Immunity and Infection Class Questions
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/L. Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC), which statement by the nurse is correct? A. "The patient will develop symptomatic HIV infection within 1 year." B. "The patient meets the criteria for a diagnosis of acute HIV infection." C. "The patient will be diagnosed with asymptomatic chronic HIV infection." D. "The patient has developed acquired immunodeficiency syndrome (AIDS)."
"The patient has developed acquired immunodeficiency syndrome (AIDS)."
When an infant has had 2 negative tests, testing with ELISA should be performed at what ages? (mother is HIV positive) a)12,15,18 months b) 3,10,24 months c) 3 days old, 6months, 15 months d) 3, 9,20 months
12,15,18 months
What are 3 major classifications of SLE? SATA A. Cardiac Lupus B. Systemic Lupus C. Cutaneous or Discoid Lupus D. Drug Induced Lupus
B. Systemic Lupus C. Cutaneous or Discoid Lupus D. Drug Induced Lupus
Select all that apply, prevention of HIV/AIDS. A. Drink plenty of milk B. Treat all patients alike C. Use barrier precautions to prevent contact D. Shower regularly E. Treat all high-risk body fluids as infectious
B. Treat all patients alike C. Use barrier precautions to prevent contact E. Treat all high-risk body fluids as infectious
A 26 year-old woman has been diagnosed with early systemic lupus erythematosus (SLE) involving her joints. In teaching the patient about the disease, the nurse includes the information that SLE is an A Hereditary disorder of women but usually does not show clinical symptoms unless a woman becomes pregnant. B Autoimmune disease of women in which antibodies are formed that destroy all nucleated cells in the body. C Disorder of immune function, but it's extremely variable in its course, and there is no way to predict its progression. D Disease that causes production of antibodies that bind with cellular receptors, causing inflammatory response.
Disorder of immune function, but it's extremely variable in its course, and there is no way to predict its progression.
After teaching the client with severe rheumatoid arthritis about prescribed Methotrexate (Rheumatrex) which of the following statements indicated the need for further teaching? I will take my vitamins while on this drug I must not drink any alcohol while I'm taking this drug I should brush my teeth after every meal I will continue taking my birth control pills.
I will take my vitamins while on this drug
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 teratogenic. 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).
Most infants born to HIV-positive mothers are not infected with the virus.
Which patient exposure by the nurse is most likely to require postexposure prophylaxis when the patient's 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
Needle stick with a needle and syringe used to draw blood
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
Needle stick with a needle and syringe used to draw blood
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. Needlestick injury with a suture needle during a surgical procedure
Needle stick with a needle and syringe used to draw blood
What is the main receptor to which HIV must bind to get into the host's body? (Heather Hinkle) a. Spike protein b. CD4 c. MP2 d. D501
CD4
What test is used to diagnose the progression from HIV to AIDS? - A.CD4 B.CBC C. ultrasound D. X-Ray
CD4
Select all that apply, signs and symptoms of Rheumatoid Arthritis. A. Swollen joints B. Excessive eating C. Stiffness D. Fatigue
A. Swollen joints C. Stiffness D. Fatigue
Select all that apply, what are signs/symptoms of aids dementia complex? A. memory loss B. exercising too much C. confusion D. difficulty concentrating E. lethargy
A. memory loss C. confusion D. difficulty concentrating E. lethargy
The patient has been prescribed metronidazole (Flagyl) for Pneumocystis Jirovecii pneumonia and candida. Which instruction should be included for taking Flagyl? A. Take with water only B. Arise slowly after taking medication C. Abstain from alcohol while taking medication D. Remain supine for 30 minutes after taking medication
Abstain from alcohol while taking medication
What are some potential side effects of amphotericin B, a medication used to fight fungal infections in immunocompromised patients? Anorexia b. Chills c. Cramping/Muscle and joint pain d. Circulatory problems e. All of the above
All of the above
Which immune function abnormalities are a result of HIV infection? (Select all that apply) A. lymphocytosis B. CD4+ depletion C. increased CD8+ activity D. long macrophage lifespan E. lymphocytopenia
CD4+ depletion and lymphocytopenia
A nurse is caring for a female patient with the human immunodeficiency (HIV) virus infection. Which statement about HIV infection regarding female patients is most significant? 1. Mean survival time is longer in female patients than in men. 2. Intravenous drug use is the major risk factor for HIV infection in women. 3. Recurrent vaginal candidiasis may be the first sign of the virus in female patients. 4. Women are the slowest-growing group with HIV infection and acquired immune deficiency syndrome (AIDS).
