NU307 Exam 4 Questions (PPTs)
These three things are key to HIV
Prevention, early detection, and treatment
A client who was diagnosed with HIV several years ago is asking when would he be considered to have AIDS. You explain it is when the CD4+ T-lymphocyte cell count drops below what threshold?
200 cells/mm3 of blood
A new nursing graduate is working at the hospital in the medical-surgical unit. The preceptor observes the nurse emptying a patient's wound drain without gloves on. What important information should the preceptor share with the new graduate about standard precautions? A. Standard precautions should be used with all patients to reduce the risk of transmission of blood borne pathogens. B. Standard precautions should only be used with patients who are HIV positive to reduce the risk of transmission of the HIV virus. C. It is only necessary to use gloves when you are emptying reservoirs that have body fluids in them. D. If you are careful and do not expose yourself to blood or body fluids, it is not necessary to use gloves all of the time.
A
A patient asks you about their malignancy. Which of the following statements is not true related to the malignant process and mutations in cancer?
A mutation of the cell DNA forms a clone and begins to proliferate normally
Teaching a patient to wear sunscreen is what type of cancer prevention?
Primary cancer prevention
These are genetic and prevent the body from developing normal immune response
Primary immune deficiency disorders (PIDD)
You are caring for a 28-year old female who tested positive for the BRCA gene and has a family history of breast cancer. The client is requesting a bilateral mastectomy. What type of oncologic surgery is this an example of?
Prophylactic surgery
For health care employees, these must be started no more than 72 hours after HIV exposure
Antiretroviral meds
A nurse is planning the care of a client with AIDS who is admitted to the unit withPneumocystispneumonia (PCP). Which nursing diagnosis has the highest priority for this client? A. Activity Intolerance B. Ineffective Airway Clearance C. Impaired Oral Mucous Membranes D. Imbalanced Nutrition: Less than Body Requirements
B
A patient develops gastrointestinal bleeding from a gastric ulcer and requires blood transfusions. The patient states to the nurse, "I am not going to have a transfusion because I don't want to get AIDS." What is the best response by the nurse? A. "I understand what you mean, you can never be sure if the blood is tainted." B. "I understand your concern. The blood is screened very carefully for different viruses as well as HIV." C. "If you don't have the blood transfusions, you may not make it through this episode of bleeding." D. "No one has gotten HIV from blood in a long time. You have to have the transfusion."
B
The nurse is caring for a patient who has recently been diagnosed with AIDS. Which of the following criteria is used that would confirm this diagnosis? A. Antibody test B. CD4 count <200 C. ELISA test that is positive D. Western blot test that is positive
B
HIV transmission routes
Blood, semen, vaginal secretions, and breast milk
When developing the plan of care for a client with a primary immunodeficiency, which nursing diagnosis would be the priority? A. Anxiety related to an inherited disorder B. Grieving related to the poor prognosis of the condition C. Risk for infection related to altered immune cell function D. Impaired skin integrity related to persistent deep skin abscesses
C
Cells targeted by HIV
CD4 receptors (T Lymphocytes)
A client has received the results of a HIV antibody test, which is positive. What is the best explanation for the nurse to give to the client? A. The client cannot transmit the virus to others. B. The HIV infection confirms the presence of AIDS. C. The antibodies indicate immunity. D. The client has been infected and has produced antibodies.
