HIV/AIDS- Pearson

Presence of arthralgia and myalgia ​CD4+ T-lymphocyte count higher than ​500/mm3 Malaise and​ flu-like symptoms Malaise,​ flu-like symptoms, a normal lymphocyte​ count, and presence of arthralgia and myalgia are all findings that support the diagnosis of a clinical stage 1​ (acute) HIV infection. Ataxia and oral hairy leukopenia are associated with later stages of infection.

A client reports to the nurse that they have not been feeling well and is concerned about being exposed to HIV. Which assessment finding supports a diagnosis of clinical stage 1​ (acute) HIV​ infection? (Select all that​ apply.) Presence of arthralgia and myalgia ​CD4+ T-lymphocyte count higher than ​500/mm3 Malaise and​ flu-like symptoms Oral hairy leukoplakia Ataxia

Elevated cholesterol and diabetes 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.

An patient with HIV is being treated with highly active antiretroviral therapy (HAART) and protease inhibitors (PI) therapy. Laboratory results indicate increased triglycerides. The nurse should recognize that the patient is at risk for which conditions? Skin cancer and pneumonia Kidney disease and lung cancer Elevated cholesterol and diabetes Stomach cancer and lymphoma

"If your CD4 count rises and your viral load​ decreases." Although treatment may decrease viral​ symptoms, therapy is not evaluated by a lack of symptoms in a specific time period. Periodic blood tests will be performed to measure the effectiveness of therapy. A favorable response would show an increase in CD4 counts and a decrease in viral load. A Western blot test is used at the time of initial diagnosis and is not used to determine response to therapy. Therapies may be changed periodically because the virus might mutate and therapy may not be as​ effective, but therapy is not changed randomly.

A client with HIV is being treated with a nucleoside reverse transcriptase inhibitor medication. The client asks the​ nurse, "How will I know if this drug is​ working?" Which response by the nurse is​ correct? ​"If you​ don't develop viral symptoms for a​ 3-month period." ​"It is impossible to​ know, so your doctor will frequently change your​ therapy." ​"If your Western blot test converts to​ negative." ​"If your CD4 count rises and your viral load​ decreases."

​"You should take antiretroviral medications as​ prescribed." Once an individual is diagnosed with​ HIV, the healthcare provider will prescribe antiretroviral therapy to attempt to eradicate or control the disease.​ Therefore, the nurse would instruct the client to take antiretroviral therapy as prescribed. Obtaining routine​ vaccinations, eating​ healthy, and exercising help maintain health but are not the most effective in preventing disease progression. The nurse would instruct the client to refrain from having unprotected sex to prevent disease transmission to others.

A client with a new diagnosis of HIV infection asks the nurse how to control the disease. Which statement is most accurate regarding HIV management to prevent disease​ progression? ​"You should eat healthy meals and​ exercise." ​"You should obtain routine​ vaccinations." ​"You should take antiretroviral medications as​ prescribed." ​"You should refrain from having unprotected​ sex."

It will decrease the symptoms. It will treat opportunistic infections and cancers. It will prolong life for the affected individual. It will stimulate hematopoietic response. HIV infection cannot be​ cured, but the viral load can be controlled using​ antiretrovirals, opportunistic infections can be​ treated, hematopoiesis can be​ stimulated, and individuals can greatly prolong their lives with effective therapy.

A client with newly diagnosed HIV​ states, "I​ don't know if I want to take the mediation.​ What's the​ point?" Which information should the nurse include when explaining the goals of pharmacologic management to the​ client? (Select all that​ apply.) It will decrease the symptoms. It will cure the infection. It will treat opportunistic infections and cancers. It will prolong life for the affected individual. It will stimulate hematopoietic response.

"There is a time frame between exposure and seroconversion where the test will be negative." There is a period of time (usually 13 weeks) between exposure to HIV and seroconversion, as most tests diagnose HIV by the presence of antibodies and not if the virus is present. The nurse should not inform the patient the first test 2 years ago was defective, as this is not accurate. Some diagnostic tests are more accurate than others, but this is not the best response as the patient was tested immediately after contact. The nurse would not recommend the patient contact the previous healthcare provider as this does not provide the patient with information.

