Med Surg: Chapter 37: Nursing Management: Patients With Immunodeficiency, HIV Infection, and AIDS: PREPU
A client has discussed therapy for his HIV-positive status. What does the nurse understand is the goal of antiretroviral therapy? A Eliminate the risk of AIDS. B Bring the viral load to a virtually undetectable level\ C Reverse the HIV+ status to a negative status. D Treat mycobacterium avium complex.
B
A client with AIDS has developed cytomegalovirus (CMV) retinitis and is receiving treatment with foscarnet. The nurse would monitor for which possible adverse drug effects? Select all that apply. A Seizures B Hypomagnesemia C Hypercalcemia D Hyperphosphatemia E Neutropenia
A,B,D
Which of the following is the first barrier method that can be controlled by the woman? A Female condom B Birth control pills C Diaphragm D IUD
A
The majority of patient with primary immunodeficiency are in which age group? A Younger than 20 B 20 to 40 C 41 to 50 D 51 to 60
A
What treatment option does the nurse anticipate for the patient with severe combined immunodeficiency disease (SCID)? A Antibiotics B Radiation therapy C Removal of the thymus gland D Bone marrow transplantation
D
A nurse is caring for a client diagnosed with human immunodeficiency virus (HIV). The client wants to know when medication for the disease will begin. What is the nurse's best response? A If the client has a CD4 T-cell count less than 350 cells/mm3. B When the client is coinfected with hepatitis C. C If the client is diagnosed with HIV-associated liver disease. D After the client has been cured of Kaposi's sarcoma.
A
Which blood test confirms the presence of antibodies to HIV? A Reverse transcriptase B Enzyme-linked immunosorbent assay (ELISA) C p24 antigen D Erythrocyte sedimentation rate (ESR)
B
Kaposi sarcoma (KS) is diagnosed through A visual assessment. B computed tomography. C biopsy. D skin scraping.
C
The term used to define the amount of virus in the body after the initial immune response subsides is A window period. B primary infection stage. C viral clearance rate. D viral set point.
C
When the nurse administers intravenous gamma-globulin infusion, she recognizes that which symptom, if reported by the client, may indicate an adverse effect of the infusion? A Burning urination B Increased thirst C Tightness in the chest D Nasal stuffiness
C
The lower the client's viral load, A the shorter the time to AIDS diagnosis. B the longer the time immunity. C the longer the survival time. D the shorter the survival time.
C The lower the client's viral load, the longer the time to AIDS diagnosis and the longer the survival time. The key goal of antiretrovial therapy is to achieve and maintain durable viral suppression
The clinic nurse is caring for a patient who has a longstanding diagnosis of HIV. The nurse has assessed that the patient is experiencing a progressive decline in cognitive, behavioral, and motor functions. The nurse recognizes that these symptoms are most likely related to the onset of what? A HIV encephalopathy B Wasting syndrome C B-cell lymphoma D Kaposi's syndrome
A
A client is suspected of having an immune system disorder. The health care provider wants to perform a diagnostic test to confirm the diagnosis. What test should the nurse prepare the client for? A Plasmapherisis B Complete chemistry panel C T-and C-cell assays D Enzyme-linked immunosorbent assay
D
When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following? A He has not been infected with HIV. B Antibodies to HIV are present in his blood. C He is immune to HIV. D Antibodies to HIV are not present in his blood.
D
The nurse is caring for a client whose most recent laboratory values reveal a neutrophil level of 21,000 mm3. When preparing to assess the client, the nurse should prioritize what assessment? A Assessing the client's activity level and functional status B Assessing the client for indications of internal or external hemorrhage C Assessing the client for signs of venous thromboembolism D Assessing the client for signs and symptoms of infection
D Normal neutrophil levels range from 3,000 to 7,000 mm3. Levels rise in response to infection, so the nurse should monitor the client closely for signs and symptoms of infection. Increased neutrophil levels do not normally affect coagulation or energy levels.
A client on antiretroviral drug therapy is discussing with the nurse that sometimes he "forgets to take his meds for a few days." What should the nurse inform the client can occur when the medications are not taken as prescribed? A The client is risking the development of drug resistance and drug failure. B The funding for the medications will cease if the client is not taking the meds correctly. C The client will have to take the drugs intravenously to ensure compliance. D The client will have to take higher doses of the antiviral medications.
