CYK: CH17

HIV has ____ identified stages?

3

A client with HIV-III asks the nurse why gabapentin is part of the drug regimen when the client does not have a history of seizures. What response by the nurse is best? a) "This drug helps treat the pain from nerve irritation." b) "You are at risk for seizures due to fungal infections." c) "I have no idea why you would be taking this drug." d) "Gabapentin can be used as an antidepressant too."

a) "This drug helps treat the pain from nerve irritation." Many classes of medications are used for neuropathic pain, including tricyclic antidepressants and anticonvulsants such as gabapentin

A client with HIV-II has had a sudden decline in status with a large increase in viral load. What action would the nurse take first? a) Assess the client for adherence to the drug regimen. b) Ask the client about travel to any foreign countries. c) Determine if the client has any new sexual partners. d) Request information about new living quarters or pets.

a) Assess the client for adherence to the drug regimen. Adherence to the complex drug regimen needed for HIV treatment can be daunting. Clients must take their medications on time and correctly at a minimum of 90% of the time to be effective

The nurse providing direct client care uses specific practices to reduce the chance of acquiring infection with human immune deficiency virus (HIV) from clients. Which practice is most effective? a) Consistent use of Standard Precautions b) Wearing a mask within 3 feet (1 m) of the client c) Labeling charts and armbands "HIV+" d) Double-gloving before body fluid exposure

a) Consistent use of Standard Precautions According to The Joint Commission, the most effective preventative measure to avoid HIV exposure is consistent use of Standard Precautions. Standard Precautions are required by the CDC.

Which findings are AIDS-defining characteristics? (Select all that apply.) a. CD4+ cell count less than 200/mm3 (0.2 × 109/L) or less than 14% b. Taking antiretroviral medications c. Positive enzyme-linked immunosorbent assay (ELISA) test for human immune deficiency virus (HIV) d. Infection with P. jiroveci e. Presence of HIV wasting syndrome f. Confusion, dementia, or memory loss

a. CD4+ cell count less than 200/mm3 (0.2 × 109/L) or less than 14% d. Infection with P. jiroveci e. Presence of HIV wasting syndrome f. Confusion, dementia, or memory loss A diagnosis of AIDS requires that the person be HIV positive and have either a CD4+ T-cell count of less than 200 cells/mm3 (0.2 × 109/L) or less than 14% (even if the total CD4+ count is above 200 cells/mm3) or an opportunistic infection such as P. jiroveci and HIV wasting syndrome. Confusion, dementia, and memory loss are central nervous system indications.

Some of the first signs of HIV infection are? (select all) a. Fever b. Chills c. Cough d. SOB e. Rash

a. Fever b. Chills e. Rash

AIDS defining illness are? (Select all that apply) a. Kaposi sarcoma b. Urinary tract infection c. TB d. Eczema e. Pneumocystis

a. Kaposi sarcoma c. TB e. Pneumocystis

A client with HIV-III has oral thrush and difficulty eating. What actions does the nurse delegate to the assistive personnel (AP)? (Select all that apply.) a. Offer the client soft foods like gelatin or pudding. b. Assist the client with oral care every 2 hours. c. Remind the client to use only a soft toothbrush. d. Apply oral anesthetic gels before meals. e. Offer the client frequent sips of cool drinks. f. Provide the client with alcohol-based mouthwash.

a. Offer the client soft foods like gelatin or pudding. b. Assist the client with oral care every 2 hours. c. Remind the client to use only a soft toothbrush. e. Offer the client frequent sips of cool drinks. The AP can help the client with oral care, offer fluids, and remind the client of things the nurse (or other professional) has already taught. Soft foods and liquids are tolerated better than harder foods.

