HIV AIDS Nclex
A 24-year-old woman who uses injectable illegal drugs asks the nurse about preventing AIDS. The nurse informs the patient that the best way to reduce the risk of HIV infection from drug use is to a. participate in a needle-exchange program. b. clean drug injection equipment before use. c. ask those who share equipment to be tested for HIV. d. avoid sexual intercourse when using injectable drugs.
A Rationale: Participation in needle-exchange programs has been shown to control the rate of HIV infection. Cleaning drug equipment before use also reduces risk, but it might not be consistently practiced by individuals in withdrawal. HIV antibodies do not appear for several weeks to months after exposure, so testing drug uses would not be very effective in reducing risk for HIV exposure. It is difficult to make appropriate decisions about sexual activity when under the influence of drugs. Cognitive Level: Comprehension Text Reference: pp. 262-263 Nursing Process: Planning NCLEX: Health Promotion and Maintenance
To evaluate the effectiveness of ART, the nurse will schedule the patient for a. viral load testing. b. enzyme immunoassay. c. rapid HIV antibody testing. d. immunofluorescence assay.
A Rationale: The effectiveness of ART is measured by the decrease in the amount of virus detectable in the blood. The other tests are used to detect for HIV antibodies, which remain positive even with effective ART. Cognitive Level: Application Text Reference: p. 265 Nursing Process: Planning NCLEX: Physiological Integrity
1. A patient who seeks health care for vague symptoms of fatigue and headaches has HIV testing and is found to have a positive enzyme immunoassay (EIA) for HIV antibodies. In discussing the test results with the patient, the nurse informs the patient that a. the enzyme immunoassay test will need to be repeated to verify the results. b. a viral culture will be done to determine the progress of the disease. c. it will probably be 10 or more years before the patient develops AIDS. d. the Western blot test will need to be done to determine whether AIDS has developed.
A .the enzyme immunoassay test will need to be repeated to verify the results. Rationale: After an initial positive EIA test, the EIA is repeated before more specific testing such as the Western blot is done. Viral cultures are not part of HIV testing. Because the nurse does not know how recently the patient was infected, it is not appropriate to predict the time frame for AIDS development. The Western blot tests for HIV antibodies, not for AIDS. Cognitive Level: Application Text Reference: p. 256 Nursing Process: Implementation NCLEX: Physiological Integrity
The neuropsychiatric changes observed in HIV are a result of (select all that apply): A. A viral invasion of the central nervous system (CNS). B. An underlying psychiatric disorder. C. The client's previous drug use. D. A viral invasion of the renal system. E. The side effects of the pharmacological treatment.
A. A viral invasion of the central nervous system (CNS). E. The side effects of the pharmacological treatment.
A pregnant woman with a history of asymptomatic HIV infection is seen at the clinic. Which information will the nurse include when teaching the patient? a. Although infants of HIV-infected mothers always test positive for HIV antibodies, most infants are not infected with the virus. b. Because she has not developed AIDS, the infant will not contract HIV during intrauterine life. c. The infant will be started on zidovudine (AZT) after delivery to prevent HIV infection. d. It is likely that her newborn will develop HIV infection unless she takes antiretroviral drugs during the pregnancy.
A. Although infants of HIV-infected mothers always test positive for HIV antibodies, most infants are not infected with the virus. Rationale: Because antibodies are transmitted from the mother to the fetus during intrauterine life, all infants of HIV-positive mothers will test positive at birth. Ongoing antibody (or viral) testing is needed to determine whether the infant is infected with HIV. Transmission of the virus can occur during fetal life even if the mother does not have AIDS. Infants of HIV-positive mothers are not routinely started on antiretroviral therapy (ART). Only 25% of infants born to HIV-positive mothers develop HIV infection, even when the mother does not use ART during pregnancy. Cognitive Level: Application Text Reference: p. 250 Nursing Process: Implementation NCLEX: Health Promotion and Maintenance
Which action by the nurse is most effect to prevent becoming exposed to the human immune deficiency virus (HIV)? a.Always use Standard Precautions with all clients in the workplace. b.Place clients who are HIV positive in Contact Precautions. c.Wash hands before and after contact with clients who are HIV positive. d.Convert parenteral medications to an oral form for clients who are HIV positive.
