HIV

a,c,d,e

The nurse is reviewing literature to present to a group of students on the risk of acquiring HIV. Which​ at-risk populations will the nurse include in the​ presentation? ​(Select all that​ apply.) a Bisexual individuals b Clients with neuropathy c The male prison population d Gay men e IV drug users

c

The nurse is reviewing the lab reports of a client that is HIV positive. Which lab report provides information regarding the effectiveness of the clients medication regimen? a. ELISA b. Western Blot c. Viral load d. CD4 count

Ans: 3 The staff member who is most knowledgeable about the regulations regarding HIV prophylaxis and about obtaining a client's HIV status and/or ordering HIV testing is the occupational health nurse. Performing unauthorized HIV testing or asking the client yourself would be unethical. The charge nurse is not responsible for obtaining this information (unless the charge nurse is also in charge of occupational health). Focus: Prioritization

23. You have received a needlestick injury after giving a client an intramuscular injection, but you have no information about the client's HIV status. What is the most appropriate method of obtaining this information about the client? 1. You should personally ask the client to authorize HIV testing as soon as possible. 2. The charge nurse should tell the client about the need for HIV testing. 3. The occupational health nurse should discuss HIV status with the client. 4. HIV testing should be performed the next time blood is drawn for other tests.

b,d,e ​Malaise, flu-like​ symptoms, a decreased WBC count and elevated ESR are all findings that support the diagnosis of a primary HIV infection. Headache and visual disturbances are signs of cerebral​ edema, which is not associated with primary HIV infection. Elevated serum potassium is not found in the setting of primary HIV.

A client reports he has not been feeling well and is concerned that he has been exposed to HIV. Which client symptoms and assessment findings would support a diagnosis of primary HIV​ infection? ​(Select all that​ apply.) a High serum potassium level b Decreased WBCs on complete blood count c Headache and visual disturbances d Elevated ESR​ (erythrocyte sedimentation​ rate) e Malaise and​ flu-like symptoms

2 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. Focus: Prioritization

After interviewing an HIV-positive patient who is considering starting highly active antiretroviral therapy (HAART), which patient information concerns you the most? 1. The patient has been HIV positive for 8 years and has never taken any drug therapy for the HIV infection. 2. The patient tells you, "I have never been very consistent about taking medications." 3. The patient is sexually active with multiple partners and says "I always use a condom." 4. The patient has many questions and concerns regarding the effectiveness and safety of the medications.

a

After several hospitalizations for respiratory ailments a 6 month old has been diagnosed with HIV. The infants respiratory ailments were most likely due to : a. Pneumocystis jiroveci b. cytomegalovirus c. cryptosporidiosis d. Herpes simplex

4 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. Focus: Prioritization

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? 1. CD4 level 2. Complete blood count 3. Total lymphocyte percent 4. Viral load

1 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.

As the nurse manager in a public health department, you are implementing a plan to reduce the incidence of infection with human immunodeficiency virus (HIV) in the community. Which nursing action will you delegate to health assistants working for the agency? 1. Supplying injection drug users with sterile injection equipment such as needles and syringes 2. Interviewing patients about behaviors that indicate a need for annual HIV testing 3. Teaching high-risk community members about the use of condoms in preventing HIV infection 4. Assessing the community to determine which population groups to target for education

b,c,d,e

Which nursing diagnoses are applicable to clients affected by​ HIV/AIDS? ​(Select all that​ apply.) a Alteration in​ nutrition, more than body requirements b Potential for fear related to prognosis c Alteration in​ nutrition, less than body requirements d Alterations in skin integrity related to cutaneous infections e Potential for enhanced wellness

c

Which of the following is the best indicator of the diagnosis of HIV? a. WBC b. ELISA c. Western Blot d. CBC

c

a client with AIDS has a VIRAL LOAD of 200 copies per mL. The nurse should interpret this finding as: a. the client is at risk for opportunistic diseases b. the client is no longer communicable c. the clients viral load is extremely low so he is relatively free of circulating virus d. the clients T-cell count is extremely low

a,d,e

In which situation will a healthcare worker be at risk for HIV​ infection? ​(Select all that​ apply.) a Prolonged blood contact on damaged skin b Inhalation of airborne droplets c Urine contact with damaged skin d Deep injury with visible blood from a contaminated needle e Direct puncture in a vein with a contaminated needle

d PIs are associated with metabolic​ abnormalities, including elevated cholesterol and diabetes. The lab values do not indicate any increased risk for skin​ cancer, pneumonia, stomach​ cancer, lymphoma, kidney​ disease, or lung cancer.

