EX4: ch 19 HIV/AIDS NCLEX Practice Questions
which point are you sure to include when teaching a new RN to prevent HIV transmission from patients? A. wear gloves when in contact with patients mucous membrane or non-intact skin B. be sure to wear protective gear when providing any care to HIV positive patients C. always war a mask D. use PEP whether a patient is positive or not
a
which conditions cause severe pain in HIV and AIDS (Select all that apply) a. enlarged organs b. peripheral neuropathy c. tumors d. high fever e. dry skin
a, b, c
an HIV positive women who is pregnant asks if her baby is at risk for HIV. which points must the nurse be sure to include when teaching? (Select all that apply) A. HIV can cross the placenta B. infant can contract HIV with exposure to blood and vaginal secretions during birth C. once your baby is born, you should be able to breastfeed D. there is a risk for perinatal transmission of HIV from you to your child. because you are on drug therapy, that risk is about 8% E. consider oral contraceptives o protect yourself from other STDs
a, b, d
what methods or agents are used to treat kaposi's sarcoma (Select all that apply) a. radiotherapy b. chemo c. antibiotics d. cryotherapy e. surgery
a, b, d
which actions are useful in helping orient a patient (Select all that apply) a. repeating person, place, time b. using clocks and calendars c. using MMSE screening test d. having familiar items present e. providing uninterrupted time
a, b, d
which descriptions are characteristic of a non progressor? (Select all that apply) A. has been infected for 10 years B. is asymptomatic C. has no CD4+ or t-lymphocytes D. is immunocompetent E. are functional antibodies
a, b, d
the nurse assesses a patient diagnosed with advanced AIDS for malnutirition. which findings does the nurse most likely assess (Select all that apply) a. pain b. anorexia c. urinary incontinence d. diarrhea e. vomiting
a, b, d, e
which methods or items are means of transmitting HIV (Select all that apply) a. sex b. household utensils c. breast milk d. toilet facilities e. mosquitoes
a, c
corticosteroids perform which actions (Select all that apply) a. block movement of neutrophils and monoctyes through cell membrane b. increase cell production in the bone marrow c. reduce number of circulating t cells, resulting in suppressed cell mediated immunity d. decrease ICP e. contrict blood vessels
a, c, d
where in the body can cytomegalovirus present with symptoms? (Select all that apply) a. eyes, causing visual impairment b. kidneys as glomerulonephritis c. respiratory tract causing pneumonia d. GI tract, causing diarrhea e. heart as cardiomyopathy
a, c, d
which actions can the nurse delegate to the UAP who will be giving mouth care to a patient with HIV/AIDS (Select all that apply) a. offer mouth rinses with sodium bicarb and sterile water several times a day b. assess mouth for increased presence of lesions c. encourage the patient to drink plenty of fluids d. provide a soft bristled toothbrush e. administer oral analgesic gel
a, c, d
which conditions may be the first signs of HIV in women? (Select all that apply) A. vaginal candidiasis B. bladder infections C. cervical caner D. PID E. mononucleosis
a, c, d
which lab resluts will the nurse expect to decrease (Select all that apply) a. cd4+ b. cd8+ c. WBC d. lymphocytes e. HIV antibodies
a, c, d
a patient presenting with toxicoplasmosis may have with s/s? (Select all that apply) A. speech difficulty B. Shortness of breath C. visual changes D. impaired gait E. mental status changes
a, c, d, e
which opportunistic infections can be observed in AIDS (Select all that apply) A. toxicoplasmosis B. gastroenteritis C. TB D. candidiasis E. cytomegalovirus
a, c, d, e
which practices are recommended to prevent transmission of HIV? (Select all that apply) A. latex condoms for genital and anal intercourse B. natural membrane condoms for genital and anal intercourse C. topical contraceptives D. antiviral meds E. latex barrier for genital and anal intercourse
a, e
HAART causes what effects? A. reversal of a patients antibody status B. decrease of the viral load C. increase of the viral load D. moe delectable HIV
b
What type of precautions should the nurse take for a patient suspected of having TB as a result of HIV? A. universal b. airborne c. enteric d. protective isolation
b
the nurse is teaching a patient about preventing infection through sex. which statement indicates effective teaching? a. latex condom with spermicide proves the best protection b. mutually monogamous sex with a non infected partner will best prevent HIV c. contraceptive methods like implants and injections are recommended to prevent HIV transmission d. if my partner and i are both HIV positive, unprotected sex is permitted
b