A patient admitted to the hospital is diagnosed with Pneumocystis jiroveci pneumonia and AIDS. The patient informs the nurse of having a negative HIV test 2 years ago after having unprotected sex and asks how this could happen. Which response by the nurse is accurate? "There is a time frame between exposure and seroconversion where the test will be negative." "I would contact your former healthcare provider that prescribed the test 2 years ago and followup." "Which diagnostic test did your healthcare provider use? There are some that are more effective than others." "The diagnostic test may have been defective and given you a false negative result."

"Continue taking antiretroviral therapy." It has been determined that antiretroviral therapy is beneficial for both the mother and the fetus during pregnancy. It helps prevent disease progression in the mother and decreases the risk of disease transmission to the fetus. The nurse should not recommend that the mother obtain an abortion. The healthcare provider will provide the patient information needed to make an informed decision regarding the pregnancy. The nurse would not instruct the patient to stop taking all medication, as this instruction should be provided by the primary healthcare provider, not the nurse. The nurse would instruct the patient to see an HIV and AIDS perinatal healthcare provider, not a geneticist.

A patient who is HIV positive informs the nurse about being pregnant. Which instruction should the nurse give to the patient? "Seek medical attention from a geneticist." "I recommend you obtain an abortion." "Refrain from taking any medications." "Continue taking antiretroviral therapy."

"Your infection-fighting cells are diminished because of AIDS." T lymphocytes function to maintain normal immune function (a body's ability to resist disease). HIV infection causes the loss of the T lymphocytes, leading to immunodeficiencies. If a patient is immunodeficient, it allows infectious materials, such as the organisms that cause bronchitis, to invade and proliferate in the patient's body. While patients with AIDS are at risk for opportunistic infections, bronchitis is not an opportunistic infection. The patient is not experiencing bronchitis because of smoking. Taking extra vitamin C will not increase the patient's ability to ward off infection. This patient has a compromised immune system and is more vulnerable to infection.

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

Complete blood count The side effects of zidovudine include anemia and neutropenia. Therefore, the nurse would assess the complete blood count for the red blood cell and white blood cell counts. The CD4 test and viral load determines disease progression, not medication side effects. The ELISA test is a test used to diagnose HIV.

A patient with HIV was prescribed zidovudine about a month ago to manage the disease. Which laboratory test should the nurse monitor to assess for dose-limiting side effects of this medication? Complete blood count ELISA test Viral load CD4 count

Access to support systems Client understanding information relating to the condition Access to resources for future care An initial psychosocial assessment is important to determine the​ client's developmental age and ability to understand the​ diagnosis, coping​ mechanisms, and support​ systems, as well as access to and availability of resources in order to provide competent care. The psychosocial assessment does not include assessment of​ symptoms, or determination of exposed individuals.

During the initial​ interview, the nurse assesses the psychosocial history of a client diagnosed with HIV. Which information is the nurse​ seeking? (Select all that​ apply.) Presence of​ viral-like symptoms that will aid in staging infection Access to support systems Contacts who will require notification of potential exposure Client understanding information relating to the condition Access to resources for future care

"This test measures the amount of actively replicating HIV." HIV viral load tests measure the amount of actively replicating HIV. The most widely used screening test for HIV infection is the ELISA test, not the viral load test. A complete blood count (CBC), not a viral load test, detects anemia, leukopenia, and thrombocytopenia.The Western blot, ELISA, and HIV rapid antibody test screen for HIV antibodies and do not measure viral load.

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

Infusing total parenteral nutrition Reviewing total protein and albumin levels Obtaining daily weights The client has wasting syndrome related to AIDS. The​ collaborative-care interventions would be to weigh the client every day to assess response to total parenteral nutrition. The nurse would collaborate with the pharmacist and the healthcare provider for this intervention. The healthcare provider would prescribe laboratory diagnostic testing such as total protein and albumin​ levels, which the nurse would review.

The healthcare team is discussing the care of a client with wasting syndrome secondary to AIDS. Which intervention would be appropriate for the nurse to include in the plan of care to address the​ client's nutritional​ needs? (Select all that​ apply.) Turning the client every 2 hours Administering intravenous fluids Infusing total parenteral nutrition Reviewing total protein and albumin levels Obtaining daily weights

A​ 60-year-old male who has unprotected sex HIV is becoming more prevalent in older adults due to inadequate knowledge of HIV transmission. They may not take preventive​ measures, such as using​ condoms, or may not feel comfortable discussing​ HIV/AIDS risk or condom use with their new partners.​ Therefore, the​ 60-year-old male who has unprotected sex is at highest risk. Intravenous drug​ use, not inhaled and oral drug​ abuse, is a risk factor. Cervical dysplasia can occur from HIV​ infection, but it is not a risk factor. A​ 30-year-old female in a heterosexual monogamous relationship is at low risk for contracting HIV.

