pediatric success chapter 7 immunological

14. Which of the following can lead to a possible diagnosis of human immunodeficiency virus (HIV) in a child? Select all that apply. 1. Repeated respiratory infections. 2. Intermittent diarrhea. 3. Excessive weight gain. 4. Irregular heartbeat. 5. Poor weight gain.

14. 1, 2, 5. 1. Symptoms of human immunodeficiency virus include frequent respiratory infections. The symptoms present based on the underlying cellular immunodeficiency-related disease. 2. Symptoms of human immunodeficiency virus include intermittent diarrhea. The symptoms present based on the underlying cellular immunodeficiency-related disease. 3. Symptoms of human immunodeficiency virus include poor weight gain. The symptoms present based on the underlying cellular immunodeficiency-related disease. 4. Irregular heart rate is not associated with human immunodeficiency virus. 5. Symptoms of human immunodeficiency virus include poor weight gain. TEST-TAKING HINT: Review symptoms of HIV that should lead to a differential diagnosis.

16. A child diagnosed with HIV is prescribed a combination of antiretroviral drugs to delay ______________________.

16. Drug resistance. A combination of antiretroviral medications is prescribed for a child who is HIV positive to delay develoment of drug resisitance. HIV drugs work on different stages of the HIV life cycle to prevent reproduction of new virus particles. TEST-TAKING HINT: The test taker understands the use of antiretroviral medications.

60. The parent of a 2-year-old who is HIV+ questions the nurse about placing the child in day care. Which of the following is the best response? 1. The child should not go to day care until older, because there is a high risk for transmission of the disease. 2. The child can be admitted to day care without restrictions and should be allowed to participate in all activities. 3. The child can go to day care but should avoid physical activity. 4. The child may go to day care, but the parent must inform all the parents at the day care that the child is HIV+.

2 60. 1. The child can attend day care. The risk of transmission remains the same at any age. 2. The child can attend day care without any limitations but should not attend with a fever. 3. There is no need to restrict the child's activity. 4. There is no law that requires notification of the child's condition. TEST-TAKING HINT: Review the modes of transmission of human immunodeficiency virus infection in children. The day-care facility should practice universal precautions when caring for all its children.

57. Which of the following is the most common opportunistic infection in children infected with human immunodeficiency virus (HIV)? 1. CMV. 2. Encephalitis. 3. Meningitis. 4. Pneumocystic pneumonia.

4 57. 1. CMV infection is one common characteristic of human immunodeficiency virus infections, but it is not the most common. 2. Encephalitis is not a specific opportunistic infection noted in human immunodeficiency virus-infected children. 3. Meningitis is not a specific opportunistic infection noted in human immunodeficiency virus-infected children. 4. Pneumocystis carinii pneumonia is the most common opportunistic infection that can occur in human immunodeficiency virus-infected children, and such children are treated prophylactically for this. TEST-TAKING HINT: Note the words "most common" in the question.

58. Which of the following laboratory tests will be ordered to determine the presence of the human immunodeficiency virus antigen in an infant whose parent is HIV+? 1. CD4 cell count. 2. Western blot. 3. IgG levels. 4. p24 antigen assay.

4 58. 1. The CD4 cell count indicates how well the immune system is working. 2. A Western blot test confirms the presence of human immunodeficiency virus antibodies. 3. An IgG level samples the immune system. 4. Detection of human immunodeficiency virus in infants is confirmed by a p24 antigen assay, viral culture of human immunodeficiency virus, or polymerase chain reaction. TEST-TAKING HINT: Review the laboratory tests for HIV-infected clients. The important word in the question is "infant."

59. The nurse is instructing the parent of a child with HIV about immunizations. Which of the following should the nurse tell the parent? 1. Hepatitis B vaccine will not be given to this child. 2. Members of the family should be cautioned not to receive the varicella vaccine. 3. The child will need to have a Western blot test done prior to all immunizations. 4. Pneumococcal and influenza vaccines are recommended.

4 59. 1. Hepatitis B vaccine is administered according to the immunization schedule. 2. The varicella vaccine is avoided in the child who is human immunodeficiency virus infected. 3. A Western blot test is not done and is not necessary. 4. Immunizations against childhood illnesses are recommended for children exposed to or infected with human immunodeficiency virus. Pneumococcal and influenza vaccines are recommended. TEST-TAKING HINT: Review the immunization schedule, keeping in mind that human immunodeficiency virus-infected children should not receive live viruses.