Recurrent vaginal candidiasis may be the first sign of the virus in female patients.
A patient with human immunodeficiency virus (HIV) infection has developed a 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.
The patient will maintain intact perineal skin
Which patient with AIDS should the nurse see first? A. The patient with Kaposi's Sarcoma B. The patient with oral lesions C. The patient with vaginal candidiasis D. The patient with Pneumocystic Jirovecii pneumonia
The patient with Pneumocystic Jirovecii pneumonia
Why can't HIV be passed through sweat, tears or saliva? A. There is no blood in order to sustain the virus. B. The ph is too hostile for the HIV virus to survive. C.There are enzymes in these substances that inhibit HIV. D. The virus is very strong and can survive in these body fluids. E. All of the above.
The ph is too hostile for the HIV virus to survive. There are enzymes in these substances that inhibit HIV.
Why can't HIV be passed through sweat, tears, or saliva? A. There is no blood in order to sustain the virus. B. The ph is too hostile for the HIV virus to survive. C. There is enzymes in these substances that inhibit HIV. D. The virus is very strong and can survive in these body fluids. E. All of the above.
The ph is too hostile for the HIV virus to survive. There are enzymes in these substances that inhibit HIV.
An AIDS patient reports the intention to try acupuncture to help relieve pain. The nurse should be most concerned about this due to: A. Oils and extracts that affect antiretroviral therapy B. Unregulated environment that could lead to an opportunistic infection C. Pressure on affected internal organs D. An increase in neuropathy pain
Unregulated environment that could lead to an opportunistic infection
On a visit to the clinic, a client reports the onset of early symptoms of rheumatoid arthritis. The nurse should conduct a focused assessment for: 1. Limited motion of joints. 2. Deformed joints of the hands. 3. Early morning stiffness. 4. Rheumatoid nodules.
early morning stiffness
What is the most important means of preventing HIV spread? A. engineering B. education C. isolation D. counseling
education
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)
varicella vaccine
The nurse provides dietary teaching for a client who is diagnosed with AIDS. Which client statement indicates a correct understanding of the information presented by the nurse? A. "I will eat three large meals a day" B. "I will be sure to eat my eggs before my toast at breakfast" C. "I will choose french fries instead of a baked potato for dinner tonight" D. "I will use an alcohol-based mouthwash twice per day"
"I will be sure to eat my eggs before my toast at breakfast"
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."
"It is important to participate in a needle-exchange program."
A patient receiving immunosuppressant therapy reports GI upset. Which advice would the nurse give the patient to minimize discomfort? A. "Wait a day and it will stop." B. "You must stop the medication." C. "You must take the medication with food." D. Ask your provider about taking an oral antifungal medicine."
"You must take the medication with food."
When preparing the newly diagnosed client with HIV and significant other for discharge, which explanation by the nurse accurately describes proper condom use? A) ''Condoms should be used when lesions on the penis are present.'' B) ''Always position the condom with a space at the tip of an erect penis.'' C) ''Make sure it fits loosely to allow for penile erection.'' D) ''Use adequate lubrication.
''Always position the condom with a space at the tip of an erect penis.''
Of the Clients listed below, who is at risk for developing RA? (Select all that apply) - 1- Adult between ages 20-50 2-Adult who have had an infectious disease with Epstein-Barr Virus 3-Adults that are of male gender 4- Adults who posses the genetic link specifically HLA-DR4 5- Adults who also have osteoarthritis.
1. Adult between ages 20-50 2-Adult who have had an infectious disease with Epstein-Barr Virus 4- Adults who posses the genetic link specifically HLA-DR4
WHAT IS THE PATHO BEHIND RA? Select all that apply A) LONG TERM EXPOSURE TO UNIDENTIFIED ANTIGEN B)NORMAL ANTIBODIES BECOME AUTOANTIBODIES C)PHYSICAL DAMAGE TO BODY D)MEDICATION
A) LONG TERM EXPOSURE TO UNIDENTIFIED ANTIGEN B)NORMAL ANTIBODIES BECOME AUTOANTIBODIES
Which client is at the highest risk for systemic lupus erythematosus (SLE)? A. An Asian male B. A white female C. An African American male D. An African American female
An African American female
Which client is at the highest risk for contracting HIV? A. An ER Nurse working in a level 1 Trauma center. B. An individual struggling with IV drug use. C. A couple in a monogamous relationship. D. The fetus of a mother who is HIV positive.
