Lewis Chapter 14: Infection
The nurse prepares to administer the following medications to a hospitalized patient with human immunodeficiency (HIV). Which medication is most important to administer at the scheduled time?
Oral tenofovir AF/emtricitabine/bictegravir (Biktarvy)
A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS) tells the nurse, "I feel obsessed with morbid thoughts about dying." Which response by the nurse is appropriate?
"Can you tell me more about the thoughts that you are having?"
A patient who uses injectable illegal drugs asks the nurse how to prevent acquired immunodeficiency syndrome (AIDS). Which response by the nurse is most accurate?
"Consider participating in a needle-exchange program."
Which information about a patient population would be most useful to help the nurse plan for human immunodeficiency virus (HIV) testing needs?
Age
The nurse is advising a patient who was exposed 4 days ago to human immunodeficiency virus (HIV) through unprotected sexual intercourse. The patient's antigen-antibody test has just been reported as negative for HIV. What information should the nurse give to this patient?
"You will need to be retested in 2 weeks."
Which patient would benefit from education about HIV preexposure prophylaxis (PrEP)?
A 52-year-old recently single woman just diagnosed with chlamydia.
The nurse plans a presentation for community members about how to decrease the risk for antibiotic-resistant infections. Which information will the nurse include in the teaching plan? (Select all that apply.)
Antibiotics may sometimes be prescribed to prevent infection. Continue taking antibiotics until all of the prescription is gone. Hand washing is effective in preventing many viral and bacterial infections.
A patient treated for human immunodeficiency virus (HIV) infection for 6 years has developed fat redistribution to the trunk with wasting of the arms, legs, and face. What recommendation will the nurse give to the patient?
Discuss a change in antiretroviral therapy.
Eight years after seroconversion, a patient with human immunodeficiency virus infection has a CD4+ cell count of 800/μL and an undetectable viral load. What should be included in the plan of care at this time?
Encourage adequate nutrition, exercise, and sleep.
The nurse palpates enlarged cervical lymph nodes on a patient diagnosed with acute human immunodeficiency virus (HIV) infection. Which action would be appropriate for the nurse to take?
Explain to the patient that this is an expected finding.
According to the Center for Disease Control and Prevention (CDC) guidelines, which personal protective equipment will the nurse put on before assessing a patient who is on contact precautions for Clostridium difficile diarrhea? (Select all that apply.)
Gown Gloves
Which nursing action will be most useful in assisting a young adult to adhere to a newly prescribed antiretroviral therapy (ART) regimen?
Help the patient develop a schedule to decide when the drugs should be taken.
The nurse is caring for a patient who is living with human immunodeficiency virus (HIV) and taking antiretroviral therapy (ART). Which information is most important for the nurse to address when planning care?
The patient reports missing doses of tenofovir AF/emtricitabine (Descovy).
To evaluate the effectiveness of antiretroviral therapy (ART), which laboratory test result will the nurse review?
Viral load testing
A patient informed of a positive rapid screening test result for human immunodeficiency virus (HIV) is anxious and does not appear to hear what the nurse is saying. What action by the nurse is most important at this time?
Remind the patient to return for retesting to verify the results.
The nurse is caring for a patient living with asymptomatic chronic HIV infection (HIV). Which prophylactic measures will the nurse include in the plan of care? (Select all that apply.)
Hepatitis B vaccine Pneumococcal vaccine Influenza virus vaccine
An older adult who takes medications for coronary artery disease and hypertension is newly diagnosed with HIV infection and is starting antiretroviral therapy. Which information will the nurse include in patient teaching?
Many drugs interact with antiretroviral medications.
A pregnant woman with asymptomatic chronic human immunodeficiency virus (HIV) infection is seen at the clinic. The patient states, "I am very nervous about making my baby sick." Which information will the nurse include when teaching the patient?
Most infants born to HIV-positive mothers are not infected with the virus.
Which exposure by the nurse is most likely to require postexposure prophylaxis when the patient's human immunodeficiency virus (HIV) status is unknown?
Needle stick with a needle and syringe used for a venipuncture
Which patient who has arrived at the human immunodeficiency virus (HIV) clinic should the nurse assess first?
Patient who has had 10 liquid stools in the last 24 hours.
A patient who is human immunodeficiency virus (HIV)-infected has a CD4+ cell count of 400/μL. Which factor is most important for the nurse to determine before the initiation of antiretroviral therapy (ART) for this patient?
Patient's ability to follow a complex medication regimen
The nurse designs a program to decrease the incidence of human immunodeficiency virus (HIV) infection in the adolescent and young adult populations. Which information should the nurse assign as the highest priority?
Prevention of HIV transmission between sexual partners.
A patient who has a positive test for human immunodeficiency virus (HIV) antibodies is admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP) and a CD4+ count of less than 200 cells/uL. Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC), which statement by the nurse is correct?
The patient has developed acquired immunodeficiency syndrome (AIDS)."
A patient with human immunodeficiency virus (HIV) infection has developed Cryptosporidium parvum infection. Which outcome would be appropriate for the nurse to include in the plan of care?
The patient will maintain intact perineal skin.
The registered nurse (RN) is caring for a patient who is living with HIV and admitted with tuberculosis. Which task can the RN delegate to unlicensed assistive personnel (UAP)?
Stock the patient's room with the necessary personal protective equipment.
