Ch 14 - Infection and HIV infection

17. To evaluate the effectiveness of antiretroviral therapy (ART), which laboratory test result will the nurse review? a. Viral load testing b. Enzyme immunoassay c. Rapid HIV antibody testing d. Immunofluorescence assay

a. a viral load testing

What should the nurse teach patients in the assisted living facility to decrease their risk for antibiotic-resistant infection. Select All a. wash hands frequently b. take antibiotics as prescribed c. take the antibiotic until its gone d. take antibiotics to prevent illnesses like colds e. save leftover antibiotics to take if needed later

a, b, c

1. A patient who has vague symptoms of fatigue, headaches, and a positive test for human immunodeficiency virus (HIV) antibodies using an enzyme immunoassay (EIA) test. What instructions should the nurse give to this patient? a. "The EIA test will need to be repeated to verify the results." b. "A viral culture will be done to determine the progression of the disease." c. "It will probably be 10 or more years before you develop acquired immunodeficiency syndrome (AIDS)." d. "The Western blot test will be done to determine whether acquired immunodeficiency syndrome (AIDS) has developed."

a. "The EIA test will need to be repeated to verify the results."

When teaching a patient infected with HIV regarding transmission of the virus to others, which statement made by the patient would indicate a need for further teaching? a. I will need to isolate any tissues I use so as not to infect my family b. I will notify all my sexual partners so they can get tested for HIV c. Unprotected sexual contact is the most common mode of transmission d. I do not need to worry about spreading this virus to others by sweating at the gym.

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

21. An older adult who takes medications for coronary artery disease has just been diagnosed with asymptomatic chronic human immunodeficiency virus (HIV) infection. Which information will the nurse include in patient teaching? a. Many medications have interactions with antiretroviral drugs. b. Less frequent CD4+ level monitoring is needed in older adults. c. Hospice care is available for patients with terminal HIV infection. d. Progression of HIV infection occurs more rapidly in older patients.

a. Many medications have interactions with antiretroviral drugs.

6. Which patient exposure by the nurse is most likely to require postexposure prophylaxis when the patient's human immunodeficiency virus (HIV) status is unknown? a. Needle stick with a needle and syringe used to draw blood b. Splash into the eyes when emptying a bedpan containing stool c. Contamination of open skin lesions with patient vaginal secretions d. Needle stick injury with a suture needle during a surgical procedure

a. Needle stick with a needle and syringe used to draw blood

the nurse teaches the staff ensuring that standard precautions should be used when providing care for which type of patient. a. all patients regardless of diagnosis b. pediatric and gerontologic patients. c. patients who are immunocompromised d. patients with a history of infectious diseases.

a. all patients regardless of diagnosis

3. 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)? a. Continue taking antibiotics until all the medication is gone. b. Antibiotics may sometimes be prescribed to prevent infection. c. Unused antibiotics that are more than a year old should be discarded. d. Antibiotics are effective in treating influenza associated with high fevers. e. Hand washing is effective in preventing many viral and bacterial infections.

a. continue taking antibiotics until all the medication is gone b. antibiotics may sometimes be prescribed to prevent infection e. hand washing is effective in preventing many viral and bacterial infections

A patient who is infected with HIV is being taught by the nurse about health promotion activities such as good nutrition, avoiding alcohol, tobacco, drug use, and exposure to infectious agents, keeping up to date with vaccines, getting adequate rest, and stress management. What is the rationale behind these interventions that the nurse knows? a. delaying disease progression b. preventing disease transmission c. helping to cure the HIV infection d. enabling an increase in self-care activities.

a. delaying disease progression

1. The nurse cares for a patient infected with human immunodeficiency virus (HIV) who has just been diagnosed with asymptomatic chronic HIV infection. Which prophylactic measures will the nurse include in the plan of care (select all that apply)? a. Hepatitis B vaccine b. Pneumococcal vaccine c. Influenza virus vaccine d. Trimethoprim-sulfamethoxazole e. Varicella zoster immune globulin

a. hepatitis B vaccine b. pneumococcal vaccine c. influenza virus vaccine

11. Which information would be most important to help the nurse determine if the patient needs human immunodeficiency virus (HIV) testing? a. Patient age b. Patient lifestyle c. Patient symptoms d. Patient sexual orientation

a. patient age

A patient has AIDS and the viral load is reported as undetectable. What patient teaching should be provided by the nurse related to this laboratory study result? a. the patient has the virus present and can transmit the infection to others. b. the patient is not able to transmit the virus to others through sexual contact c. the patient will be prescribed lower doses of antiretroviral medications for 2 months d. the syndrome has been cured, and the patient will be able to discontinue all medications

a. the patient has the virus present and can transmit the infection to others.