Mr. Glass is HIV positive and is being treated with highly active antiretroviral therapy​ (HAART) and protease inhibitors​ (PI) therapy. His laboratory results show increased triglycerides. Based on the laboratory​ results, what is Mr. Glass at risk for developing related to the HIV​ infection? a Increased risk for developing skin cancer and pneumonia b Increased risk for developing kidney disease and lung cancer c Increased risk for developing stomach cancer and lymphoma d Increased risk for elevated cholesterol and diabetes

a

Problem A patient who has tested positive for the human immunodeficiency virus (HIV) arrives at the clinic with a report of fever, nonproductive cough, and fatigue. The patient's CD4 count is 184 cells/mcL. How should the healthcare provider interpret these findings? a The patient is diagnosed with acquired immunodeficiency syndrome (AIDS). b The patient is now in the latent stages of HIV infection c These findings provide evidence that the patient has seroconverted. d This is an expected finding because the patient has tested positive for HIV.

a,b,d,e

The mother of an​ Anna, an​ 8-year-old girl infected with​ HIV, is describing​ Anna's condition and activities to the nurse. Which statements would indicate positive outcomes for the​ child? Select all that apply. ​a "Anna is attending school and doing well in her​ class." ​b "Anna attends a weekly support group for kids with​ HIV." ​c "Anna seems somewhat isolated and​ doesn't have any real​ friends." ​d "Anna hasn't shown any sign of​ infection." e ​"Anna has a good appetite and eats regular​ meals.

b

The nurse assesses a cough, shortness of breath, and tachypnea in a client diagnosed with AIDS. For which of the following will the nurse expect to treat the client? a Cytomegalovirus b Pneumocystis carinii c Toxoplasmosis d Cryptococcus neoformans

b African American adolescents account for​ 65% of new HIV cases among adolescents. This​ at- risk population would benefit the most from receiving counseling and education regarding the spread of HIV.

The community health nurse plans education sessions at local community centers to promote safer sex and prevention of sexually transmitted infections. Which group of adolescents would benefit the most from this education due to an increased risk of contracting​ HIV? a Latin American boys who identify as heterosexual b African American adolescents c Girls affected by gender dysphoria d Caucasians aged​ 16-20

b Rationale: The family has concerns, and demonstrating acceptance of the child is the best way to foster acceptance of the child and development of further coping skills. Prevention of transmission, handwashing, and drug therapy are all important, but none of these individually targets the global concerns of the family.

The family of a 12-year-old client, who is hospitalized and diagnosed with HIV infection secondary to factor transfusions for hemophilia, is concerned about keeping the child at home for fear that others in the household would be at risk for contracting HIV. Which action by the nurse will best promote family coping at this time? a bShow the family how to perform hand hygiene. b Demonstrate positive acceptance of the child with each contact. c Explain that the infection is not transmitted by casual contact. d Explain that prophylactic drugs will prevent the spread of the virus.

c

The healthcare provider is assessing the skin of a patient who is at risk for becoming infected with the human immunodeficiency virus (HIV). Which of the following findings requires immediate follow-up by the healthcare provider? a Ecchymoses on the legs b Patches of dry, flaky skin c Purplish-red raised lesions d Numerous moles on the chest and back

b,c,d Rationale: The risk of opportunistic infection is the most common manifestation of AIDS. The risk of opportunistic infection is predictable by the T4 and CD4 cell count. The normal CD4 cell count is greater than​ 1,000/mm3. All of the labs are abnormal except for the CD4 cell count and the​ WBC, which was within normal range​ (4,500-10,000).

