NUR424 Chapter 37 Prep-U

Which of the following indicates that a client with HIV has developed AIDS?

A diagnosis of AIDS cannot be made until the person with HIV meets case criteria established by the Centers for Disease Control and Prevention. The immune system becomes compromised. The CD4 T-cell count drops below 200 cells and develops one of the opportunistic diseases.

The nurse receives a phone call at the clinic from the family of a patient with AIDS. They state that the patient started "acting funny" after complaining of headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member?

A fungal infection, Cryptococcus neoformans is another common opportunistic infection among patients with AIDS, and it causes neurologic disease like mental status change.

The nurse advises a patient who has received a negative test result from his HIV antibody test that he:

A negative test result indicates that antibodies to HIV are not present in the blood at the time of the testing. This means either the patient has not been infected or, if infected, that the body has not yet produced antibodies.

A client has undergone diagnostic testing for human immunodeficiency virus (HIV) using the enzyme immunoassay (EIA) test. The results are positive and the nurse prepares the client for additional testing to confirm seropositivity. The nurse would prepare the client for which test?

A positive EIA test indicates seropositivity. To confirm this, a Western blot assay would be done. The OraSure test uses saliva to perform an EIA test. The p24 antigen test and nucleic acid sequence-based amplification test are used to test viral load and evaluate response to treatment.

Which of the following statements reflects the treatment of HIV infection?

Although specific therapies vary, treatment of HIV infection for an individual patient is based on three factors: the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).

The client comes to the clinic to obtain the results from the test to determine if he is infected with HIV. The physician informs the client that he has a CD4 cell count of 300 cells/mm3 and a high viral load. What does the nurse anticipate the physician will discuss with the client?

Based on randomized trials, nonrandomized trials, and observational studies, the current guideline is to initiate treatment if the client has a CD4 T-cell count less than 350 to 500 cells/mm3,whereas others will begin treatment with a CD4 cell count over 500 cells/mm3 based on expert opinions.

The nurse is collecting objective data for a client with AIDS at the clinic. The nurse observes white plaques in the client's oral cavity, on the tongue, and buccal mucosa. What does the nurse understand this finding indicates?

Candidiasis is a yeast infection caused by the Candida albicans microorganisms. It may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in folds of the skin. It is often called thrush when located in the mouth.

You are caring for a client who has a diagnosis of HIV. Part of this client's teaching plan is educating the client about his or her medications. What is essential for the nurse to include in the teaching of this client regarding medications?

Describing the side effects of drug therapy is essential, with the admonition to refrain from discontinuing any of the prescribed drugs without first consulting the prescribing physician.

Diagnosis of Kaposi's sarcoma (KS) is made by which of the following?

Diagnosis of KS is made by biopsy of the suspected lesions. Visual assessment will not confirm a diagnosis. A CT scan will not assist in determining skin cell changes. Skin scraping is a procedure to collect cells, not to evaluate cells.

A client visits the nurse complaining of diarrhea every time they eat. The client has AIDS and wants to know what they can do to stop having diarrhea. What should the nurse advise?

Diarrhea may subside when the client avoids residue, lactose, fat, and caffeine. Although eating may seem to cause diarrhea, the client must understand that limiting the intake of food to control diarrhea only exacerbates wasting.

A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority?

In a client with AIDS, central nervous system (CNS) deterioration can lead to AIDS-related dementia. This type of dementia impairs cognition and judgment, placing the client at risk for injury.

Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm?

More than 500 CD4+ CDC category A: HIV asymptomatic. The period from infection with HIV to the development of antibodies to HIV is known as primary infection and 200 to 499 CD4+ T indicates CDC category B: HIV symptomatic. Less than 200 CD4+ indicates CDC category C: AIDS.

An older adult widowed woman informs the nurse that she notices vaginal dryness now that she has become sexually active again. She is not using barrier protection because it makes the dryness worse. What education should the nurse provide to the patient?

Other than abstinence, consistent and correct use of condoms is the only effective method to decrease the risk of sexual transmission of HIV infection. When latex male condoms are used consistently and correctly during vaginal or anal intercourse.

A client with HIV will be started on a medication regimen of three medications. Which medication will be given that will interfere with the virus's ability to make a genetic blueprint. What drug will the nurse instruct the client about?

Reverse transcriptase inhibitors are drugs that interfere with the virus' ability to make a genetic blueprint. A protease inhibitor is a drug that inhibits the ability of virus particles to leave the host cell. The integrase inhibitors are a class of drug that prevents the incorporation of viral DNA into the host cell's DNA.

A client with suspected HIV has had two positive enzyme-linked immunosorbent assay tests. What diagnostic test would be run next?

The enzyme-linked immunosorbent assay (ELISA) test, an initial HIV screening test, is positive when there are sufficient HIV antibodies; it also is positive when there are antibodies from other infectious diseases. The test is repeated if results are positive. If results of a second ELISA test are positive, the Western blot is performed.

The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluids does the nurse inform them will transmit the virus? Select all that apply.

There are only four known body fluids through which HIV is transmitted:blood, semen, vaginal secretions, and breast milk. HIV may be present in saliva, tears, and conjunctival secretions, but transmission of HIV through these fluids has not been implicated, HIV is not found in urine, stool, vomit, or sweat.

HIV is harbored within which type of cell?

Because HIV is harbored within lymphocytes, a type of white blood cell, any exposure to infected blood results in significant risk of infection. HIV infection is not harbored in platelets, erythrocytes, or nerve cells.

During assessment of a patient with Kaposi's sarcoma, the nurse knows to look for the initial sign of:

Localized cutaneous lesions may be the first manifestation of this HIV-related malignancy, which appears in 90% of patients as immune function deteriorates. Other symptoms develop over time as the lesions increase in size and spread to other locations.

A new nursing graduate is working at the hospital in the medical-surgical unit. The preceptor observes the nurse emptying a patient's wound drain without gloves on. What important information should the preceptor share with the new graduate about standard precautions?

Standard precautions are designed to reduce the risk of transmission of bloodborne pathogens and of pathogens from moist body substances.

The nurse is instructing a male client about safer sexual behaviors. Which client statement indicates a need for additional instruction?

The client should use only water-soluble lubricant, such as K-Y jelly or glycerin. Baby oil can cause the condom to break. The client should use a new condom for each sexual activity and hold onto the condom so that it does not come off when pulling out. Manual-anal intercourse should be avoided.