Elsevier Ch 14

A nurse is caring for a patient who is diagnosed with HIV infection. What education can the nurse provide the patient in order to delay the progression of the disease? Select all that apply.

Eat a well-balanced diet. Get adequate rest and exercise. Avoid alcohol, tobacco, and drug use. Avoid exposure to new infectious agents.

The nurse is caring for a patient who is suspected to have a fungal infection on the groin area. What organism does the nurse determine could possibly be causing the rash? Select all that apply.

Epidermophyton Trichophyton Microsporum

A nurse is caring for a patient with a diagnosis of acquired immunodeficiency syndrome (AIDS). What precautions should the nurse take for self-protection when administering IV injection to the patient? Select all that apply.

Gloves Hand Hygiene

A patient is diagnosed with Staphylococcus aureus in a surgical abdominal wound. What does the nurse anticipate the treatment will be to eliminate this bacteria?

Vancomycin

The nurse is preparing to administer an antibiotic for a patient with methicillin-resistant staphylococcus aureus (MRSA). Which antibiotic does the nurse administer that will be most effective for treatment?

Vancomycin

A patient has been tested and received a positive diagnosis for human immunodeficiency virus (HIV). What finding by the nurse indicates this result for the patient? Select all that apply.

A positive Western blot test A positive enzyme immunoassay (EIA) test

The nurse assesses a patient with recently diagnosed acquired immunodeficiency syndrome (AIDS). When obtaining a health history from the patient, what statement does the nurse determine most correlates with this diagnosis?

"I have had a steady weight loss over the past several months."

Which bacteria is considered normal flora in the large intestine?

E.Coli

The nurse assesses a patient who tests positive for human immunodeficiency virus (HIV). Which finding would the nurse identify as the highest priority for follow-up?

New or productive cough

The nurse reviews a plan of care for a patient who has sustained a deep laceration to an extremity. Which goal listed on the plan is inappropriate and should be questioned by the nurse?

The patient will stop taking the antibiotics after two days if he or she detects no signs of infection

A human immunodeficiency virus (HIV)-infected patient is about to receive treatment with antiretroviral drugs. Which statement by the patient reflects a correct understanding of the purpose of these drugs?

"These drugs work by decreasing the viral load."

The nurse provides education to a patient who has expressed concern about contracting HIV infection. Which statement indicates that the patient understands the teaching?

"Using a condom with a spermicide will reduce my risk of contracting HIV."

The patient with cellulitis has a prescription to receive cefotetan 1.5 g intravenous piggyback (IVPB) q12h. The reconstituted vial contains 3000 mg per 20 mL. The nurse should draw up how many milliliters to add to the IVPB solution? Record your answer using a whole number.

10 mL 1500 mg (20 mL/3000 mg) = x mL or x mL/1500 mg = 20mL/3000 mg 3000 (x) = (20)(1500) x = 20*1500/3000 x = 10 mL

A primary health care provider advises against prescribing an antibiotic to a patient with a severe cold, sore throat, and running nose. The patient tells the nurse, "I really want an antibiotic to make this cold go away." What is the best response by the nurse?

"An antibiotic is ineffective against a cold or flu."

A patient has an undetectable level of plasma human immunodeficiency virus (HIV) RNA after six months of antiretroviral therapy. The patient exclaims, "I'm so glad to be cured!" Which response by the nurse is most therapeutic and accurate?

"An undetectable level means that your therapy was successful but not that you were cured."

A nurse who is providing ambulatory care for patients with human immunodeficiency virus (HIV) is assisting the patients as they struggle to resolve end-of-life issues. Which question posed by the nurse may help the patients to address life and death issues?

"Do you desire support from a spiritual counselor?"

A nurse is assessing a patient's human immunodeficiency virus (HIV) risk. Which questions should the nurse ask to assess for an increased risk? Select all that apply.

"Have you ever had a blood transfusion?" "Have you ever had unprotected sexual intercourse?" "Have you ever had a sexually transmitted infection?"

A patient newly diagnosed with HIV is being educated about ways to prevent transmission of HIV to others. What statement made by the patient indicates an understanding of the education provided?

"I will avoid unprotected sexual contact."