The nurse is reviewing the laboratory values of a client who has been newly diagnosed with AIDS. Which laboratory values would the nurse report to the​ physician? Select all that apply. a WBC​ 6,500 b T4 cell count 150 c CD4 lymphocytes​ 12% d Viral load​ 11,500 copies/mL e CD4 cell count​ 1,100/mm3

a

The nurse should monitor a client prescribed zidovudine (Retrovir) for which of the following adverse reactions? a Leukopenia b Cardiotoxicity c Polycythemia d Nephrotoxicity

c

The nurse, caring for a client with AIDS experiencing nausea and weight loss, would initiate which of the following interventions for this client? a Lie down after eating. b Drink liquids with meals. c Eat small, frequent meals. d Eat high-fat foods.

c

The nurse, planning care for a client diagnosed with AIDS who is in transmission-based precautions, sets psychosocial integrity as a goal. Which of the following will the nurse plan to achieve a positive outcome for the client? a Letting the client sleep to build up stamina b Maintaining strict precautions so the client believes the best care is being given c Providing diversional activities to enhance sensory input d Providing care in a limited time frame to keep the client safe

a

The physician has ordered pentam (pentamidine) IV for a client with pneumocystis jirovecki. While receiving the medication, the nurse should carefully monitor the clients: a. blood pressure b. temp c. heart rate d. respirations

a,b,c,d

What are the goals of the pharmacologic management of the client with​ HIV? ​(Select all that​ apply.) a Prolonging life for the affected individual b Treating opportunistic infections and cancers c Stimulating hematopoietic response d Decreasing symptoms e Curing the infection

b

Where are most cases of HIV​ occurring? a Asia ​b Sub-Saharan Africa c Latin America d Eastern Europe

a,c,d

Which interventions are appropriate for treating imbalanced nutrition in clients with​ HIV? ​(Select all that​ apply.) a Providing supplementary vitamins and enteral feedings b Providing a low calorie diet c Identifying causes of altered nutrition d Providing or assisting with oral hygiene e Encouraging the client to eat only when hungry

b

Which lab test will be positive for HIV antibodies if blood or oral mucosal transudate of an infected person reacts with the surface antigen of killed HIV​ virus? a Western blot b ELISA​ (enzyme-linked immunosorbent​ assay) ​c Ora-Quick Rapid​ HIV-1 d Estrone

d Rationale: CD4 cells are indicative of a client's HIV status. As the disease progresses, the T-helper cells decrease in number and lose their ability to function. B lymphocytes indicate the status of humoral activity. NK cells and T-cytotoxic cells are not directly related to HIV.

Which of the following laboratory measurements should the nurse assess as a reliable indicator of lymphocyte status in a client with HIV infection? a B lymphocytes b T-cytotoxic cells c Natural killer cells (NK) d T-helper cells (CD4)

b

the nurse is teaching the client with AIDS regarding needed changes in food preparation. Which statement indicates the client understands the nurses teaching? a. adding fresh ground pepper to my food will increase the flavor b. meat should be thoroughly cooked to the proper temperature c. eating cheese and yogurt will prevent aids related diarrhea d. it is important to eat four or five servings of fresh fruits and vegetables a day

c pyridoxine is vitamin B6

which vitamin should be administered with INH (isoniazid) in order to prevent possible nervous system side effects? a. thiamine b. niacin c. pyridoxine d. riboflavin

d Rationale: When the client tests positive for HIV, it means that antibodies to the AIDS virus are in the blood. Being seropositive for HIV does not equate to having AIDS. It is important for the nurse to explain the difference between HIV and AIDS to the client. AIDS is diagnosed when the CD4 count drops below 200. The client should be made aware that AIDS could develop in the future.