A. Always use standard precautions with all clients in the workplace
The ART drug, which should be avoided in case of pregnancy is: A. Efavirenz B. Indinavir C. Lamivudine D. Zidovudine
A. Efavirenz
The nurse is caring for a client with HIV who has been prescribed didanosine (Videx EC). Which action by the nurse is most appropriate? a. Help the client plan specific meal and dosing times. b. Explain that the client will have frequent complete blood counts (CBCs) drawn. c. Advise the client to take Videx EC with milk or a small meal. d. Tell the client to take Tylenol (acetaminophen) for any abdominal pain.
A. Help the client plan specific meal and dosing times
The nurse is caring for a young client who ass acquired immune deficiency syndrome (AIDS) and a very low CD4+ cell count. The nurse is teaching the client how to avoid infection at home. Which statement by the client indicates that additional teaching is needed? a."I will let my sister clean my pet iguana's cage from now on." b."My brother will change the kitty litter box from now on." c."It will seem funny but I'll run my toothbrush through the dishwasher." d."I will not drink juice that has been sitting out for longer than an hour."
A. I will let my sister clean my pet iguana's cage from now on.
Risk factors that increase the risk of the individual with serious mental illness being affected by human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) include (select all that apply): A. Limited impulse control. B. Limited use of drugs or alcohol in conjunction with sex. C. Impaired judgment. D. Deficits in problem-solving skills. E. Controlled psychiatric symptoms due to adherence with medications.
A. Limited impulse control. C. Impaired judgment. D. Deficits in problem-solving skills.
A patient with ADIS is having a recurrence of 10-12 loose stools a day . What medication may help this patient to control the chronic diarrhea? A. Octreotide B. Rifaximin C. Bismuth subsalucytate D. Atropine diphenhynoxylate.
A. Octreotide
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
A. Place the client in Airborne precautions. Some people with HIV infection will have a negative test result even if they are infected with TB germs. This is because the immune system, which causes the reaction to the tests, is not working properly.
The nurse is caring for a client who is HIV positive. The client has become confused over the course of the shift, and the client's pupils are no longer reacting to light equally. The nurse anticipates an order for which medication? a.Prednisone (Deltazone) b.Trimethoprim/sulfamethoxazole (Bactrim) c.Pentamidine isethionate (Pentam) d.Ketoconazole (Nizoral)
A. Prednisone (Deltazone) HIV can damage the eye, cause inflammation and therefor prednisone is used.
The nurse is caring for a young woman at the primary health care clinic. Which assessment finding leads the nurse to question the client about risk factors for HIV? a.Six vaginal yeast infections in the last 12 months b.Unable to become pregnant for the last 2 years c.Severe cramping and irregular periods d.Very heavy periods and breakthrough bleeding
A. Six vaginal yeast infections in the last 12 months.
A patient diagnosed with Pneumocytis pneumonia. What medication does the nurse anticipated educating the patient about for treatment ? A. TMP-SMZ B. Cephalexin C. Azithromycin D. Garamycin
A. TMP-SMZ
A client who is receiving highly active antiretroviral therapy (HAART) tells the nurse, "The doctor said that my viral load is reduced. What does this mean?" What is the nurse's best response? A. "The HAART medications are working well right now." B. "You are not as contagious as you were anymore." C. "Your HIV infection is becoming resistant to your medications." D. "You are developing an opportunistic infection."
A. The HAART medications are working well right now. Highly active antiretroviral therapy (HAART) is a medication regimen used to manage and treat human immunodeficiency virus type 1 (HIV-1). It is composed of several drugs in the antiretroviral classes of medications.
A nursing assistant asks the nurse if respiratory isolation is needed for a client with Pneumocystis jiroveci pneumonia. What is the nurse's best response? a."This type of pneumonia is an opportunistic infection, so the staff is not at risk." b."You should wear a mask and a gown to provide care." c."Yes, please institute respiratory isolation because this is very contagious." d."You are not at risk for this infection if you have had a vaccination.