The nurse is assigned to care for four clients today in the clinic. Which client has the highest risk for contracting HIV​ infection? A​ 60-year-old male who has unprotected sex A​ 50-year-old female with cervical dysplasia A​ 40-year-old male who smokes marijuana A​ 30-year-old female in a heterosexual monogamous relationship

A 60-year-old who is healthy and asymptomatic The asymptomatic patient is most likely to question a new diagnosis of HIV. The 50-year-old female with arthralgia and lymphadenopathy has symptoms of HIV disease, but not full-blown AIDS. The 30-year-old male who presents with Kaposi sarcoma is presenting a symptom often found in patients with AIDS. The 40-year-old patient with Pneumocystis jiroveci pneumonia indicates the presence of an opportunistic infection. This is diagnostic of full-blown AIDS.

The nurse is assigned to care for four patients today. Which patient is most likely to question a new diagnosis of HIV? A 60-year-old who is healthy and asymptomatic A 50-year-old female with arthralgia and lymphadenopathy A 40-year-old male with Pneumocystis jiroveci pneumonia A 30-year-old male who presents with Kaposi sarcoma

Nystatin The client with oral candidiasis would be prescribed nystatin swish and spit. Ganciclovir is used to treat cytomegalovirus. Amphotericin B is an antifungal medication that is used to treat esophagitis.​ Trimethoprim-sulfamethoxazole is used to treat bacterial infections such as Pneumocystis jiroveci pneumonia.

The nurse is caring for a client that presents with oral candidiasis related to HIV and AIDS immunosuppression. Which medication shouldthe nurse expect the healthcare provider to​ prescribe? Amphotericin B ​Trimethoprim-sulfamethoxazole Ganciclovir Nystatin

Identifying the cause of altered nutrition Providing supplementary vitamins Providing foods that are high in protein and calories Assisting with oral hygiene Appropriate interventions for a client experiencing imbalanced nutrition related to AIDS include providing foods that are high in protein and​ calories, assisting with oral​ hygiene, providing supplementary​ vitamins, and identifying the cause of the altered nutrition. Serving larger portions is not an appropriate intervention for this client.

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

Purplish-red skin lesions The patient with Kaposi sarcoma would present with purplish-red lesions on the skin. A productive cough occurs with tuberculosis and other respiratory infections, not Kaposi sarcoma. Candidiasis involves white patches in the oral cavity. An elevated alkaline phosphatase is seen in Mycobacterium avium complex.

The nurse is caring for a patient with AIDS who presents with a diagnosis of Kaposi sarcoma. Which manifestation should the nurse expect to find during the physical assessment? White bumps in the mouth Elevated alkaline phosphatase A productive cough Purplish-red skin lesions

Offering soft foods The best way to help this patient improve nutrition is by offering soft foods until the candidiasis improves. Megestrol will increase the appetite but will not alleviate the soreness related to eating. Tube feedings and parenteral nutrition would work but are not very cost effective as the patient has no problems with absorption or swallowing.

The nurse is caring for a patient with AIDS who reports painful mouth sores related to candidiasis. The patient is losing weight due to the sores and a poor appetite. Which nursing intervention is appropriate for this patient? Administering megestrol Providing tube feedings Administering parenteral nutrition Offering soft foods

Skin integrity A patient with Kaposi sarcoma will have purplish-red lesions on the skin. Therefore, it is important that the nurse assess the skin. The nurse would assess breath sounds and cough in a patient with Pneumocystis jiroveci pneumonia. The nurse would assess for nausea and vomiting in a patient taking antiretrovirals or with AIDS wasting syndrome.

The nurse is caring for a patient with Kaposi sarcoma due to AIDS. Which assessment would be most appropriate for the nurse to include in the plan of care? Breath sounds Presence of a cough Skin integrity Nausea and vomiting

Collaborate with healthcare prescriber to administer intravenous fluids. The best intervention for a patient with a fluid volume deficit related to multiple diarrheal stools would be to provide fluids to meet the losses. It is important to provide perineal care after each bowel movement, but this does not address fluid needs. The nurse would not collaborate with the healthcare provider to discuss discontinuation of the antiretroviral medications, as this would worsen the HIV/AIDS. A meeting with the nutritionist to discuss increasing dietary fiber would not be indicated since including more fiber in the diet may increase the amount of diarrhea the patient is experiencing.