An individual struggling with IV drug use.
The nurse is assigned to care for a client with systemic lupus erythematosus (SLE). The nurse plans care knowing that this disorder is: A. A local rash that occurs as a result of allergy B. A disease caused by overexposure to sunlight C. An inflammatory disease of collagen contained in connective tissue D. A disease caused by the continuous release of histamine in the body
An inflammatory disease of collagen contained in connective tissue
Select all that apply. What differentiates rheumatoid arthritis from osteoarthritis? A. Autoimmune related B. Caused by wear and tear. C. Age-related D. Joints are disfigured E. Exercise makes it worse.
Autoimmune related Joints are disfigured
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.
Check the patient's class schedule to help decide when the drugs should be taken.
What does HIV stand for? A: Human, Infection, Virus B: Human, Immunodeficiency, Virus C: Human, In Blood, Virus D: Human, Infestation, Virus
Human, Immunodeficiency, Virus
Which medication below used to treat Systemic Lupus Erythematosus decreases inflammation quickly, is not for long-term usage, and can lead to weight gain, susceptibility to infection, diabetes, and osteoporosis? A. Hydroxychloroquine B. Prednisone C. Azathioprine D. Belimumab
Hydroxychloroquine
A client with AIDS has been admitted with fever, night sweats, and weight loss of 6 pounds in 2 weeks. The client's purified protein derivative (PPD) test, placed 3 days ago in the clinic, is negative. Which action by the nurse is most appropriate? A. Place the client in Airborne Precautions. B. Facilitate the client's chest x-ray. C. Initiate a 3-day calorie count. D. Start an IV of normal saline.
Place the client in Airborne Precautions.
What are some possible extra-articular manifestations of RA? SATA A. Pleural Effusion B. Vasculitis C. Pericarditis D. Pneumonia
Pleural Effusion Vasculitis Pericarditis
Which opportunistic infection complicates human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS)? A. Giardiasis B. Toxoplasmosis C. Trichomoniasis D. Pneumocystis
Pneumocystis
In regards to HIV education, which is the most important education for the Nurse? A. Prevention of HIV. B. Interventions against opportunistic infections. C. Treatment regimen compliance. D. Determine at-risk behavior.
Prevention of HIV.
A nurse is taking a health assessment of a patient who complains of a low-grade fever, fatigue, joint pain, muscle pain, and photosensitivity. SLE is suspected, and the nurse would check for which of the following signs that also occur with SLE? Ascites Polycythemia Red butterfly rash across cheeks and nose Rhonchi
Red butterfly rash across cheeks and nose
What are manifestations of lupus? Select all that apply Red butterfly rash on face Hives Ringing in ears Mouth ulcers
Red butterfly rash on face Hives
Select all that apply, signs and symptoms of SLE. A. Red scaly rashes B. Hair loss C. Extra energy D. Weight loss
Red scaly rashes Hair loss Weight loss
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.
Remind the patient about the need to return for retesting to verify the results.
The nurse is caring for a client with systemic lupus erythematosus (SLE). Which system should the nurse consider as being most affected by the formation of immune complexes and tissue damage? Respiratory Renal Cardiac Integumentary
Renal
Viruses may remain inactive in infected cells, but still produce antibody proteins. This process is called. A. Lysis B. Phagocytosis C. Seroconversion D. Virions
Seroconversion
The nurse is completing a health screening for a school-age child with rheumatoid arthritis. The parents ask the nurse to recommend activities that will promote exercise for their child. Which is an appropriate recommendation by the nurse? A. Softball B. Basketball C. Swimming D. Football
Swimming
What opportunistic diseases are most likely to cause death or disability in HIV patients? (Heather Hinkle) SATA a. Cancer b. TB c. Cold d. Gastritis
TB
Rapid HIV antibody test benefit Test results in 2 days Test results in 5 mins Test results in 15-20 mins Test results in 1 hour
Test results in 15-20 mins
The clinic nurse is instructing the parent of a child with human immunodeficiency virus (HIV) infection regarding immunizations. The nurse should provide which instruction to the parent? a) The hepatitis B vaccine will not be given to the child. b) The inactivated influenza vaccine will be given yearly. c) The varicella vaccine will be given before 6 months of age. d) A Western blot test needs to be performed and the results evaluated before immunizations.