D
The nurse has four clients that come to the clinic for healthcare. Which client has the highest risk factor for HIV infection? A. 46-year-old female who has been in a monogamous relationship for 9 years B. 22-year-old heterosexual male who has had one relationship for 2 years C. 34-year-old female who has donated blood on several occasions D. 26-year-old inmate who receives tattoos in prison
D
An infectious retrovirus that carries its genetic material in the form of RNA
HIV
Physical & emotional support during terminal stages
Hospice care
Medications that blocks the newly formed DNA to integrate itself into the host's genetic structure
Integrase inhibitors
Protecting against HIV infection programs
Needle exchange program
Occurs during stage 3; an example would be pneumocystis pneumonia (PJP)
Opportunistic infections
90% of 40 year olds have degenerative changes related to this disorder
Osteoarthritis
A big risk factor of this disorder is obesity
Osteoarthritis
Cartilage fragments can break off into the synovial cavity
Osteoarthritis
Formation of osteophytes (bone spurs)
Osteoarthritis
Limited to affected joints, not systemic
Osteoarthritis
Losing weight helps with this disorder
Osteoarthritis
Medical treatment might include pain meds, steroids, or ultimately joint replacement
Osteoarthritis
Most common joint disorder
Osteoarthritis
Non-inflammatory, degenerative disorder of the joints
Osteoarthritis
Prior (sports) injuries or occupation (laborers) can be at risk for this disorder
Osteoarthritis
Results form breakdown of articular cartilage & damage to underlying bone
Osteoarthritis
Treatments include a brace or use of alternative treatments, like massage, yoga, or acupuncture
Osteoarthritis
Typically occurs in weight bearing & repetitive used joints of the hips & knees
Osteoarthritis
"Silent thief" robs the skeleton of its banked resources
Osteoporosis
Dexa Scan used to diagnose
Osteoporosis
Low vitamin D levels, smoker, caffeine, alcohol, carbonated beverages can all increase risk
Osteoporosis
Most prevalent bone disease
Osteoporosis
Pregnancy can deplete calcium reserves in this disorder
Osteoporosis
Primary or Type 2 occurs in women after menopause
Osteoporosis
Type 2 can be the result of medications or disease that affect bone metabolism
Osteoporosis
Vertebral fractures & paralytic ileus can occur with this disorder
Osteoporosis
Weight bearing exercises are part of prevention/treatment
Osteoporosis
You are caring for a 78-year old male with terminal colon cancer. The client is having surgery to repair a bowel obstruction. What type of oncologic surgery is this an example of?
Palliative surgery
A systemic disorder with weight loss, fatigue, fever, generalized aches & stiffness
Rheumatoid Arthritis
Advanced treatment includes addition of immunosuppressants, such as imuran
Rheumatoid Arthritis
Autoimmune Disease
Rheumatoid Arthritis
Early treatment includes NSAIDs
Rheumatoid Arthritis
Females 2.5 times increased incidence
Rheumatoid Arthritis
Immune response to an antigen
Rheumatoid Arthritis
Most likely a combination of genetics and environmental triggers
Rheumatoid Arthritis
Neuropathies and paresthesia & demyelination of nerves can occur
Rheumatoid Arthritis
Nutitional therapy for weight loss management
Rheumatoid Arthritis
Remission & exacerbation
Rheumatoid Arthritis
Swan neck deformity of fingers
Rheumatoid Arthritis
Synovial lining thickens
Rheumatoid Arthritis
Will have elevated WBC's
Rheumatoid Arthritis
Teaching a patient the importance of a mammogram is what type of cancer prevention?
Secondary cancer prevention
This stage of HIV is when the T lymphocyte counts in between 200-499
Stage 2 - early stage AIDS
This stage of HIV is when the T lymphocyte count drops below 200
Stage 3 - considered to have AIDS
What health care providers should use with ALL patients to prevent transmission of organisms
Standard Precautions
A patient is receiving a vesicant IV chemotherapy medication treatment for cancer, you observe swelling at the IV site and the patient complains of pain. Which action should you do first?
Stop the infusion immediately
Your patient is receiving a stem cell transplant related to malignant myeloma. The patient is receiving the bone marrow transplant from an identical twin. What type of hematopoietic stem cell transplant (HSCT) would this be?
Syngenic
A client is in the primary infection stage of HIV. What is true of this client's current health status?
The client is infected with HIV but lacks HIV-specific antibodies
A patient receiving an allogeneic stem cell transplant (AlloHSCT) asks why he needs to be on the immunosuppressant drug cyclosporine. Which statement is not correct?
To prevent the immune response, the donor takes immunosuppressant drugs for life
One of the 8 steps in the life cycle of HIV
Transcription
Involuntary loss of more than 10% of ones body weight; loss of body fat; diarrhea
Wasting syndrome