A client who has tested positive for HIV asks the nurse what that means. The best response by the nurse would be which of the following? a "You have been diagnosed with AIDS." b "This means that you will not develop AIDS in the future." c "At this point, AIDS is not active in your blood." d "Antibodies to the AIDS virus are present in your blood."

a

A client with AIDS asks the nurse why he seems to get bronchitis so often. Which response by the nurse is the most​ appropriate? a ​"Your infection-fighting cells are diminished because of​ AIDS." b "Bronchitis is caused by a bacterial​ infection, and AIDS is from a​ virus, so I don​'t think there is a​ connection." c "Taking extra vitamin C usually helps ward off​ infections." d "Are you still smoking ​cigarettes?

a

A home health nurse has just received the list of clients who need to be seen during the shift. Which client should the nurse plan to see​ first? a A client with Pneumocystis carinii pneumonia​ (PCP) who called the office this morning to report a new onset of​ fever, cough, and shortness of breath b A client with a long history of AIDS who is receiving IV antibiotics daily for toxoplasmosis c A client with wasting syndrome who has​ end-stage AIDS who needs modifications and education regarding dietary changes d A client with AIDS who is receiving lamivudine​ (Epivir) because of a diagnosis of a low CD4 cell count

1 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. Focus: Delegation

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? 1. Administering oxandrolone (Oxandrin) 5 mg daily 2. Assessing the patient for other nutritional risk factors 3. Developing a plan of care to improve the patient's appetite 4. Providing instructions about a high-calorie, high-protein diet

a,b,e

A nurse in an outpatient clinic is assessing a client who reports night sweats and fatigue. He states he has had a cough along with Nausea and Diarrhea. His temp is 100.6 orally. The client is afraid he has HIV. Which of the following actions should the nurse take? SELECT ALL THAT APPLY a. Perform a physical assessment b. Determine when the manifestations began c. Teach the client about HIV transmission d. Draw blood for HIV testing. e. Obtain a sexual history

a,d,e perinatal exposure is a risk factor.. pregnant women should be cautious to avoid exposure. Being an older adult woman is a risk due to vaginal dryness and thinning of the vaginal wall. Occupational exposure such as health care worker is a risk factor.

A nurse is assessing a client for HIV. The nurse should identify that which of the following are risk factors associated with this virus? SELECT ALL THAT APPLY a. Perinatal exposure b. pregnancy c. monogamous sex partner d. older adult woman e. occupational exposure

a,b positive western blot and positive indirect immunofluorescence assay confirm presence of HIV infection. CD4+ assists with classifying stage of HIV infection. HIV RNA tests determine vial level and monitor tx. CSF can be used to confirm meningitis.

A nurse is caring for a client who is suspected of having HIV. The nurse should identify that which of the following diagnostic tests and laboratory values are used to confirm HIV infection? SELECT ALL THAT APPLY a. Western blot b. Indirect Immunofluorescence assay c. CD4+ T-lymphocyte count d. HIV RNA quantification test e. Cerebrospinal fluid (CSF) analysis

c ​Rationale: All options are potential nursing diagnoses for this client. Deficient knowledge related to preventing transmission of HIV would be the priority diagnosis for this client due to his statement of wanting to remain sexually active. The client will need to be educated on safer sex practices to decrease the risk of transmission to potential sexual partners.

A nurse is developing a plan of care for a client who was recently diagnosed with HIV. The client admits to being sexually active and states that he will remain sexually active. Which would be a priority nursing diagnosis for this client based on this​ information? a Death Anxiety b Risk for Infection related to immunodeficiency c Deficient Knowledge related to preventing transmission of HIV d Social Isolation related to fear of AIDS

a

A nurse is performing an admission assessment on a client with symptoms that indicate the client may have human immunodeficiency virus​ (HIV). Which question from the nurse addresses a major risk factor for contracting​ HIV? a ​"Have you ever experimented with intravenous​ drugs?" b ​"Has your partner been experiencing these​ symptoms?" c ​"Have you had any​ fever, diarrhea, or chills over the last 48​ hours?" ​d "When was your first sexual​ experience?"

d High fat foods should be avoided because of fat intolerance in clients with HIV/AIDS. Small frequent meals should be taught. Drink 2-3 L of fluids a day.

A nurse is preparing teaching for a client who has stage 2 HIV disease and is having difficulty maintaining a normal weight. Which of the following statements by the client should indicate to the RN an understanding of the teaching? a I will choose a diet high in fat to help me gain weight. b. I will be sure to eat 3 large meals c. I will drink up to 1 liter of liquid each day d. I will add high protein foods to my diet.

d A client with HIV should not clean a litter box, and avoid consuming any raw foods. A client with HIV/AIDS should avoid any contact with ill family members.