A patient has been diagnosed with HIV. What rationale for taking more than one antiretroviral medication should the nurse give to the patient to improve compliance? a. viral replication will be inhibited b. they will decrease CD4+ T cell counts c. it will prevent interaction with other drugs d. more than one drug has a better chance of curing HIV

a. viral replication will be inhibited

A patient is admitted to the ED with fever, swollen lymph glands, sore throat, headache, malaise, joint pain, and diarrhea. What nursing actions will help identify the need for futher assessment of the cause of this patients manifestations. Select all. a. Assessment of lung sounds b. assessment of sexual behavior c. assessment of living conditions d. assessment of drug and syringe use. e. assessment of exposure to an ill person.

b, d

12. A patient who uses injectable illegal drugs asks the nurse about preventing acquired immunodeficiency syndrome (AIDS). Which response by the nurse is best? a. "Avoid sexual intercourse when using injectable drugs." b. "It is important to participate in a needle-exchange program." c. "You should ask those who share equipment to be tested for HIV." d. "I recommend cleaning drug injection equipment before each use."

b. "It is important to participate in a needle-exchange program."

The nurse is caring for a patient newly diagnosed with AIDS. What does the nurse explain to the patient the criteria for diagnosis is based on? a. Presence of HIV antibodies. b. CD4+ t cell count below 200/uL c. Presence of oral hairy leukoplakie d. WBC count below 5000/uL

b. CD4+ T cell count below 200/uL

19. Eight years after seroconversion, a human immunodeficiency virus (HIV)-infected patient has a CD4+ cell count of 800/µL and an undetectable viral load. What is the priority nursing intervention at this time? a. Teach about the effects of antiretroviral agents. b. Encourage adequate nutrition, exercise, and sleep. c. Discuss likelihood of increased opportunistic infections. d. Monitor for symptoms of acquired immunodeficiency syndrome (AIDS).

b. Encourage adequate nutrition, exercise, and sleep.

5. A pregnant woman with a history of 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? a. The antiretroviral medications used to treat HIV infection are teratogennic. b. Most infants born to HIV-positive mothers are not infected with the virus. c. Because she is at an early stage of HIV infection, the infant will not contract HIV. d. It is likely that her newborn will become infected with HIV unless she uses antiretroviral therapy (ART).

b. Most infants born to HIV-positive mothers are not infected with the virus.

16. 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 right time? a. Oral acyclovir (Zovirax) b. Oral saquinavir (Invirase) c. Nystatin (Mycostatin) tablet d. Aerosolized pentamidine (NebuPent)

b. Oral saquinavir (Invirase)

22. The registered nurse (RN) caring for an HIV-positive patient admitted with tuberculosis can delegate which action to unlicensed assistive personnel (UAP)? a. Teach the patient about how to use tissues to dispose of respiratory secretions. b. Stock the patient's room with all the necessary personal protective equipment. c. Interview the patient to obtain the names of family members and close contacts. d. Tell the patient's family members the reason for the use of airborne precautions

b. Stock the patient's room with all the necessary personal protective equipment.

A nurse was accidentally stuck with a needle used on a patient who is infected with HIV. After reporting the incident, what care should this nurse first receive a. personal protection equipment b. combination antiretroviral therapy c. counseling to report blood exposures d. a negative evaluation by the manager.

