapy are very infectious An undetectable viral load requires greater or multiple exposures
A mother with the diagnosis of AIDS states that she has been caring for her baby even though she has not been feeling well. What important information should the nurse determine?
If the baby is breastfeeding
During an AIDS education class a client states, "Vaseline works great when I use condoms." Which conclusion about the client's knowledge of condom use can the nurse draw from this statement?
Ignorance related to correct condom use
A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism. The client asks, "What does my drinking have to do with my diagnosis?" What effect of alcohol should the nurse include when responding?
Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas
A nurse is caring for a client who is HIV positive. For which complication associated with this diagnosis is it most important for the nurse to teach prevention strategies?
Infection
The patient with AIDS comes to the emergency department and reports a cough, dyspnea, chest pain, fever, chills, night sweats, weight loss, and anorexia. He tells the nurse that he recently had a TB skin test, which was negative. What should the nurse do first?
Initiate airborne precautions and assess respiratory status
The patient reports numbness or tingling on the lip that occurred 24 hours ago, and now there is a painful lesion. Which action is the nurse most likely to take?
Instruct caregiver to wear gloves during oral hygiene because of suspected herpes simplex virus
Which malignancy is most common in patients with HIV/AIDS?
Kaposi's sarcoma
A client is admitted to the hospital with a diagnosis of alcohol withdrawal syndrome. What body organ should the nurse teach the client will be protected by the ingestions of a high-calorie diet fortified with vitamins?
Liver
The patient tells the nurse that he drinks 3 or 4 servings of alcohol every day. He also reports frequently taking acetaminophen for stress-related headaches. Based on this information, which laboratory results are the most important to follow up on?
Liver function tests
The HIV positive patient is receiving cART therapy drugs. Why is it essential that the drugs be taken every day at the same time?
Missing or delaying doses decreases the blood concentration needed to inhibit viral replication
A nurse assesses a client recently admitted to an alcohol-detoxification unit. What common clinical manifestation should the nurse expect during the initial stage of alcohol detoxification?
Nausea
Thiamine (vitamin B1) and niacin (vitamin B3) are prescribed for a client with alcoholism. Which body function maintained by these vitamins should the nurse include in a teaching plan?
Neuronal activity
Which nursing actions can the nurse delegate to UAP who will be giving mouth care to a patient with HIV/AIDS? SATA
Offer the patient mouth rinses with sodium bicarbonate and sterile water several times a day Encourage the patient to drink plenty of fluids Assist the patient to brush teeth with a soft toothbrush
Based on the concept of Treatment as Prevention, which outcome statement indicates that the goal of cART therapy is being met?
Patient's viral load is at an undetectable level
The nurse hears in shift report that the patient has toxoplasmosis encephalitis. The nurse is most likely to perform which types of focused assessments?
Performs a mental status exam and assess for headache
Which groups are experiencing increased numbers of new HIV infections in the US and Canada?
Persons of color: African and Hispanic
A patient who is HIV positive has been taking combination antiretroviral therapy (cART) for several years. Today the nurse sees that test results now show a CD4+ T-cell count of less than 200 cells/mm. Which intervention is the nurse most likely to perform?
Provide emotional support when patient is informed about AIDS diagnosis
Nurse B frequently asks to be assigned to care for patients who require opioids for pain; drug counts involving Nurse B frequently show discrepancies. Nurse A suspects that Nurse B may have a substance abuse problem. Based on the ethical principles of negligence, what should Nurse A do first?
Report facts to the nursing supervisor to include date, time, circumstance, and behaviors
The nurse is assessing a patient whose lifestyle creates a high risk for HIV/AIDS. Which assessment is the nurse most likely to perform to differentiate HIV from AIDS?
S/s of opportunistic infections
The home health nurse is assisting a family member who lives with and cares for a member who is HIV positive. Which item would the nurse instruct the family not to share in order to decrease the risk of accidental exposure to HIV?
Safety razor
HIV is most commonly transmitted by which routes? SATA
Sexual Parenteral Perinatal
A client is recovering from an acute episode of alcoholism that included esophageal involvement. What are the components of a therapeutic diet that are most appropriate for the nurse to include in the teaching plan for this client? SATA
Soft diet High-protein diet High-carbohydrate diet
Which person is displaying behaviors that most strongly suggest the need for additional screening for possible substance abuse?
Stay-at-home mom reports drinking while her kids are in school and after they go to bed
Which practices are generally recommended to prevent sexual transmission of HIV? SATA
Use of a latex or polyurethane condoms for genital and anal intercourse Use of an appropriate water-based lubricant with a latex condom Use of a latex barrier for genital and anal intercourse Use of latex gloves for finger or hand contact with the vagina or rectum
Which conditions may be the first signs of HIV in women? SATA
Vaginal candidiasis PID Genital herpes
What is a clinically significant feature for patients who are identified as nonprogressors?
Viral load is either undetectable or very low
A patient diagnosed with HIV is receiving cART. Which lab test is the best for determining effectiveness of the therapy?
Viral load testing
The nurse is orienting a newly graduated RN to the medical unit. Which point should be included about protecting self from HIV exposure when caring for patients?
Wear gloves when in contact with patients' mucous membranes or nonintact skin
Which person is the most likely candidate for cART as post-exposure prophylaxis?
Woman who was raped by an assailant with unknown HIV status