When educating a patient infected with human immunodeficiency virus (HIV) regarding transmission of the virus to others, which statement made by the patient would indicate a need for further teaching?

"I will need to isolate any tissues I use so as not to infect my family."

The nurse is providing teaching for a patient who has a new prescription for an antibiotic. Which statement by the patient indicates a need for further teaching?

"I will stop taking the antibiotic when my symptoms are better."

A patient receiving long-term antiretroviral therapy (ART) for HIV has developed lipodystrophy, hyperlipidemia, insulin resistance, and bone disease. Which should be the first intervention?

Change antiretroviral medications

A nurse is caring for older adults in a long-term care facility. For which early manifestation should the nurse monitor to detect infection in older adults?

Cognitive changes

A patient with acquired immunodeficiency syndrome (AIDS) is placed on antiretroviral therapy and has been taking the medications for four weeks. During the one-month follow-up visit, what findings will help the nurse identify whether the patient outcomes are positive? Select all that apply.

90% drop in viral load CD4 T cell count above 14% 3-unit drop in viral load on a log scale

As part of an awareness program for high school students on acquired immunodeficiency syndrome (AIDS), a public nurse is giving information about routes of transmission. What information should the nurse provide to students regarding the routes of transmission? Select all that apply.

A person can be infected by having intercourse with one stable partner. A person can be infected even if a condom is used each time there is sexual intercourse. A person can be infected if sexual contact is limited to those without human immunodeficiency virus (HIV) antibodies.

A woman infected with human immunodeficiency virus (HIV) delivers a baby with congenital anomalies. The patient was put on Atripla (tenofovir DF+emtricitabine+efavirenz) during pregnancy to control infection. The nurse recognizes that what is the probable cause for the fetal malformations?

Adverse effects of efavirenz

A woman who is three months pregnant finds out that she is human immunodeficiency virus (HIV)-positive on routine HIV testing. She wishes to continue her pregnancy. What information should be given to this patient? Select all that appl

Advise her to consider tubectomy after delivery. Advise her to follow a healthy lifestyle with nutritious food and regular exercise. Advise her that antiretroviral therapy (ART) can decrease the risk of transmission.

A patient that is presently homeless is admitted to the healthcare facility with a respiratory infection suspected to be caused by tuberculosis (TB). Which isolation precaution should the healthcare team initiate?

Airborne

The nurse is reviewing home medications with a patient diagnosed with human immunodeficiency virus (HIV). Which medications and over-the-counter pills may have interactions with HIV therapy? Select all that apply.

Antacids St. John's wort Proton pump inhibitors

A patient with acquired immunodeficiency syndrome (AIDS) tells the home care nurse, "I brought the disease upon myself." The patient tells the nurse, I stopped going to church and speaking with those who previously provided spiritual support." What would a priority goal related to spirituality during this terminal phase be?

Assisting the patient to reconcile with his or her God or higher being

The nurse is assessing a patient with human immunodeficiency virus (HIV) taking antiretroviral therapy (ART) for eight months. Which education should the nurse continue to provide to the patient about metabolic side effects of ART? Select all that apply.

Body changes include central fat accumulation and peripheral wasting. Elevated triglyceride levels and decreases in high-density lipoproteins can occur. Exercise, dietary changes, and calcium and vitamin D supplements for bone health.

A patient with human immunodeficiency virus (HIV) is educated about health promotion activities. What should the nurse inform the patient the importance of these activities is?

Delaying disease progression

A public health nurse recently visited a rural area surrounded by a dense forest. This area has a high incidence and prevalence of zoonotic diseases. What possible infections could be spread to humans by animals in this area? Select all that apply.

Dengue fever West Nile encephalitis Severe acute respiratory syndrome (SARS)

A patient who participates in high-risk activities has undergone an enzyme immunoassay (EIA) test for human immunodeficiency virus (HIV) infection. The nurse reviews the patient's lab results and notes a positive EIA result. What is likely to be included in the patient's plan of care? Select all that apply.

Repeat the EIA test Confirm with a Western blot test Confirm with an immunofluorescence assay

A nurse educator is teaching a group of nurses how to prevent health care-associated infections (HAI) in hospitals. Which bacteria are common culprits for the spread of health care-associated infections? Select all that apply.