The inactivated influenza vaccine will be given yearly.
Which of the following are early signs and symptoms of an HIV infection. (Select all that apply) Dry mouth Weight loss Sore throat Vaginal dryness Nausea Dyspnea
Weight loss Sore throat Dyspnea
The nurse is teaching a postmenopausal client about the risk of acquiring HIV infection. The client states, I'm an old woman! I cannot possibly get HIV. What is the nurse's best response? A. Your vaginal walls become thicker after menopause, which increases your risk. B. Women in your age-group are the fastest growing population of AIDS clients today. C. Hormonal fluctuations after menopause make it harder to fight off infection. D. You might be right. How often do you engage in sexual activities?
Women in your age-group are the fastest growing population of AIDS clients today.
Which home care instructions should the nurse provide to the parent of a child with acquired immunodeficiency syndrome (AIDS)? Select all that apply. a) Monitor the child's weight. b) Frequent hand washing is important. c) The child should avoid exposure to other illnesses. d) The child's immunization schedule will need revision. e) Clean up body fluid spills with bleach solution (10:1 ratio of water to bleach). f) Fever, malaise, fatigue, weight loss, vomiting, and diarrhea
a) Monitor the child's weight. b) Frequent hand washing is important. c) The child should avoid exposure to other illnesses. e) Clean up body fluid spills with bleach solution (10:1 ratio of water to bleach).
What does the Elisa test for? Antibodies Antigens CD4 cells RBC's
antibodies
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?"
"Can you tell me more about the kind of thoughts that you are having?"
The nurse is caring for a patient who recently had unprotected sex with a partner who has HIV. Which response by the nurse is best? a."You should have your blood drawn today to see if you were infected." b."If you have the virus, you will have flu-like symptoms in 6 months." c."Highly active antiretroviral therapy has been shown effective in slowing the disease process." d."I will set you up with a support group to help you cope with dying within the next 10 years."
"Highly active antiretroviral therapy has been shown effective in slowing the disease process."
The nurse provides home care instructions to the parent of a child with acquired immunodeficiency syndrome (AIDS). Which statement by the parent indicates the need for further teaching? a) "I will wash my hands frequently." b) "I will keep my child's immunizations up to date." c) "I will avoid direct unprotected contact with my child's body fluids.'' d) "I can send my child to daycare if he has a fever, as long as it is a low-grade fever."
"I can send my child to daycare if he has a fever, as long as it is a low-grade fever."
Following instruction for a patient with newly diagnosed systemic lupus erythematosus (SLE), the nurse determines that teaching about the disease has been effective when the patient says: A. "I should expect to have a low fever all the time with this disease." B. "I need to restrict my exposure to sunlight to prevent an acute onset of symptoms." C. "I should try to ignore my symptoms as much as possible and have a positive outlook." D. "I can expect a temporary improvement in my symptoms if I become pregnant."
"I need to restrict my exposure to sunlight to prevent an acute onset of symptoms."
A patient with a negative rapid antibody HIV test result asks the nurse why the HCP scheduled another HIV test in 2 months. What is the nurse's best response? (Rebecca McKee) A. "To obtain baseline data before beginning prophylactic antiretroviral therapy." B. "The diagnosis of HIV is confirmed after two consecutive test results are positive." C. "The rapid antibody HIV test can produce a false-positive result, so it will be repeated." D. "There is a period during which the virus is present in the body but not detected in blood tests."
"There is a period during which the virus is present in the body but not detected in blood tests."
Of the clients listed below, who is at risk for developing rheumatoid arthritis (RA)? Select all that apply. 1. Adults between the ages of 20 and 50 years. 2. Adults who have had an infectious disease with the Epstein-Barr virus. 3. Adults that are of the male gender. 4. Adults who possess the genetic link, specifically HLA-DR4. 5. Adults who also have osteoarthritis.
1. Adults between the ages of 20 and 50 years. 2. Adults who have had an infectious disease with the Epstein-Barr virus. 4. Adults who possess the genetic link, specifically HLA-DR4.