The nurse is caring for a patient with severe diarrhea related to wasting syndrome and antiretroviral therapy. The nurse develops a plan of care to address altered fluid volume related to multiple diarrheal stools. Which intervention is most appropriate for the nurse to implement? Collaborate with healthcare prescriber to administer intravenous fluids. Collaborate with healthcare prescriber to discontinue the use of antiretroviral medication. Meet with nutritionist to discuss ways to increase fiber in diet. Implement independent nursing intervention to provide skin care to perineal area

They are not comfortable talking about condom use. Their HIV symptoms may be overlooked. They may not understand the importance of HIV testing. Older clients who have been in monogamous relationships earlier in their lives often find themselves newly single as a result of divorce or death of a​ partner; when these clients resume sexual​ relations, they may not understand the risks for HIV due to lack of knowledge about its transmission. They may not take preventive​ measures, such as using​ condoms, or may not feel comfortable discussing​ HIV/AIDS risk or condom use with their new partners. Individuals in this age group also may not be aware of the importance of getting tested for HIV or discussing it with their healthcare provider. In​ addition, manifestations of HIV may be overlooked by healthcare​ professionals, being attributed to normal​ age-related physiologic changes. There is not evidence that this group frequently engages in​ same-sex relationships or commonly experiments with drugs.

The nurse is caring for a​ 59-year-old woman who is recently divorced. The nurse understands that this client falls into the population of individuals who are called the​ "invisible population" due to which​ factor? (Select all that​ apply.) They will frequently engage in​ same-sex relationships. They commonly experiment with drugs. They are not comfortable talking about condom use. Their HIV symptoms may be overlooked. They may not understand the importance of HIV testing.

"When a person is initially infected, they will feel like they have the flu. After that, they may be asymptomatic for years." Most patients who are HIV positive dismiss the initial symptoms, as they are similar to a viral infection and go away after time. The second stage is the latency period where the patient does not experience any symptoms. This supports the nurse's response. The nurse would not point out the risk factors or question why the patient feels the way they do. This is not therapeutic communication. The nurse could talk to the healthcare provider about repeat testing, but that is not necessary. The nurse would not tell the patient that the laboratory tests are double checked, as this is inaccurate.

The nurse is developing a plan of care for a patient with a new diagnosis of HIV. The patient is confused and denies the diagnosis as there are no symptoms present. Which is the nurse's best response to this patient? "When a person is initially infected, they will feel like they have the flu. After that, they may be asymptomatic for years." "You have several of the risk factors for the development of HIV. What makes you think this diagnosis is inaccurate?" "The laboratory results usually are accurate, as they double check any positive test results." "I can talk to your healthcare provider to have you undergo repeat diagnostic testing for HIV infection."

Sub-Saharan Africa Two thirds of all cases exist, and 90% of infected children live, in sub-Saharan Africa. Other geographic regions with high HIV and AIDS population are: Southeast and Central Asia the Americas Eastern Europe the Pacific Latin America the Caribbean.

The nurse is preparing a presentation regarding HIV. Which location regarding where most cases of HIV are occurring does the nurse include? Sub-Saharan Africa Latin America Eastern Europe Asia

Nausea and vomiting Didanosine has a life-threatening side effect of pancreatitis. Therefore, if the patient has nausea and vomiting and/or elevated pancreatic enzymes, the nurse would hold the dose and notify the healthcare provider. Thrombocytopenia is a side effect of zidovudine. A CD4 count of less than 250/mm3 is expected in a patient with HIV/AIDS. Although the risk for peripheral neuropathy increases with didanosine, it more commonly occurs with abacavir.

The nurse is preparing to administer didanosine, a nucleoside reverse-transcriptor inhibitor, to a patient who is HIV positive. Which assessment finding would cause the nurse to hold the dose of medication? Peripheral neuropathy Thrombocytopenia CD4 count of less than 250/mm3 Nausea and vomiting

Total parenteral administration The patient with wasting syndrome related to malabsorption would most benefit from total parenteral nutrition as this form of nutrition is administered through the veins. A patient with malabsorption would not be able to absorb nutrients from the gastrointestinal tract. Therefore, enteral tube feedings, increasing oral protein intake, and oral nutritional supplements would not be effective.