Escherichia coli S. Aerus Enterobacter aerogenes

The nurse is traveling to a third world country to assist with medical care to an underserved population. Dengue fever is a concern in this part of the world, and the nurse recognizes that what virus causes this disease?

Flavivirus

A hospital has seen a recent increase in the incidence of hospital care-associated infections (HAIs). Which nursing intervention should be prioritized in the response to this trend?

Frequent and thorough hand washing

The nurse is teaching a patient and family about preventing the spread of infection when someone has a cold or the flu. What is the single most important action the family members can adhere to in order to prevent the spread of infection?

Frequent handwashing

The nurse is preparing to disconnect IV fluid tubing from the access port so the patient can ambulate to the bathroom. What will the nurse wear to prevent the spread of pathogens?

Gloves

A patient's laboratory report reveals that the CD4+ T-cell count has dropped below 200 cells/µL. There is a history of a recent 10% loss of body mass and herpes simplex with chronic ulcers. The patient is diagnosed with Burkitt's lymphoma. Which infection is likely to be found in this patient?

HIV

A nurse providing education for a patient who is human immunodeficiency virus (HIV) positive and pregnant. What information should the nurse give about routes of transmission and infective periods? Select all that apply.

HIV can be transmitted by breastfeeding. HIV can be transmitted lifelong once a person is HIV-positive. HIV can be transmitted even before it is detected on a screening test.

A public health nurse is teaching a group of people about preventing transmission of contagious infection. Which infections that are airborne and require transmission-based precautions should the nurse include in the teaching? Select all that apply.

Rubeola Tuberculosis

A patient with acquired immunodeficiency syndrome (AIDS) comes into the clinic reporting yellow skin color, fatigue, and knee pain. What does the nurse suspect the patient is experiencing?

Hepatitis B virus (HBV)

A goal of Healthy People 2020 is to prevent the transmission of human immunodeficiency virus (HIV) and early detection of those infected. Which are strategies aimed at meeting this goal? Select all that apply.

Increased accessibility to HIV testing facilities Inclusion of voluntary HIV testing in routine prenatal care Advocacy for safer sex practices including use of condoms

A nurse is caring for a patient diagnosed with acquired immunodeficiency syndrome (AIDS) who wants to know about the opportunistic carcinomas that are included in the diagnostic criteria of AIDS. Which opportunistic cancers should the nurse discuss with the patient? Select all that apply.

Kaposi sarcoma Burkitt's lymphoma Invasive cervical cance

An HIV patient is on long-term antiretroviral therapy (ART). Of what side effects of the antiretroviral therapy should the nurse instruct the patient to be aware?

Lipodystrophy

The nurse should assess a patient with acquired immunodeficiency syndrome (AIDS) for which most common symptoms?

Low-grade fever and persistent diarrhea

The nurse is to administer a first dose of cephalexin to a patient with an upper respiratory infection. What information is of the highest priority before administering the cephalexin?

No penicillin allergy

An older adult patient with a history of lupus arrives at the emergency department via ambulance with acute confusion. The healthcare provider suspects an infection and orders blood work, a urine culture, and a chest X-ray despite a normal body temperature of 98.6°F. What does the nurse know is the physiologic basis for this order?

Older adults have lower core body temperatures and lowered immune responses.

Which is a microorganism capable of causing disease?

Pathogen

A patient has been prescribed antiretroviral therapy (ART), and the nurse is monitoring the assessment of growth of HIV in the concentrations of prescribed antiretroviral drugs. The nurse anticipates that what test will be advised for the patient?

Phenotype assay

A patient with human immunodeficiency virus (HIV) taking antiretroviral therapy reports they are starting to feel like they did before starting the therapy. What test should the nurse prepare the patient for?

Phenotype assay

The nurse is providing education to parents to prepare their children for school. Which infection is preventable with vaccines?

Poliomyelitis

The nurse knows that more patients are developing antibiotic-resistant infections requiring inpatient care. What actions may have contributed to the development of antibiotic-resistant infections? Select all that apply.