A female client with systemic lupus erythematosus (SLE) is being treated with immunosuppressant drugs and corticosteroids. When providing teaching to this client, which of the following points are appropriate for the nurse to include? Select all that apply. A. Avoid large crowds. B. Don't get a flu shot. C. Use contraception to prevent pregnancy. D. Refrain from taking aspirin products. E. Report any signs of infection to the healthcare provider.
A. Avoid large crowds. C. Use contraception to prevent pregnancy. D. Refrain from taking aspirin products. E. Report any signs of infection to the healthcare provider.
The nurse explains to the patient newly diagnosed with HIV that prophylactic measures should be taken as early as possible during the infection. Should include the following (Select all that apply.)? A. Hepatitis A vaccine B. Hepatitis B vaccine C. Pneumococcal vaccine D. Influenza virus vaccine E. Trimethoprim-sulfamethoxazole F. Varicella zoster immune globulin
A. Hepatitis A vaccine B. Hepatitis B vaccine C. Pneumococcal vaccine D. Influenza virus vaccine
Which statements below are INCORRECT about Systemic Lupus Erythematosus? Select all that apply: A. Lupus mainly affects Black, Asian, and Hispanic men. B. Lupus is a chronic condition that has periods of flare-ups and remission. C. The joints and skin are rarely affected in lupus. D. Systemic Lupus Erythematosus (SLE) is the most common form of lupus.
A. Lupus mainly affects Black, Asian, and Hispanic men. C. The joints and skin are rarely affected in lupus.
Select all that apply, risk factors for HIV/AIDS. A. unprotected sexual intercourse B. high carb diet C. sharing drug equipment D. healthcare as an occupation
A. unprotected sexual intercourse C. sharing drug equipment D. healthcare as an occupation
A patient with polyarthralgia with joint swelling and pain is being evaluated for systemic lupus erythematosus (SLE). The nurse knows that the serum test result that is the most specific for SLE is the presence of: A. Rheumatoid factor. B. Anti-Smith antibody (Anti-Sm). C. Antinuclear antibody (ANA). D. Lupus erythematosus (LE) cell prep.
Anti-Smith antibody (Anti-Sm).
A patient with rheumatoid arthritis has been taking oral corticosteroids for 2 years. Which nursing action is most likely to detect early signs of infection in this patient? A. Monitor white blood cell counts. B. Check the skin for areas of redness. C. Measure the temperature every 2 hours. D. Ask about feelings of fatigue or malaise.
Ask about feelings of fatigue or malaise.
Teaching that the nurse will plan to include for the patient with RA about how to manage ADL's, suggesting Stand rather than sit when performing chores Strengthen small hand muscles by wringing sponges/washcloths Protect the knee joints with a small pillow under the knees while sleeping Avoid activities that require use of the same muscles and joints
Avoid activities that require use of the same muscles and joints
The nurse is caring for a postpartum patient with human immunodeficiency virus (HIV). What should the nurse suggest to the patient to prevent the spread of infection to the newborn? 1. Avoid kissing the newborn. 2. Avoid hugging the newborn. 3. Avoid breastfeeding the newborn. 4. Avoid providing kangaroo care to the newborn.
Avoid breastfeeding the newborn.
A patient with suspected SLE asks the nurse which symptoms of the disease are likely to occur. Which manifestations should the nurse include? SATA A. Cachexia B. Hemoptysis C. Hematemesis D. Blood in the urine E. Facial butterfly rash F. Increased hair growth
Blood in the urine Facial butterfly rash
The health care provider orders ritonavir for a patient who has acquired immune deficiency syndrome. The nurse would inform the patient about which adverse effect of ritonavir therapy? A. Pancreatitis B. Photophobia C. Bone marrow suppression D. Bony appearance of the face
Bony appearance of the face
The nurse anticipates the following diagnostic tests for a patient suspected of having SLE: (SATA) BMP CBC ESR Anti-DNA antibody testing Urinalysis
CBC ESR Anti-DNA antibody testing Urinalysis
A Nurse is caring for a patient with HIV who inquires about a CD4 level. The best response from the Nurse would be? A. CD4 cells fight infection and the level is used to check the health of the immune system in people who are HIV positive. B. The CD4 level measures how much HIV is in a drop of blood. C. This level is the amount of specific genetic mutations that are known to cause resistance to certain drugs. D. This level is used to confirm HIV infection when the antibody screen test is positive.