the patient with HIV/AIDS appears emaciated and has diarrhea, anorexia, mouth lesions, and peristent weight loss. what condition does the nurse suspect this patient is developing? a. AIDS dementia B. AIDS wasting syndrome C. AIDS GI opportunistic infection D. AIDS candidiasis opportunistic infection
b
what is the most important means of preventing HIV spread? A. engineering B. education C. isolation D. counseling
b
which definition of immunodeficiency is accurate? A. disease/deficiency acquired as a result of viral infection, contact with toxin, or medical therapy B. deficient immune response as a result of imapired or missing immune components C. chronic infection wih immunodeficiency virus D. disease/deficiency pesent since birth
b
A hospitalized patient with AIDS has a nursing diagnosis of Imbalanced Nutrition: Less than Body Requirements related to nausea and anorexia. Which nursing action is most appropriate to delegate to an LPN/LVN who is providing care to this patient? A. Administering oxandrolone (Oxandrin) 5 mg daily B. Assessing the patient for other nutritional risk factors C. Developing a plan of care to improve the patient's appetite D. Providing instructions about a high-calorie, high-protein diet
Answer: A Rationale: Administration of oral medication is included in LPN/LVN education and scope of practice. Assessment, planning of care, and teaching are more complex RN-level interventions.
A patient with newly diagnosed acquired immunodeficiency syndrome (AIDS) has a negative result on a skin test for tuberculosis (TB). Which action will you anticipate taking next? A. Obtain a chest radiograph and sputum smear. B. Tell the patient that the TB test results are negative. C. Teach the patient about the anti-TB drug isoniazid. D. Schedule TB testing again in 12 months.
Answer: A Rationale: Patients with severe immunodeficiency may be unable to produce an immune response, so a negative TB skin test result does not completely rule out a TB diagnosis for this patient. The next steps in diagnosis are chest radiography and sputum culture. Teaching about isoniazid and follow-up TB testing may be required, depending on the radiographic findings and sputum culture results
As the nurse manager in a public health department, you are implementing a plan to reduce the incidence of infection with the human immunodeficiency virus (HIV) in the community. Which nursing action will you delegate to health assistants working for the agency? A. Supplying injection drug users with sterile inection equipment such as needles and syringes B. Interviewing patients about behaviors that indicate a need for annual HIV testing C. Teaching high-risk community members about the use of condoms in preventing HIV infection D. Assessing the community to determine which population groups to target for education
Answer: A Rationale: Supplying sterile injection supplies to patients who are at risk for HIV infection can be done by staff members with health assistant education. Assessing for high-risk behaviors, education, and community assessment are RN-level skills.
A patient who is HIV-positive and is taking nucleoside reverse transcriptase inhibitors and a protease inhibitor is admitted to the psychiatric unit with a panic attack. Which information about the patient is most important to discuss with the health care provider? A. The patient states, "I'm afraid I'm going to die right here!" B. The patient has an order for midazolam (Versed) 2 mg IV immediately (STAT). C. The patient is diaphoretic and tremulous, and reports dizziness. D. The patient's symptoms occurred suddenly while she was driving to work.
Answer: B Rationale: Because protease inhibitors decrease the metabolism of many drugs, including midazolam, serious toxicity can develop when protease inhibitors are given with other medications. Midazolam should not be given to this patient. The other patient data are consistent with the patient's diagnosis of panic attack and do not indicate an urgent need to communicate with the provider.
After interviewing an HIV-positive patient who is considering starting highly active antiretroviral therapy (HAART), which patient information concerns you the most? A. The patient has been HIV positive for 8 years and has never taken any drug therapy for the HIV infection. B. The patient tells you, "I have never been very consistent about taking medications." C. The patient is sexually active with multiple partners and says "I always use a condom." D.The patient has many questions and concerns regarding the effective ness and safety of the medications.
Answer: B Rationale: Drug therapy for HIV infection requires taking medications very consistently. Failure to take the medications daily can lead to mutations and the emergence of more virulent forms of the virus. Although the other data indicate the need for further assessments or interventions, they will not affect the decision to initiate antiretroviral therapy for this patient.