A nurse providing teaching for a client who has stage 3 HIV disease. Which of the following statements made by the client should indicate to the RN an understanding of the teaching? a. I will wear gloves while changing the pet litter box b. I will rinse raw fruits with water before eating them c. I will wear a mask when around ill family members d. I will cook vegetables before eating them

4 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. Focus: Prioritization

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? 1. Ask about patient risk factors for HIV infection. 2. Send a blood specimen for Western blot testing. 3. Provide information about antiretroviral therapy. 4. Discuss the positive test results with the patient.

2 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. Focus: Prioritization

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? 1. The patient states, "I'm afraid I'm going to die right here!" 2. The patient has an order for midazolam (Versed) 2 mg IV immediately (STAT). 3. The patient is diaphoretic and tremulous, and reports dizziness. 4. The patient's symptoms occurred suddenly while she was driving to work.

1 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. Focus: Prioritization

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? 1. Obtain a chest radiograph and sputum smear. 2. Tell the patient that the TB test results are negative. 3. Teach the patient about the anti-TB drug isoniazid. 4. Schedule TB testing again in 12 months.

d Mrs.​ Knopp's CD4​ T-cell count indicates that she is at risk for opportunistic infection. Candidiasis is a type of opportunistic infection commonly found in the setting of low CD4​ T-cell count. The other disorders are not opportunistic infections.

Ms. Knopp is a​ 31-year-old woman with a history of HIV. She presents to the healthcare provider for a regularly scheduled appointment. You notice that her latest laboratory report shows that her CD4​ T-cell count is less than​ 200/mm3. What would you assess for during Ms.​ Knopp's examination? a Rheumatoid arthritis b Psoriasis c Dysmenorrhea d Candidiasis

b

The healthcare provider is teaching a patient who has been diagnosed with acquired immunodeficiency syndrome (AIDS) about the need for multi-drug therapy. Which of the following best explains the rationale for using more than one antiretroviral medication to treat AIDS? a "This combination of medications will eliminate the AIDS virus from your body." b "This is intended to keep the virus from developing resistance to the medications." c "You will not be able to transmit the disease while you take this medication combination." d "You will experience less side effects when you take a combination of medications."

c

The nurse is caring for a client who is newly diagnosed with human immunodeficiency virus​ (HIV). The client asks the nurse if there are ways to protect the​ client's life partner from getting the HIV virus. After educating the​ client, which statement indicates the need for further​ education? ​a "I can still kiss and hug my partner to show​ affection." b ​"I know I have to practice safer sex with my partner by using a latex​ condom." c ​"I know to use an​ oil-based lubricant to prevent spread of the disease to my​ partner." d ​"I will not share my razor with my​ partner

c

The nurse is caring for a client who was recently tested for HIV at the client​'s request. The client asks the​ nurse, "Will this test really tell me if I have​ HIV?" Which response by the nurse is the most​ appropriate? a "You should be using condoms when you have sex. b "With the​ state-of-the art testing we now​ have, antibodies confirming HIV infection can be detected within 5 days of​ infection." c "The presence of antibodies indicative of HIV infection can be detected in blood 6 weeks to 6 months after the initial​ infection." d "Why do you think you need an HIV ​test?

a,b,c,d

The nurse is caring for a client with AIDS and has identified the problem of imbalanced nutrition. The client is currently underweight. Which interventions are appropriate for this​ client? ​(Select all that​ apply.) a Identifying the cause of altered nutrition b Assisting with oral hygiene c Providing supplementary vitamins d Providing foods high in protein and calories e Serving large portions

b,d,e

The nurse is caring for a client with AIDS who has been receiving protease inhibitors​ (PIs). Which side effects will the nurse inquire about during the health history for this​ client? ​(Select all that​ apply.) a Kaposi sarcoma b Diabetes mellitus c Hypothyroidism d Elevated cholesterol and triglycerides e Insulin resistance

c

The nurse is caring for a client with AIDS who has come to the clinic for an HIV viral load test. The client​ asks, "What is a viral load​ test?" Which response by the nurse is the most​ appropriate? a "This test detects​ anemia, leukopenia, and thrombocytopenia. b "This test is the most widely used screening test for HIV infection. c "This test measures the amount of actively replicating HIV. d "This test is used to detect HIV antibodies.