CD4 cells fight infection and the level is used to check the health of the immune system in people who are HIV positive.
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? Psoriasis Dysmenorrhea Candidiasis Rheumatoid arthritis
Candidasis
A young adult female patient who is HIV positive has a new prescription for 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 HCP C-Continue to use contraception while on this medication D-Take this medication in the morning on an empty stomach.
Continue to use contraception while on this medication
Where can Candidiasis r/t HIV occur? Nose Esophagus Vagina Mouth Ears
Esophagus Vagina Mouth
A patient previously diagnosed with HIV presents with enlarged cervical lymph nodes. Which of the following should the nurse do? A. Instruct the patient to apply ice to the area for alternating 10 minute periods. B. Explain to the patient that risk of developing goiters has increased. C. Explain that this is a normal finding. D. Explain to the patient that the finding is highly unusual and will require further testing.
Explain that this is a normal finding.
True or False: Rheumatoid arthritis tends to affect women more than men and people who are over the age of 60.
False
Alfalfa tablets help prevent flare ups in patients with SLE? True/False
False. Alfalfa tablets have been shown to cause flare ups in SLE patients
Which of the following are characteristics of Rheumatoid nodules? SATA Firm, movable or fixed Found in the viscera, heart, lungs and dura Found in the sinus cavities Found on the soles of the feet
Firm, movable or fixed Found in the viscera, heart, lungs and dura
Because early detection of infants who have HIV infection or at risk for HIV/AIDS is essential during the newborn period the nurse anticipates the following diagnostic test during the first 48 hours after birth: A. HIV DNA polymerase chain reaction (PCR) test B. Western blot test C. ELISA test D. Rapid HIV test
HIV DNA polymerase chain reaction (PCR) test
What is CD4 cell count
It provides a marker of immune function. (normal 800-1200 cells/UL)
The nurse completes an assessment of a patient with RA. In addition to bilateral swollen tender joints, weight loss, and fatigue, what additional manifestations of RA might be present? SATA Weight gain. Joints tender, painful, and warm to touch. Joint stiffness on arising that usually subsides after 30 minutes. Fever. Swan neck deformity of fingers. Bilateral symmetric joint involvement.
Joints tender, painful, and warm to touch. Fever. Swan neck deformity of fingers. Bilateral symmetric joint involvement.
In cases of older adults with RA more emphasis may be placed on: Maintaining functional status Controlling pain Reversing joint damage Implementing an exercise program
Maintaining functional status
A client is in the acute phase of rheumatoid arthritis. Which of the following should the nurse identify as lowest priority in the plan of care? A. Relieving pain. B. Preserving joint function. C. Maintaining usual ways of accomplishing tasks. D. Preventing joint deformity.
Maintaining usual ways of accomplishing tasks.
An adult patient who takes medications for coronary artery disease has just been diagnosed with asymptomatic HIV. Which information will the nurse include inpatient teaching? A. Less frequent CD4+ level monitoring is needed in older adults B. Many medications have interactions with antiretroviral drugs C. Hospice care is available for patients with terminal HIV infection D. Progression of HIV infection occurs more rapidly in older patients
Many medications have interactions with antiretroviral drugs
A patient with an acute exacerbation of systemic lupus erythematosus (SLE) is hospitalized with incapacitating fatigue, acute hand and wrist pain, and proteinuria. The health care provider prescribes prednisone (Deltasone) 40 mg twice daily. Which nursing action should be included in the plan of care? A. Institute seizure precautions. B. Reorient to time and place PRN. C. Monitor intake and output. D. Place on cardiac monitor.
Monitor intake and output.