A
The nurse receives a phone call at the clinic from the family of a client with AIDS. They state that the client started "acting funny" and reported headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member? A "The client probably has a case of the flu and you should give acetaminophen." B "This is one of the side effects from antiretroviral therapy and will require changing the medication." C "The client may have cryptococcal meningitis and will need to be evaluated by the health care provider." D "The client probably has pneumocystis pneumonia and will need to be evaluated by the health care provider."
C
A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client? A Using volume expanders in case blood is needed. B Bank autologous blood. C Ask people to donate blood. D Sign a refusal of blood transfusion form so the client will not receive the transfusion.
B
A client with acquired immune deficiency syndrome (AIDS) is exhibiting shortness of breath, cough, and fever. What type of infection will the nurse most likely suspect? A Legionella B Pneumocystis jiroveci C Cytomegalovirus D Mycobacterium avium complex
B
A client with human immunodeficiency virus undergoes intradermal anergy testing using Candida and mumps antigen. During the 3 days following the tests, there is no induration or evidence of reaction at the intradermal injection sites. What accurate conclusion can the nurse make? A The client isn't allergic to the antigens and therefore doesn't react. B The client is immunodeficient and won't have a skin response. C The client has antibodies to the antigens. D The client has no previous exposure to the antigens injected.
B
A nurse was administering a scheduled subcutaneous dose of heparin to a patient who has HIV when the needle penetrated the nurse's thumb. What prophylactic action should the nurse first take? A Maintain the hand in a dependent position. B Perform a thorough wash of the injury site with soap and water. C Apply chlorhexidine to the wound site and to all the skin in a 3-inch radius. D Apply negative pressure to the wound site using suction tubing.
B
The nurse is working with a parent whose child has just been diagnosed with selective immunoglobulin A deficiency. The parent asks the nurse, "Does this mean that my child is going to die?" How should the nurse respond? A "If left untreated, selective immunoglobulin A deficiency can cause uncontrolled muscle movements with progressive neurologic deterioration." B "Your child has a mild genetic immune deficiency caused by a lack of immunoglobulin A, a type of antibody that protects against infections of the lining the mouth and digestive tract." C "Selective immunoglobulin A deficiency is the term used to describe the early stages of AIDS." D "Your child may die without proper medication and treatment."
B
A nurse on a medical unit is caring for a patient who has experienced a recent exacerbation of HIV. The nurse is being vigilant in assessments and preventative measures related to the common complications of HIV infection. What assessment addresses the most common opportunistic infection related to HIV? A Palpating the patient's pedal pulses and monitoring for peripheral edema B Inspecting the patient's skin and monitoring for signs of skin breakdown C Auscultating the patient's lungs and monitoring oxygen saturation and respiratory rate D Gauging the patient's orientation, insight, and judgment on a daily basis
C
The nurse is preparing a teaching plan for a client with an immunodeficiency. What aspect would the nurse emphasize as most important? A Incorporation of treatment regimens into daily patterns B Identifying the signs and symptoms of infection C Frequent and thorough hand washing D Adherence to prophylactic medication administration
C
A client receiving antiretroviral therapy reports "not urinating enough." What is the nurse's best action? A Administer fluids 100 mL/hour IV. B Assess liver function tests. C Encourage the client to drink more fluids. D Assess blood urea nitrogen and creatinine.
A
A client with AIDS has become forgetful with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms? A AIDS dementia complex (ADC) B cytomegalovirus (CMV) C candidiasis D distal sensory polyneuropathy (DSP)
A
Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS? A Liquids B Sucrose C Iron and zinc D Gluten
A
The nurse is assessing a 28-year-old man with HIV who has been admitted with pneumonia. In assessing the patient, which of the following observations takes immediate priority? A Tachypnea and restlessness B Oral temperature of 100°F C Weight loss of 1 pound since yesterday D Frequent loose stools
A Tachypnea and restlessness are symptoms of altered respiratory status and need immediate priority.
A client with acquired immune deficiency syndrome (AIDS) informs the nurse of difficulty eating and swallowing, and shows the nurse white patches in the mouth. What problem related to AIDS does the nurse understand the client has developed? A MAC B Wasting syndrome C Candidiasis D Kaposi's sarcomA
C
Which adverse effect(s) should the nurse closely monitor in a client who has secondary immunodeficiencies due to immunosuppressive therapy? A Rheumatoid arthritis B Cardiac dysrhythmias and heart failure C Respiratory or urinary system infections D Depression, memory impairment, and coma
C