The lower the CD4 count the more at risk a patient with HIV is for infection a. True b. False

a. True

PrEP is? (Select all that apply) a. to prevent HIV b. Used to treat present HIV infection in positive patient c. Treatment with Discovy and Truvada d. Can replace safer sex practices e. Is used when there is an occupational exposure

a. to prevent HIV c. Treatment with Discovy and Truvada e. Is used when there is an occupational exposure

An opportunistic infection is a. Any infection in an HIV positive patient b. The flu in an HIV positive patient c. Caused by an organism that usually doesn't cause disease d. Always present in HIV positive patients

c. Caused by an organism that usually doesn't cause disease

A client with HIV-III is hospitalized and has weeping Kaposi sarcoma lesions. The nurse dresses them with sterile gauze. When changing these dressings, which action is most important for the nurse's safety? a) Disposing of soiled dressings properly b) Adhering to Standard Precautions c) Assessing tolerance to dressing changes d) Performing hand hygiene before and after care

b) Adhering to Standard Precautions

Antiretroviral medications can cure HIV infection a. True b. False

b. False

If a patient has HIV infection their long-time sexual partner has it too a. True b. False

b. False

Viral load is the amount of virus present and doesn't affect transmission? a. True b. False

b. False

A nurse is learning about human immune deficiency virus (HIV) infection. Which statements about HIV infection are correct? (Select all that apply.) a. People with HIV-I disease are not infectious to others. b. Opportunistic infections and cancer are leading causes of death. c. Antibodies produced are incomplete and do not function well. d. CD4+ cells begin to create new HIV virus particles. e. The CD4+ T-cell is only affected when the disease has progressed to HIV-III f. Macrophages stop functioning properly.

b. Opportunistic infections and cancer are leading causes of death. c. Antibodies produced are incomplete and do not function well. d. CD4+ cells begin to create new HIV virus particles. f. Macrophages stop functioning properly. In HIV, CD4+ cells begin to create new HIV particles. Antibodies the client produce are incomplete and do not function well. Macrophages also stop functioning properly. Opportunistic infections and cancer are the two leading causes of death in client's with HIV infection. People infected with HIV are infectious in all stages of the disease. The CD4+ T-cell is the immune system cell most affected by infection with the HIV virus.

HIV must enter the bloodstream and take over certain cells. One of the main cells taken over are? a. WBC b. RBC c. CD4+T cell d. Monocyte

c. CD4+T cell

A nurse is talking with a client about a negative enzyme-linked immunosorbent assay (ELISA) test for human immune deficiency virus (HIV). The test is negative and the client states "Whew! I was really worried about that result." What action by the nurse is most important? a) Tell the client to be retested in 3 months. b) Express happiness over the test result. c) Remind the client about safer sex practices. d) Assess the client's sexual activity and patterns.

d) Assess the client's sexual activity and patterns. The ELISA test can be falsely negative if testing occurs after the client has become infected but prior to making antibodies to HIV. This period of time is known as the window period and can last up to 21 days. The confirmatory Western Blot test takes an additional 7 days, so using that testing algorithm, the client's status may not truly be known for up to 28 days. The client may have had exposure that has not yet been confirmed. The nurse needs to assess the client's sexual behavior further to determine the proper response.

The nurse is caring for a client diagnosed with HIV-II. The client's CD4+ cell count is 399/mm3 (0.399 × 109/L). What action by the nurse is best? a) Help the client plan high-protein/iron meals. b) Encourage the client to abstain from alcohol. c) Facilitate genetic testing for CD4+ CCR5/CXCR4 co-receptors. d) Counsel the client on safer sex practices/abstinence.

d) Counsel the client on safer sex practices/abstinence. This client is in the Centers for Disease Control and Prevention HIV-II case definition group. He or she remains highly infectious and would be counseled on either safer sex practices or abstinence

A client with known HIV-II is admitted to the hospital with fever, night sweats, and severe cough. Laboratory results include a CD4+ cell count of 180/mm3 and a negative tuberculosis (TB) skin test 4 days ago. What action would the nurse take first? a) Initiate Droplet Precautions for the client. b) Use Standard Precautions to provide care. c) Notify the primary health care provider about the CD4+ results. d) Place the client under Airborne Precautions.

d) Place the client under Airborne Precautions. Since this client's CD4+ cell count is so low, he or she may have energy, or the inability to mount an immune response to the TB test. The client also appears to have progressed to HIV-III. The nurse would first place the client on Airborne Precautions to prevent the spread of TB if it is present. Next the nurse notifies the primary health care provider about the low CD4+ count and requests alterative testing for TB.