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)
Oral saquinavir (Invirase)
Which information would be most important to help the nurse determine if the patient needs HIV testing. A. Patient age B. Patient lifestyle C. Patient symptoms D. Patient sexual orientation
Patient age
Which of these patients who have arrived at the human immunodeficiency virus (HIV) clinic should the nurse assess first? A. Patient whose rapid HIV-antibody test is positive B. Patient whose latest CD4+ count has dropped to 250/μL C. Patient who has had 10 liquid stools in the last 24 hours D. Patient who has nausea from prescribed antiretroviral drugs
Patient who has had 10 liquid stools in the last 24 hours
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
Patient who tested positive for HIV 2 years ago and now has cytomegalovirus (CMV) retinitis
A patient who is HIV infected has a CD4+ cell count of 400 microliters. 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 therapy
Patient's ability to comply with ART therapy
The nurse prepares a program to decrease incidence of HIV in the teen and young adult populations. Which information should the nurse assign as the highest priority? (Rebecca McKee) a. Means to prevent transmission through blood transfusions b. Ways to sterilize needles used by injectable drug users c. Prevention of HIV transmission between sexual partners d. Methods to prevent perinatal HIV transmission
Prevention of HIV transmission between sexual partners
A patient with systemic lupus erythematosus (SLE) who has a facial rash and alopecia tells the nurse, "I hate the way I look! I never go anyplace except here to the health clinic." An appropriate nursing diagnosis for the patient is: A. Activity intolerance related to fatigue and inactivity. B. Impaired skin integrity related to itching and skin sloughing. C. Social isolation related to embarrassment about the effects of SLE. D. Impaired social interaction related to lack of social skills.
Social isolation related to embarrassment about the effects of SLE.
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? Please choose from one of the following options. 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.
The patient is diagnosed with acquired immunodeficiency syndrome (AIDS).
The nurse cares for a patient who is HIV positive and taking antiretroviral therapy (ART). Which information is most important for the nurse to address when planning care? A. The patients blood glucose level is 141 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)"
The patient states, "Sometimes I miss a dose of zidovudine (AZT)"
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.
The patient will maintain intact perineal skin.
What are the modes of transmission? A: Direct- hands, broken skin B: Indirect- tubes, needles, catheter, equipment C: Droplet- Cough or sneeze D: Vehicle- Blood E: All of the above
all of the above
What biologic or chemical substance is recognized as foreign by the body's immune system? A. Antigen B. Antibody C. Adjuvant D. Immunostimulant
antigen
The nurse is teaching a client newly diagnosed the systemic lupus erythematosus (SLE). Which information should the nurse include in the client's teaching? A-Using high dose birth control pills. B-Using only acetaminophen for pain relief. C-Avoiding large crowds D-Increasing daily sun exposure.
avoiding large crowds
Body fluids that can transmit HIV (select all that apply) Blood Semen Vomit Saliva Breast milk
blood, semen, and breast milk
What is a way that a mother can spread HIV to her child?- A. kissing him or her B. breast feeding C. not washing her hands after using the bathroom D. vaginal birth
breast feeding and vaginal birth
A client with acquired immunodeficiency syndrome (AIDS) has a nursing diagnosis of Imbalanced nutrition: less than body requirements. The nurse plans which of the following goals with this client? a) consume foods and beverages that are high in glucose b) plan large menus and cook meals in advance c) eat low-calorie snacks between meals d) eat small, frequent meals throughout the day
eat small, frequent meals throughout the day
What supplement can be given to help lessen the side effects of methotrexate? Vitamin B1 Folic Acid Vitamin C Vitamin D3
folic acid
Routes that do NOT transmit HIV include.... (Heather Hinkle) SATA a. Hugging b. sexual intercourse c. shaking hands d. sharing eating utensils
hugging, shaking hands, sharing eating utensils
The nurse is reviewing medications ordered for a newly admitted female client with systemic lupus erythematosus (SLE). Which medication order should the nurse question? Immunosuppressive Oral contraceptive Antineoplastic Corticosteroid
oral contraceptive
Systemic lupus can cause what specific disease process in the lungs? Pleurisy Pneumonia Pulmonary hypertension Bronchitis
pleurisy
The teaching plan for the client with rheumatoid arthritis includes rest promotion. Which of the following would the nurse expect to instruct the client to avoid during rest periods? 1. Proper body alignment. 2. Elevating the part. 3. Prone lying positions. 4. Positions of flexion.