b

The nurse is caring for a client with AIDS who has oral candidiasis. The nurse should clean the clients mouth using: a. a toothbrush b. a soft guaze pad c. antiseptic mouthwash d. lemon and glycerin swabs

a,d ​Rationale: Megestrol​ (Megace) and dronabinol​ (Marinol) are often ordered to increase the​ client's appetite and promote weight gain. Ciprofloxacin​ (Cipro) is an​ anti-infective medication, and zidovudine​ (Retrovir, AZT) is an antiretroviral agent. Abacavir​ (Ziagen) is a potent inhibitor of reverse transcriptase.

The nurse is caring for a client with AIDS who is taking an antiretroviral medication. The client complains of​ nausea, fever, severe​ diarrhea, and anorexia. Which of the following medications would the nurse determine to be most effective to relieve the​ anorexia, as well as to stimulate the​ client's appetite? Select all that apply. a Dronabinol​ (Marinol) b Zidovudine​ (Retrovir, AZT) c Ciprofloxacin​ (Cipro) d Megestrol​ (Megace) e Abacavir​ (Ziagen)

b

The nurse is caring for a client with suspected AIDS dementia. The first sign of dementia in the client with AIDS is: a. changes in gait b. loss of concentration c. problems with speech d. seizures

b

The nurse is caring for a hospitalized client with a decreased CD4​ T-cell count. What is this client​'s priority​ need? a Planning diet and nutrition b Implementing careful infection control measures c Teaching regarding safer sex d Referring to social work for counseling

a ​Rationale: A child with an immune disorder such as​ HIV/AIDS should not be immunized with a live varicella​ vaccine, because of the risk of contracting the disease.​ DTaP, HIB, and hepatitis B vaccinations are not live​ vaccines, and should be given on schedule.

The nurse is discharging an​ HIV-positive pediatric client who has recently developed AIDS. The nurse is teaching the​ client's mother about health promotion activities for the child. It is important for the nurse to tell the mother that the client should not receive which immunizations due to​ HIV/AIDS status? a Varicella vaccine b Haemophilus influenzae type B​ (HIB conjugate​ vaccine) c Hepatitis B vaccine​ (hep B) d Diphtheria and tetanus toxoids and acellular pertussis vaccine​ (DTaP)

b

The nurse is discussing breast feeding with a postpartum client. Breast feeding is contraindicated in the postpartum client with: a. diabetes b. HIV c. hypertension d. thyroid disease

a,c,d ​Rationale: A client with HIV is at risk for a myriad of​ bacterial, viral,​ fungal, and opportunistic infections because of the effect of the virus on the immune system. The nurse teaches the family to keep those who have symptoms of illness away from the child and also instructs them in proper​ hand-washing technique and proper food handling to prevent infection. Tuberculosis skin tests should be administered​ annually, not every six months. Fresh fruits and vegetables are not recommended for a client with a depressed immune system.

The nurse is planning care for a pediatric client with HIV. The nurse selects Risk for Infection as a priority nursing diagnosis for this client. Which interventions are appropriate for a child with this​ diagnosis? Select all that apply. a Monitoring​ hand-washing techniques used by the famly b Instructing on the importance of consuming ample fresh fruits and vegetables c Assessing the health status of all visitors d Teaching proper​ food-handling techniques to the family e Administering tuberculosis skin tests every six months

a

The nurse is preparing to discuss issues of sexuality with a client with AIDS. Which discussion point would be the most beneficial to the client​ initially? a Establishing a trusting relationship and nonjudgmental attitude b Providing the client with names of support groups for persons with AIDS c Advising the client that sexual relations are not recommended d Arranging for a spiritual advisor to visit the client

b

The nurse is providing education to a client with HIV who wishes to pursue complementary therapies to decrease the side effects of antiretroviral therapies. Which complementary therapy is not recommended for this​ client? a Vitamin supplements b Garlic supplements c Aroma therapy d Meditation therapy