The nurse is prioritizing care for a patient with AIDS that presents with malabsorption related to wasting syndrome. Which collaborative intervention would most benefit this patient to improve their nutritional status? Oral nutritional supplements Total parenteral administration Diet high in protein Enteral tube feedings

Medications and side effects Importance of regular​ follow-up examinations and monitoring of immune status Signs and symptoms of opportunistic infections and cancers Infection prevention and transmission Discharge instructions for a client with AIDS should focus on infection prevention and​ transmission, the importance of​ follow-up appointments and monitoring the immune​ status, signs and symptoms of opportunistic infections and​ cancer, and medication teaching to include side effects. If the client asks about spiritual​ counseling, information should be provided.​ However, this is not a necessity for discharge teaching.

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

Lethargy Urinary incontinence Ataxia AIDS-related dementia is the most common reason for mental status changes in the client with AIDS. The clinical manifestations include memory​ loss, confusion, and lethargy. As the disorder​ progresses, the client will develop ataxia​ (an abnormal​ gait) and incontinence. A rash and myalgia are early clinical manifestations of HIV infection.

The nurse is reviewing the medical record of a client with a diagnosis of​ AIDS-related dementia. Which clinical manifestation should the nurse expect to find during the physical​ assessment? (Select all that​ apply.) Lethargy Urinary incontinence Myalgia Rash Ataxia

Frequently washing hands Individuals who become immunosuppressed due to HIV are at risk for contracting secondary infections. The most important strategy to prevent infection is frequent handwashing using correct technique. Prophylactic antibiotics are not indicated at this point in the HIV spectrum. Wearing masks and avoiding pet excrement may or may not be​ indicated, but are not more important than handwashing.

The nurse is teaching a client who has HIV about preventing secondary infections. Which action is most important for the nurse to include for helping the client prevent a secondary​ infection? Frequently washing hands Wearing a mask in public places Adhering to prophylactic antibiotics Avoiding cleaning up pet excrement

Influenza The client who is HIV positive should receive an annual influenza vaccine to decrease the risk of obtaining the flu. Zostavax is a​ one-time vaccination to prevent shingles. Hepatitis B vaccine is administered over a​ 6-month time frame and three injections. Pneumovax is given 5 years apart over two injections.

The nurse is teaching a client who is HIV positive about needed immunizations. Which vaccination should the client obtain on an annual​ basis? Zostavax Pneumovax Hepatitis B Influenza

Abstinence from any sexual activity The nurse should include information regarding safe sexual practices in order to prevent HIV transmission. The best way to prevent HIV is complete sexual abstinence. The patient does not need to refrain from drinking after others, as HIV does not live long outside the body. The patient should never share needles, not limit. While thorough hand washing is always good practice, this will not impact the transmission of HIV.

The nurse is teaching a group of college students ways to prevent contracting HIV. Which should the nurse include as an effective way to prevent HIV transmission? Abstinence from any sexual activity Refraining from drinking from the same glass after others Meticulous hand washingafter using restroom Limiting the number of people with whom they share needles

Garlic supplements Garlic supplements are contraindicated for a patient receiving antiretroviral therapies. Meditation therapy and aromatherapy are complementary therapies that can be safely implemented. Vitamin supplements are not considered a complementary therapy.

The nurse is teaching a patient with HIV who wishes to pursue complementary therapies to decrease the side effects of antiretroviral therapies. Which complementary therapy should the nurse instruct the patient to avoid? Vitamin supplements Garlic supplements Aroma therapy Meditation therapy

Candidiasis The patient'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.

The nurse notices that the latest laboratory report of a patient with a history of HIV indicates a CD4 T-cell count of less than 200/mm3. Which condition should the nurse assess for during the patient's examination? Rheumatoid arthritis Dysmenorrhea Psoriasis Candidiasis

"If you test positive for HIV, we will confirm with another test that is more accurate." Rapid diagnostic tests are widely used because the results can be given immediately. Immediate notification of results is critical because many patients who are tested for HIV do not return to learn the results and then cannot be located to be given the test results and taught about safe behaviors regardless of their HIV status. Further testing is always required to confirm a reactive or rapid screening test result.