positions of flexion
Newborns exposed to HIV in utero can experience (select all that apply) Cognitive delays Premature birth Failure to thrive Jaundice Low birth weight
premature birth failure to thrive low birth weight
All infants of HIV infected mothers should A. Be strictly isolated from other family members B. Start prophylaxis against PCP by 4-6 weeks of age C. Not be vaccinated against common childhood illnesses due to potentially compromised immune system D. Continue prophylaxis until 12 months of age unless 2 out of 3 HIV PCR tests at 48 hrs, 1-2 months and 2-4 months are documented as negative E. Undergo periodic lab testing to ensure early detection
start prophylaxis against PCP by 4-6 weeks of age Continue prophylaxis until 12 months of age unless 2 out of 3 HIV PCR tests at 48 hrs, 1-2 months and 2-4 months are documented as negative Undergo periodic lab testing to ensure early detection
What risk factors put adolescents at an increased risk for HIV? Select all that apply A. unprotected sex B. drug use C. drinking under age D. sneaking out
unprotected sex drug use
The nurse instructs a client diagnosed with rheumatoid arthritis (RA) about the use of splints to reduce strain on joints. Which instruction is most important for the nurse to include in the teaching? "Be sure to remove the splints twice a week." "Splints should be made of lightweight materials." "The best way to splint your hip is to lie supine on a bed." "Splints should be put on only during the day."
"Splints should be made of lightweight materials."
ELISA and Western blot tests cannot distinguish between infant and maternal antibodies, therefore these tests are inappropriate before 18 months of age. HIV DNA PCR and HIV RNA assays are the preferred method of testing with the first HIV DNA PCR test being conducted within the first 48 hours after birth. A patient who has vague symptoms of fatigue, headaches, and a positive test for 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 year before you develop AIDS" D. "The Western blot test will be done to determine whether AIDS has developed."
"The EIA test will need to be repeated to verify the results"
A nurse Provides human immunodeficiency virus (HIV) education at a community clinic. The nurse includes in the education that which factor affects the transmission of HIV? (Select all that apply) A. Sex B. Type of Sexual encounter C. Viral load D. Type of bodily fluid E. Age
A. Sex B. Type of Sexual encounter C. Viral load D. Type of bodily fluid
What puts older adults (50 years of age or greater) at increased risk for contracting the HIV virus. A. They are less likely to discuss personal sex life with their physician. B. They are less likely to be tested or asked by their physician. C. They are party animals. D. May mistake signs and symptoms of infection as normal signs of aging. E. Consider themselves to be less likely to contract HIV F. Lack of knowledge about the disease.
A. They are less likely to discuss personal sex life with their physician. B. They are less likely to be tested or asked by their physician. D. May mistake signs and symptoms of infection as normal signs of aging. E. Consider themselves to be less likely to contract HIV F. Lack of knowledge about the disease.
The nurse provides care to a client diagnosed with acquired immunodeficiency syndrome (AIDS). Two weeks earlier, the client was prescribed nevirapine, a non-nucleoside reverse transcriptase inhibitor (NNRTI). For which adverse reactions does the nurse assess? (Select all that apply) A. Yellowing of the sclera and palms B. Raised pink or brown lesions on the legs and trunk C. A pH of 7.33 found on arterial blood gas analysis D. White patches in the mouth E. Increased bacteria in the urine
A. Yellowing of the sclera and palms C. A pH of 7.33 found on arterial blood gas analysis
What does AIDS stand for? A: Acquired, Immuno, Deficiency, Syndrome B: Acquired, Infection, Depletion, Syndrome C: Assumed, Infection, Deficiency, Syndrome D: Assumed, Immuno, Depletion, Syndrome
A: Acquired, Immuno, Deficiency, Syndrome
Which of the following is the most common cause of changes in mental status for patients with HIV infection? A. Parkinsonism Disorder B. Kaposi Sarcoma Syndrome C. Mycobacterium Complex D. AIDS Dementia Complex
AIDS Dementia Complex
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.
Continue to use contraception while on this medication.
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? Purplish- red skin lesions Elevated alkaline phosphatase White bumps in the mouth A productive cough
Purplish- red skin lesions
Which new clinical manifestations noted by the nurse may indicate an HIV + patient is no longer in the incubation stage and is moving into the next stage? SATA A. Rash B. Fatigue C. Muscle aches D. Photophobia E. Nausea and vomiting
Rash Fatigue Muscle aches Photophobia
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? A. CD4 level B. Complete blood count C. Total lymphocyte percent D. Viral load
viral load
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
viral load testing
Name systemic effects of Rheumatoid arthritis (select all that apply) Weight gain Weakness High fever Fatigued in the morning Chronic hand deformities
weakness chronic hand deformities