b,c,d,e

The nursing is providing discharge instructions for a client with AIDS. Which instructions should the nurse​ emphasize? ​(Select all that​ apply.) a Necessity of spiritual counseling b Importance of regular​ follow-up examinations and monitoring of immune status c Medications and side effects d Signs and symptoms of opportunistic infections and cancers e Infection prevention and transmission

b Rationale: Zinc deficiency is associated with taste changes, so the nurse would suggest zinc supplements. Drinking salty broth will replace lost electrolytes but will not help taste. Dairy foods are better food choices than meat when taste is altered. Using plastic utensils sometimes helps avoid a metallic taste when eating.

Which of the following should the nurse suggest to a client who is HIV positive and who has the nursing diagnosis of Disturbed Gustatory Perception? a Increase intake of meat to at least once a day. b Try zinc supplements to stimulate taste perception. c Drink plenty of salty broths to stimulate the taste buds. d Avoid using plastic eating utensils.

4 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. Focus: Prioritization

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? 1. The patient is reporting pain at the site of the infusion. 2. The patient is not taking in an adequate amount of oral fluids. 3. Blood pressure is 104/76 mm Hg after pentamidine administration. 4. Blood glucose level is 55 mg/dL after medication administration.

d

You are providing nursing care for Ms.​ James, who was diagnosed with HIV last year. Ms. James tells you that she has become isolated and depressed because she fears she will never have another sexual relationship. Which response is most​ appropriate? a ​"It is possible to be happy while having only nonsexual​ relationships." ​b "It is important that you accept that you may never have another sexual relationship​ again." ​c "It is important that you avoid meeting new people because that can lead to unsafe​ sex." ​d "It is important to continue to meet people and develop social relationships while practicing safer​ sex."

2 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. Focus: Delegation

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? 1. Assessing patients' nutritional needs and individualizing diet plans to improve nutrition 2. Collecting data about the patients' responses to medications used for pain and anorexia 3. Teaching the UAPs about how to lower the risk for spreading infections 4. Assisting patients with personal hygiene and other activities of daily living as needed

2 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. Focus: Prioritization

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? 1. Putting on a mask and gown before entering the patient's room 2. Giving the patient a glass of water after administering the ordered oral nystatin (Mycostatin) suspension 3. Suggesting that the patient should order chile con carne or chicken soup for the next meal 4. Placing a "No Visitors" sign on the door of the patient's room

d

a client with AIDS asks why he cannot have a pitcher of water left at his bedside. The nurse tells the client that: a. it would be best for him to drink ice water b. he should drink several glasses of juice instead c. it makes it easier to keep a record of his intake d. he should not drink water that has been sitting for a period of time

d

a client with AIDS complains of weight loss of 20 pounds in the past month. Which diet is suggested for the client with AIDS? a. high calorie, high protein, high fat b. high calorie, high carbohydrate, low protein c. high calorie, low carbohydrate, high fat d. high calorie, high protein, low fat

a

a client with AIDS tells the nurse that he regulary takes echinacea to boost his immune system. The nurse should tell the client that: a. Herbals can interfere with the action of the antiviral medication b. supplements have proven effective in prolonging life c. herbals have been shown to decrease the viral load d. supplements appear to prevent replication of the virus

d

a client with HIV has gastrointestinal symptoms including diarrhea. The nurse should teach the client to avoid: a. calcium rich foods b. canned or frozen veges c. processed meat d. raw fruits and veges

d

a client with HIV is taking Zovirax (acyclovir). Which instruction should the nurse give the client taking acyclovir? a limit your activity while taking the medication b. supplement your diet with high carbohydrate sources c. use an incentive spirometer to improved respiratory function d. increase your fluid intake to eight glasses of water a day

b if infused to rapidly pentamidine can cause severe hypotension and hypoglycemia

a client with pneumocystis jiroveci pneumonia is receiving intravenous pentam (pentamidine) While administering the medication the nurse should give priority to checking the clients: a. deep tendon reflexes b. blood pressure c. urine output d. tissue turgor