The nurse performs a rapid diagnostic test for HIV at a patient's request. The patient asks, "Will this test really tell me if I have HIV?" Which response by the nurse is the most appropriate? "It is not very reliable, but is less costly." "This test is very sensitive and will confirm one way or the other." "You don't need to worry as we wouldn't use this if it were not completely accurate." "If you test positive for HIV, we will confirm with another test that is more accurate."

Keep the client NPO if diarrhea occurs. Diarrhea is a common occurrence for a client with AIDS. The client should not be​ NPO, but rather antidiarrheal medications should be administered after stools and the client should receive an antiemetic prior to meals. Reducing diarrhea improves nutrient absorption. Preprandial medication with an antiemetic reduces nausea and improves food intake. Administering appetite stimulants such as megestrol​ (Megace) may increase appetite and promote weight gain. Oral care before and after meals will help maintain intact mucosa.​

The nurse preceptor is reviewing a plan of care created by a new graduate for a client with AIDS with a nursing diagnosis of ​Nutrition, Imbalanced: Less than Body Requirements. Which nursing intervention requires​ follow-up by the​ preceptor? Administer prescribed megestrol​ (Megace) prior to meals. Provide oral care before and after meals. Keep the client NPO if diarrhea occurs. Administer prescribed preprandial antiemetic prior to meals.

Roommate with community acquired pneumonia The patient with AIDS and a CD4 count of less than 100/mm3 is at high risk for infection. Therefore, the nurse should not assign the patient to a room with a roommate that has an infectious disease such as community-acquired pneumonia. If a private room is not available, then a patient with chronic obstructive pulmonary disease, congestive heart failure, and uncontrolled diabetes mellitus would not increase this patient's risk of infection.

The nurse receives a report from the emergency department on a new patient to be admitted with AIDS and a CD4 count of less than 100/mm3. Which room assignment would be contraindicated for this patient? Roommate with chronic obstructive pulmonary disease Roommate with uncontrolled diabetes mellitus Roommate with congestive heart failure Roommate with community acquired pneumonia

Having unprotected sex Sharing needles Getting tattoos HIV is spread through contact with blood and body fluids.​ Therefore, the nurse should instruct the adolescent to refrain from getting​ tattoos, sharing​ needles, and having unprotected sex. Using public restrooms does not increase an​ individual's likelihood of contracting HIV. Smoking crack cocaine does not lead to the spread of​ HIV, because there is no contact with blood or body fluids.

The nurse working in a clinic discusses HIV prevention with an adolescent. Which behavior should the nurse instruct the adolescent to avoid to minimize the risk of contracting​ HIV? (Select all that​ apply.) Using public restrooms Having unprotected sex Sharing needles Smoking crack cocaine Getting tattoos

To be protected, condoms must be worn for vaginal, oral, and anal intercourse. The school nurse should include information about the most common modes of transmission for individuals in this age group. The most common modes of transmission in adolescents is unsafe sex and substance abuse practices. Adolescents need to be informed that condoms should be worn for every sexual encounter; not just for vaginal intercourse. They also need to be informed that they should never share needles, since the current HIV status of all individuals would not be known. A mutually monogamous sexual relationship may be safe onlyif both individuals are known to be HIV negative. Mutual masturbation with direct contact is not a safe practice and would require protection.

The school nurse is teaching a group of adolescents about HIV transmission. Which risk factor is imperative to include in the presentation for this age group? To be protected, condoms must be worn for vaginal, oral, and anal intercourse. Mutual masturbation with direct contact is a low risk sexual practice. Sharing needles for drug injection is safe if both individuals are HIV negative. Sex is safe if the relationship is monogamous.

Cough Dyspnea Fever Pneumocystis jiroveci pneumonia is an opportunistic infection that can affect clients with HIV. The clinical manifestations include​ fever, cough,​ dyspnea, tachypnea, and tachycardia. Diarrhea causes wasting syndrome. Oral lesions are seen with candidiasis.

Which clinical manifestation should the nurse expect to find in a client with a diagnosis of Pneumocystis jiroveci​ pneumonia? (Select all that​ apply.) Cough Dyspnea Fever Diarrhea Oral lesions

Unprotected sexual activity The incidence of HIV and AIDS in older adults has increased due to unprotected sexual activity. Many older adults are unaware how the HIV virus is transmitted. Older adults are divorced or widowed and engage more in unprotected sexual activity. Needle sharing and tattoos are not risk factors in older adults. Polypharmacy becomes a problem when antiretroviral therapy is combined with medications commonly used in the older adult.