Prescribing antibiotics for viral infections Prescribing inadequate drug regimens to treat infections Prescribing broad-spectrum antibiotics when only first-line antibiotics are needed

A patient diagnosed with acquired immunodeficiency syndrome (AIDS) comes to the clinic to find out which tests would determine the prognosis of the syndrome. What information will the nurse provide? Select all that apply.

Prognosis can be assessed by viral load Prognosis can be assessed by CD4 +T-cell count.

The nurse is teaching a group of nursing students about caring for a patient who has human immunodeficiency syndrome (HIV). The nurse correctly identifies the most frequent form of work-related HIV transmission as what?

Puncture wounds from contaminated needles

A patient is concerned about receiving a bite from an unknown dog. What disease should the nurse be concerned about that is caused by rhabdovirus?

Rabies

Which patient factor has contributed to the development of antibiotic-resistant superinfections?

Skipping doses of antibiotics

A patient with a recent diagnosis of acquired immunodeficiency syndrome (AIDS) is expressing anger and asks the nurse, "Why has God done this to me?" What behaviors is the patient exhibiting?

Spiritual Distress

A nurse is caring for a patient who is suspected of being positive for human immunodeficiency virus (HIV) in the hospital setting. What method of transmission precaution should the nurse be sure to use when caring for this patient?

Standard Precautions

The nurse was stuck accidently with a needle used on a patient with human immunodeficiency virus (HIV). After reporting this, what is a priority action by the nurse?

Start on combination antiretroviral therapy

A patient with phlebitis due to prolonged intravenous cannulation develops a fever, chills, and an elevated white blood cell count. Blood cultures are drawn and reveal staphylococcus aureus. Of which type of infection is this an example?

Systemic

In the early stages of human immunodeficiency virus (HIV) infection, which cells protect the human body from infections? Select all that apply.

T lymphocytes B lymphocytes

A patient is concerned they may contract human immunodeficiency virus (HIV) from a partner that engages in sexually risky activities. What should the nurse include when educating about preexposure prophylaxis? Select all that apply.

Take emtricitabine and tenofovir regularly Have regular HIV testing for both partners Use condoms for risk-reducing sexual relations

The nurse is caring for a patient with hepatitis B. What isolation precautions should the nurse follow for this type of infection? Select all that apply.

Take measures to avoid splash contamination. Wear gloves and a gown when providing direct patient care. Educate the patient and family on how to follow contact precautions.

A patient is being placed on efavirenz with a once-a-day dose. Which instructions should the nurse give to help the patient cope with the side effects?

Take the dose at bedtime before going to sleep.

A patient came to a clinic for a pregnancy test because she had missed her last menstrual period. Despite the use of a condom, the test was positive. What information should be given to this patient by the nurse? Select all that apply.

Tell her that failure of condoms is possible. Offer access to voluntary HIV-antibody testing. Advise her that she can choose abortion if she wants.

The nurse is monitoring the CD4 counts from a patient with human immunodeficiency virus (HIV). When does the nurse determine that the patient will need to observe for signs of immune problems?

The CD4 count falls to 500.

A patient with human immunodeficiency virus (HIV) recently started on antiretroviral therapy, but does not fully understand the purpose of the medication. What should the nurse include in the explanation to improve the patient's understanding? Select all that apply.

To decrease the viral load To prevent transmission of the HIV disease To maintain or increase the CD4 cell counts To prevent HIV-related opportunistic infection

An older adult patient from a local nursing home is admitted to the medical floor with fever and a productive cough. What precautions should the nurse institute for this patient?

Transmission-based

The nurse is discussing human immunodeficiency virus (HIV) infection with a patient. Which statements accurately describe HIV infection? Select all that apply.

Untreated HIV infection has a predictable pattern of progression. Late chronic HIV infection is called acquired immunodeficiency syndrome (AIDS). Oropharyngeal candidiasis is a common infection associated with the symptomatic stage of HIV infection.

The nurse is concerned regarding the emerging infections observed in the community. What emerging infections should the nurse be concerned with? Select all that apply.

West Nile fever H1N1 (swine) flu Human immunodeficiency virus (HIV) infection