A. This type of pneumonia is an opportunistic infection, so the staff is not at risk
When teaching a patient with HIV infection about ART, the nurse explains that these drugs a. work in various ways to decrease viral replication in the blood. b. boost the ability of the immune system to destroy the virus. c. destroy intracellular virus as well as lowering the viral load. d. increase the number of CD4+ cells available to fight the HIV.
A. work in various ways to decrease viral replication in the blood. Rationale: The three groups of antiretroviral drugs work in different ways to decrease the ability of the virus to replicate. The drugs do not work by boosting the ability of the immune system or CD4 cells to fight the virus. The viral load detected in the blood is decreased with effective therapy, but intracellular virus is still present. Cognitive Level: Application Text Reference: pp. 256-257 Nursing Process: Implementation NCLEX: Physiological Integrity
Which of these patients will the nurse working in an HIV testing and treatment clinic anticipate teaching about ART? a. A patient who is HIV negative but has unprotected sex with multiple partners b. A patient who has been HIV positive for 5 years and has cytomegalovirus (CMV) retinitis c. A patient who was infected with HIV 15 years ago and has a CD4 count of 740/µl d. An HIV-positive patient with a CD4 count of 120/µl who drinks a fifth of whiskey daily
B. A patient who has been HIV positive for 5 years and has cytomegalovirus (CMV) retinitis Rationale: CMV retinitis is an AIDS-defining illness and indicates that the patient is appropriate for ART even though the HIV infection period is relatively short. An HIV-negative patient would not be offered ART. A patient with a CD4+ count in the normal range would not require ART. A patient who drinks alcohol heavily would be unlikely to be able to manage the complex drug regimen and would not be appropriate for ART despite the low CD4+ count. Cognitive Level: Application Text Reference: p. 253 Nursing Process: Planning NCLEX: Physiological Integrity
A client who is positive for HIB presents with confusion, fever, headache, blurred vision, nausea, and vomiting. What does the nurse do first? a.Assess the client's deep tendon reflexes. b.Ask the client to place his chin on his chest. c.Start an IV line with normal saline. d.Assess the client's pupil reaction
B. Ask the client to place his chin on his chest. Possibly meningitis. Stiff neck that sometimes makes it hard to touch your chin to your chest. Headache, which can be severe.
A client has selective immune globulin A (IgA) deficiency. The provider orders an infuson of immune globulin (IVIG). Which action by the nurse is best a.Start a second IV line for the client's antibiotics. b.Call the physician to clarify the order. c.Review the client's renal panel before administration. d.Obtain baseline vital signs and another set after 15 minutes.
B. Call the physician to clarify the order
Which client problem relating to altered nutrition is a consequence of AIDS? A. Increased appetite B. Decreased protein absorption C. Increased secretions of digestive juices D. Decreased gastrointestinal absorption
B. Decreased protein absorption
The nurse is teaching a client how to prevent transmitting HIV to his sexual partner. Which statement by the client indicates that additional teaching is needed a."I can throw the condoms in the trash after I have used them." b."I will store my condoms in my wallet so they are always handy." c."Water-based lubricants are best to prevent condom breakage." d."The condom needs to stay on until I withdraw my penis."
B. I will store my condoms in my wallet so they are always handy
The nurse is teaching a seminar about preventing the spread of HIV. Which statement by a student indicates tat additional teaching is required. a."A woman can still get pregnant if she is HIV positive." b."I won't get HIV if I only have oral sex with my partner." c."Showering after intercourse will not prevent HIV transmission." d."People with HIV are still contagious even if they take HAART drugs."
B. I won't get HIV if I only have oral sex with my partner
The nurse is carign for a client with AIDS who has just been diagnosed with cryptococcal meningitis. Which is the best nursing intervention for this client? A. Initiate respiratory isolation for the next 72 hours. B.Initiate seizure precautions with padded siderails. C.Thicken the client's liquids to honey consistency D.Administer IV pentamidine isethionate (Pentam)