b. combination antiretroviral therapy

The patient is diagnosed with vancomycin-resistant enterococci (VRE) infection in a surgical wound. What infection precautions should the nurse use to best prevent transmission of the infection to others. a. droplet precautions b. contact precautions c. airborne precautions d. standard precautions

b. contact precautions

The nurse has experienced a recent increase in the incidence of hospital care-associated infections on the unit. Which nursing action should be prioritized in the response to this trend. a. use of gloves during patient contact b. frequent and thorough hand washing c. prophylactic, broad-spectrum antibiotics d. fitting and appropriate use of N95 masks

b. frequent and thorough hand washing

2. According to the Center for Disease Control (CDC) guidelines, which personal protective equipment will the nurse put on when assessing a patient who is on contact precautions for diarrhea caused by Clostridium difficile(select all that apply)? a. Mask b. Gown c. Gloves d. Shoe covers e. Eye protection

b. gown c. gloves

the nurse is teaching a group of young adults who live in a dormitory about the prevention of antibiotic-resistant infections. What should be included in the teaching plan? a. save leftover antibiotics for future uses. b. hand washing can prevent many infections c. antibiotics are indicated for preventing most colds d. stop taking prescribed antibiotics when symptoms improve.

b. hand washing can prevent many infections

A parent does not want their child to have any extra immunizations for diseases that no longer occur. What teaching about immunization should the nurse provide this mother. a. there is currently no need for those older vaccines. b. there is a reemergence of some of the infections, such as pertussis c. there is no longer an immunization available for some of those diseases. d. the only way to protect you child is to have the federally required vaccines.

b. there is reemergence of some of the infections, such as pertussis

A heterosexual patient is concerned that they may contract HIV from a bisexual partner. What should the nurse include when teaching about preexposure prophylaxis. Select all. a. Take fluconazole (Diflucan) b. take amphotericin B (fungizone) c. use condoms for risk-enducing sexual relations d. take emtricitabine and tenofovir (Truvada) e. have regular HIV testing for herself and her husband

c, d, e

2. 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+ T-cell count of less than 200 cells/mL. Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC), which statement by the nurse is correct? a. "The patient meets the criteria for a diagnosis of an acute HIV infection." b. "The patient will be diagnosed with asymptomatic chronic HIV infection." c. "The patient has developed acquired immunodeficiency syndrome (AIDS)." d. "The patient will develop symptomatic chronic HIV infection in less than a year."

c. "The patient has developed acquired immunodeficiency syndrome (AIDS)."

7. A young adult female patient who is human immunodeficiency virus (HIV)-positive has a new prescription for efavirenz (Sustiva). Which information is most important to include in the medication teaching plan? a. Driving is allowed when starting this medication. b. Report any bizarre dreams to the health care provider. c. Continue to use contraception while on this medication. d. Take this medication in the morning on an empty stomach.

c. Continue to use contraception while on this medication.

15. 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 instructions will the nurse give to the patient? a. Review foods that are higher in protein. b. Teach about the benefits of daily exercise. c. Discuss a change in antiretroviral therapy. d. Talk about treatment with antifungal agents.

c. Discuss a change in antiretroviral therapy.

10. The nurse palpates enlarged cervical lymph nodes on a patient diagnosed with acute human immunodeficiency virus (HIV) infection. Which action would be most appropriate for the nurse to take? a. Instruct the patient to apply ice to the neck. b. Advise the patient that this is probably the flu. c. Explain to the patient that this is an expected finding. d. Request that an antibiotic be prescribed for the patient.

c. Explain to the patient that this is an expected finding.

20. Which of these patients being seen at the human immunodeficiency virus (HIV) clinic should the nurse assess first? a. Patient whose latest CD4+ count is 250/µL b. Patient whose rapid HIV-antibody test is positive c. Patient who has had 10 liquid stools in the last 24 hours d. Patient who has nausea from prescribed antiretroviral drugs

c. Patient who has had 10 liquid stools in the last 24 hours

23. 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? a. Methods to prevent perinatal HIV transmission b. Ways to sterilize needles used by injectable drug users c. Prevention of HIV transmission between sexual partners d. Means to prevent transmission through blood transfusions

c. Prevention of HIV transmission between sexual partners

3. A patient with a positive rapid antibody 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? a. Teach the patient about the medications available for treatment. b. Inform the patient how to protect sexual and needle-sharing partners. c. Remind the patient about the need to return for retesting to verify the results. d. Ask the patient to notify individuals who have had risky contact with the patient.

c. Remind the patient about the need to return for retesting to verify the results.