You are working with a student nurse to care for an HIV-positive patient with severe esophagitis caused by Candida albicans. Which action by the student indicates that you need to intervene most quickly? A. Putting on a mask and gown before entering the patient's room B. Giving the patient a glass of water after administering the ordered oral nystatin (Mycostatin) suspension C. Suggesting that the patient should order chile con carne or chicken soup for the next meal D. Placing a "No Visitors" sign on the door of the patient's room
Answer: B Rationale: Nystatin should be in contact with the oral and esophageal tissues as long as possible for maximum effect. The other actions are also inappropriate and should be discussed with the student but do not require action as quickly. HIV-positive patients do not require droplet/contact precautions or visitor restrictions to prevent opportunistic infections. Hot or spicy foods are not usually well tolerated by patients with oral or esophageal fungal infections.
You are working in an AIDS hospice facility that is also staffed with LPNs/LVNs and UAPs. Which nursing action will you delegate to the LPN/LVN you are supervising? A. Assessing patients' nutritional needs and individualizing diet plans to improve nutrition B. Collecting data about the patients' responses to medications used for pain and anorexia C. Teaching the UAPs about how to lower the risk for spreading infections D. Assisting patients with personal hygiene and other activities of daily living as needed
Answer: B Rationale: The collection of data used to evaluate the therapeutic and adverse effects of medications is included in LPN/LVN education and scope of practice. Assessment, planning, and teaching are more complex skills that require RN education. Assistance with hygiene and activities of daily living should be delegated to the UAP.
A patient seen in the sexually-transmitted disease clinic has just tested positive for HIV with a rapid HIV test. Which action will you take next? A. Ask about patient risk factors for HIV infection. B. Send a blood specimen for Western blot testing. C. Provide information about antiretroviral therapy. D. Discuss the positive test results with the patient.
Answer: D Rationale: A major purpose of HIV testing for asymptomatic patients is to ensure that HIV-positive individuals are aware of their HIV status, take actions to prevent HIV transmission, and effectively treat the HIV infection. According to current national guidelines, the other actions are also appropriate. Rapid HIV testing must be confirmed by another test, usually the Western blot test. Antiretroviral therapy is recommended for all HIV-positive patients. Risk factor information will be used in tracking patient contacts and in teaching the patient how to reduce the risk for transmission to others.
You are evaluating an HIV-positive patient who is receiving IV pentamidine (Pentam) as a treatment for Pneumocystis jiroveci (PCP) pneumonia. Which information is most important to communicate to the physician? A. The patient is reporting pain at the site of the infusion. B. The patient is not taking in an adequate amount of oral fluids. C. Blood pressure is 104/76 mm Hg after pentamidine administration. D. Blood glucose level is 55 mg/dL after medication administration.
Answer: D Rationale: Pentamidine can cause fatal hypoglycemia, so the low blood glucose level indicates a need for a change in therapy. The low blood pressure suggests that the pentamidine infusion rate may need to be slowed. The other responses indicate a need for independent nursing actions (such as establishing a new IV site and encouraging oral intake) but are not associated with pentamidine infusion.
An HIV-positive patient who has been started on HAART is seen in the clinic for follow-up. Which test will be most helpful in determining the response to therapy? A. CD4 level B. Complete blood count C. Total lymphocyte percent D. Viral load
Answer: D Rationale: Viral load testing measures the amount of HIV genetic material in the blood, so a decrease in viral load indicates that the HAART is effective. The CD4 level, total lymphocytes, and complete blood count will also be used to assess the impact of HIV on immune function but will not directly measure the effectiveness of antiretroviral therapy.