Which factor best explains the increase in HIV and AIDS in older adults? Polypharmacy Sharing of needles Unprotected sexual activity Tattoos

Viral load greater than 10,000 copies/mL A person will convert from HIV to AIDS when the viral load is greater than 10,000 copies/mL. A CD4 count of 800/mm3 indicates good immune function. A person with HIV will have a diminished white blood cell count (lymphopenia). A positive Western blot test indicates a diagnosis of HIV, not AIDS.

Which finding in the patient's medical record indicates that the patient has progressed from being HIV positive to AIDS? CD4 count of 800/mm3 Positive Western blot result Viral load greater than 10,000 copies/mL Decreased white blood cell count

Providing supplementary vitamins Appropriate interventions for this patient include identifying causes of altered nutrition, providing supplemental vitamins and enteral feedings, and providing or assisting with oral hygiene. The patient should be encouraged to eat any time they are not actively anorexic or uncomfortable. The patient should also be provided with a high-calorie diet. Total parenteral nutrition is reserved for patients with wasting syndrome who are unable to absorb nutrients.

Which intervention is appropriate for treating imbalanced nutrition in a patient with HIV? Providing supplementary vitamins Providing a low-calorie diet Providing total parenteral nutrition Encouraging the patient to eat only when hungry

Pneumocystis jiroveci pneumonia A client has a diagnosis of AIDS when the client develops Pneumocystis jiroveci​ pneumonia, tuberculosis, Kaposi​ sarcoma, or sustains weight loss of greater than​ 10% total body​ weight, or the CD4 count drops below ​200/mm3. Herpes zoster is seen in​ HIV-positive individuals in stage 2.

Which medical record should indicate to the nurse that the client has converted from being HIV positive to having fully contracted​ AIDS? CD4 count of ​400/mm3 Pneumocystis jiroveci pneumonia Weight loss of​ 5% of total body weight Herpes zoster infection

Goggles Gloves Masks When using a bulb syringe to suction the nares of an​ HIV-positive infant, the personal protective equipment should include​ masks, gloves, and goggles.​ N-95 respirators are used to care for​ HIV-positive/AIDS clients with tuberculosis. Covered footwear is not necessary when suctioning the nasal passages.

Which personal protective equipment should be utilized when using a bulb syringe to suction the nose of an infant infected with​ HIV? (Select all that​ apply.) Goggles ​N-95 respirator Covered footwear Gloves Masks

The HIV virus sheds its protein coat and uses reverse transcriptase to convert viral RNA to DNA. Once the patient is exposed to the HIV virus, it discards its protein coat and uses reverse transcriptase to convert viral RNA to DNA. The DNA of the HIV virus is then combined into the DNA of the host cell, which undergoes normal cellular replication. The HIV virus produces new RNA and forms virions that are unable to reproduce outside the cell. The last step is that the HIV virus in the cells activates antibody production to its proteins, causing seroconversion.

Which statement describes the initial cellular change that occurs with HIV infection? The HIV virus sheds its protein coat and uses reverse transcriptase to convert viral RNA to DNA. The HIV virus DNA is integrated into host cell DNA, which reproduces during normal cellular replication. The HIV virus within cells triggers antibodies to be produced to its proteins, causing seroconversion. The HIV virus produces new RNA and forms virions that are unable to reproduce outside the cell.

​"I plan to breastfeed my baby to save money on infant​ formula." When the pregnant client who is HIV positive states that they wish to​ breastfeed, it requires​ correction, because breastfeeding can increase the risk of disease transmission to the infant. Women who are HIV positive will undergo a cesarean section to decrease the risk of transmission. The newborn will begin zidovudine after birth to decrease the risk of seroconversion.

Which statement made by a​ 34-week pregnant client who is HIV positive indicates a need for further​ teaching? ​"My newborn baby will begin treatment with zidovudine after​ birth." ​"I plan to breastfeed my baby to save money on infant​ formula." ​"If I follow the treatment​ regimen, my baby may not develop HIV​ infection." ​"I will enter the hospital in a month for a planned cesarean​ section."