The nurse is providing care for a patient who has been living with HIV for several years. Which assessment finding most clearly indicates an acute exacerbation of the disease? a. a new onset of polycythemia b. presence of mononucleosis-like symptoms c. a sharp decrease in the patients CD4+ count d. a sudden increase in the patients WBC cound.

c. a sharp decrease in the patients CD4+ count

The nurse is monitoring the effectiveness of antiretroviral therapy for a patient with AIDS. What laboratory study result indicates the medications are effective. a. increased viral load b. decreased neutrophil count c. increased CD4+ T cell count. d. decreased WBC count

c. increased CD4+ T cell count

A pregnant woman who was tested and diagnosed with HIV is very upset. What should the nurse teach this patient about her babys risk of being born with HIV infection a. The baby will probably be infected with HIV. b. only an abortion will keep your baby from having HIV c. treatment with antiretroviral therapy will decrease the babys chance of HIV infection d. the duration and frequency of contact with the organism will determine if the baby gets HIV infection

c. treatment with antiretroviral therapy will decrease the babys chance of HIV infection

4. A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS) tells the nurse, "I feel obsessed with thoughts about dying. Do you think I am just being morbid?" Which response by the nurse is best? a. "Thinking about dying will not improve the course of AIDS." b. "It is important to focus on the good things about your life now." c. "Do you think that taking an antidepressant might be helpful to you?" d. "Can you tell me more about the kind of thoughts that you are having?"

d. "Can you tell me more about the kind of thoughts that you are having?

13. Which nursing action will be most useful in assisting a college student to adhere to a newly prescribed antiretroviral therapy (ART) regimen? a. Give the patient detailed information about possible medication side effects. b. Remind the patient of the importance of taking the medications as scheduled. c. Encourage the patient to join a support group for students who are HIV positive. d. Check the patient's class schedule to help decide when the drugs should be taken.

d. Check the patient's class schedule to help decide when the drugs should be taken

9. The nurse will most likely prepare a medication teaching plan about antiretroviral therapy (ART) for which patient? a. Patient who is currently HIV negative but has unprotected sex with multiple partners b. Patient who was infected with HIV 15 years ago and now has a CD4+ count of 840/µL c. HIV-positive patient with a CD4+ count of 160/µL who drinks a fifth of whiskey daily d. Patient who tested positive for HIV 2 years ago and now has cytomegalovirus (CMV) retinitis

d. Patient who tested positive for HIV 2 years ago and now has cytomegalovirus (CMV) retinitis

8. 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? a. HIV genotype and phenotype b. Patient's social support system c. Potential medication side effects d. Patient's ability to comply with ART schedule

d. Patient's ability to comply with ART schedule

18. The nurse cares for a patient who is human immunodeficiency virus (HIV) positive and taking antiretroviral therapy (ART). Which information is most important for the nurse to address when planning care? a. The patient's blood glucose level is 142 mg/dL. b. The patient complains of feeling "constantly tired." c. The patient is unable to state the side effects of the medications. d. The patient states, "Sometimes I miss a dose of zidovudine (AZT)."

d. The patient states, "Sometimes I miss a dose of zidovudine (AZT).

14. A patient with human immunodeficiency virus (HIV) infection has developed Mycobacterium avium complex infection. Which outcome would be appropriate for the nurse to include in the plan of care? a. The patient will be free from injury. b. The patient will receive immunizations. c. The patient will have adequate oxygenation. d. The patient will maintain intact perineal skin.

d. The patient will maintain intact perineal skin.

A patient was exposed to HIV 2 weeks ago through sharing needles with other substance users. What symptoms will the nurse teach the patient to report that would indicate the patient has developed an acute HIV infection a. cough, diarrhea, headaches, blurred vision, muscle fatigue b. night sweats, fatigue, fever, and persistent generalized lymphadenopathy c. oropharyngeal candidiasis or thrush, vaginal candidal infection, or oral or genital herpes. d. flu-like symptoms such as fever, sore throat, swollen lymph glands, nausea or diarrhea.

d. flu-like symptoms such as fever, sore throat, swollen lymph glands, nausea or diarrhea.

The nurse is providing postoperative care for a patient with HIV infection after an appendectomy. What type of precautions should the nurse observe to prevent the transmission of this disease? a. Droplet precautions b. contact precautions. c. airborne precautions d. standard precautions

d. standard precautions