a patient asks why it is essential that HAART meds be taken everyday at the same time. what is the nurses best response? a. missing or delaying doses of these drugs decreases blood conenctrations needed to inhibit viral replication b. missing or delayed doses of these drugs decreases the risk of developing infections c. missing or delaying doses of these drugs decreases the effectiveness missing or delaying doses can decrease the risk of developing HIV resistant mutations
a
a patient with PJP usually presents with which symptom? A. dyspnea, tachypnea, persistent dry cough, fever b. cough with copious thick sputum, fever, and dyspnea c. chest pain and difficulty swallowing D. fever, persistant cough and vomiting
a
an IV drug user who regularly shares needles is in the ER. what information does the nurse provide to decrease he patients risk of HIV through shared needles after each use? A. fill and flush syringe with clear water, fill with bleach and shake for 30-60 seconds and rinse with clear water B. fill and flush with water then soap and hot water, shake for 2 minutes and flush with cold water C. rinse needles with bleach and water solution and allow to air dry D. rinse needles after each use with rubbing alcohol and water, then rinse with water
a
which statement about the transmission of HIV is true? (Select all that apply) A. can only be transmitted during end stage B. those with recent HIV infection and high viral load are very infectious C. those with end stage HIV and no drug therapy are very infectious D. HIV is only transmitted with sexual contact E. all people infected with HIV will quickly progress to AIDS
b, c
how does HSV manifest itself in patients with HIV/AIDS (Select all that apply) a. maculopapular lesions that can spread b. chronic ulceration after vesicles rupture c. vesicles ocated in the perirectal, oral, and genital area d. numbness and tingling before vesicle forms e. itching localized to perianal area
b, c, d
where can candidiasis occur in the body (Select all that apply) a. nose b. esophagus c. vagina d. mouth e. ears
b, c, d
HIV is most commonly transmitted by which routes? (Select all that apply) A. oral B. sexual C. parenteral D. airborne E. perinatal
b, c, e
which statements are true about immunodeficiency? (Select all that apply) A. it causes a decrease in the patients risk for infection B. it may be acquired or congential C. it occurs when a persons body cannot recognize antigens D. it is the same as autoimmunity E. it may cause varied reactions from mild, localized health problems to total immune system failure
b, c, e
which statements about HIV are accurate? (Select all that apply) A. may be acquired or congenital B. it is retrovirus C. it always progresses to AIDS D. it is a virus that attacks the immune system E. it is a parasite that forces cells to make copies of itself
b, d, e
which immune function abnormalities are a result of HIV infection? (Select all that apply) A. lymphocytosis B. CD4+ depletion C. increased CD8+ activity D. long macrophage life span E. lymphocytopenia
b, e
The HIV positive patient tells the nurse that his HIV negative partner will be using preexposure drugs (Truvada). which statement indicates the need for additional teaching? A. my partner will need to be tested q3m B. this drug will decrease the chances of my partner becoming positive C. once we start using Truvada I will no longer need a condom D. my partner will need to be monitored for any side effects on this drug
c
shingles results from VZV leaving the body by which route? a. mucous membrane b. pulmonary space c. body fluids and other tissues d. bone marrow
c
the HCP prescribes an integrase inhibitor for an HIV patient. the patient asks the nurse how this drug works. what is the nurses best response? A. it reduces how well HIV genetic material can be converted into human genetic material B. it reinforces the immune systems ability to fight off an infection C. it prevents viral DNA from integrating into hosts DNA D. prevent HIV infection from progressing to AIDS
c
the patient with HIV/AIDS tells the nurse that food tastes funny and is difficult to swallow. what is the nurses priority action at this time? a. Check the patients gag reflex b. ask about blood cultures c. examine the patient's mouth and throat d. collaborate with the dietitian to provide a soft diet
c
a patient with HIV is receiving meds to reduce viral load and improve cd4+ counts. which term accurately describes this HIV drug regimen a. interferon treatment b. antiviremia c. ELISA administration d. HAART
d
cryptosporidiosis is a form of intestinal infection in which diarrhea can amount to a loss of how many liters of fluid per day? A. 1-2 B. 3-5 c. 5-8 d. 15-20
d
which is the most common route for HCP to contract HIV: A. blood B. bodily fluids C. mucous membranes D. needle sticks
d
which malignancy is most common in patients with HIV/AIDS a. non-hodgkins B cell lymphoma b. anal cancer c. primary brain cancer d. kaposi's sarcoma
d
which statements regarding HIV/AIDS among older adults are true? A. the risk for HIV infection after exposure is minimal for older adults B. older men are more susceptible to HIV C. it is not necessary to assess an older adult for history of drug use D. older adults who participate in high-risk behaviors are susceptible to HIV
d
which treatments are intended to boost the immune system? a. protease inhibitors b. hematopoietic growth factors c. lymphocyte transfusion d. interleukin-2 infusion
d
which groups are experiencing increased numbers of HIV infection? (Select all that apply) A. men having sex with other men B. IV drug users C. women having sex with men D. african americans E. hispanics
d, e