B. Initiate seizure precautions with padded siderails.
An HIV positive client is taking lopinavir/ritonavir (Kaletra) and reports nausea, abdominal pain, and diarrhea. What orders does the nurse anticipate? a.Renal function studies b.Liver enzymes c.Blood glucose monitoring d.Albumin and prealbumin
B. Liver enzymes
The nurse is working with a client who has AIDS related dementia and will soon be discharged to the care to family members. What teaching topic is best for the nurse to include in the discharge plans? a.Feed the client when he will not do it by himself. b.Make sure that a clock and a calendar are easily visible. c.Remove locks from bathroom and bedroom doors. d.Do not allow the client to smoke when he is alone
B. Make sure that a clock and a calendar are easily visible
A client verbalizes a fear of contracting HIV because she has a history of intravenous substance abuse. What instructions does the nurse provide to the client to help minimize this risk? a."Boil all needles and syringes for at least 20 minutes before using them again and be sure not to share them." b."Rinse used needles and syringes with water followed by laundry bleach after using them." c."Rinse used needles and syringes with rubbing alcohol before and after using them." d."Run all needles and syringes through the dishwasher with an extra rinse cycle before using them again.
B. Rinse used needles and syringes with water followed by laundry bleach after using them.
A client with depression and AIDS is prescribed acyclovir, zidovudine, and isoniazid. The client reports that he has insomnia and disturbing nightmares each night. The nurse observes that the client is agitated, confused, and anxious. The nurse suspects the client's symptoms are related to: A. Central nervous system (CNS) lymphoma. B. Side effect of the antiretroviral medication. C. Depression. D. HIV-related dementia.
B. Side effect of the antiretroviral medication.
The nurse is interacting with a client with HIV-related dementia. Appropriate communication techniques include: A. Asking abstract questions that encourage the client to elaborate on the answer. B. Using brief, direct statements. C. Asking open-ended questions. D. Asking multiple questions at a time
B. Using brief, direct statements.
The nursing supervisor is working with an HIV positive nurse who has open weeping blisters on her arms after being exposed to poison ivy. Which instructions should the nursing supervisor provide to the nurse before she starts her shift? a."You should reassure your clients that you are not contagious." b."You should work phone triage at the desk today rather than taking clients." c."You should wear a long-sleeved scrub jacket today while working with clients." d."You should not care for clients who are immune compromised or in isolation."
B. You should work phone triage at the desk today rather than taking clients
A patient with HIV infection has developed Mycobacterium avium complex infection. An appropriate outcome for the patient is that the patient will a. be free from injury. b. maintain intact perineal skin. c. have adequate oxygenation. d. receive immunizations.
B. maintain intact perineal skin. Rationale: The major manifestation of M. avium infection is loose, watery stools, which would increase the risk for perineal skin breakdown. The other outcomes would be appropriate for other complications (pneumonia, dementia, influenza, etc) associated with HIV infection. Cognitive Level: Analysis Text Reference: p. 255 Nursing Process: Planning NCLEX: Physiological Integrity
A patient who has been treated for HIV infection for 7 years has developed fat redistribution to the trunk, with wasting of the arms, legs, and face. The nurse will anticipate teaching the patient about a. treatment with antifungal agents. b. a change in antiretroviral therapy. c. foods that are higher in protein. d. the benefits of daily exercise.
B.. a change in antiretroviral therapy. Rationale: A frequent first intervention for metabolic disorders is a change in ART. Treatment with antifungal agents would not be appropriate because there is no indication of fungal infection. Changes in diet or exercise have not proven helpful for this problem. Cognitive Level: Application Text Reference: pp. 266-267 Nursing Process: Planning NCLEX: Physiological Integrity
The occupational health nurse will teach the nursing staff that the highest risk of acquiring HIV from an HIV-infected patient is a. a needlestick with a suture needle during a surgical procedure. b. contamination of open skin lesions with vaginal secretions. c. a needlestick with a needle and syringe used to draw blood. d. splashing the eyes when emptying a bedpan containing stool.
C Rationale: Puncture wounds are the most common means for workplace transmission of blood-borne diseases, and a needle with a hollow bore that had been contaminated with the patient's blood would be a high-risk situation. The other situations described would be much less likely to result in transmission of the virus. Cognitive Level: Comprehension Text Reference: p. 250 Nursing Process: Assessment NCLEX: Safe and Effective Care Environment
Interventions such as promotion of nutrition, exercise, and stress reduction should be promoted by the nurse for patients who have HIV infection, primarily because these interventions will a. promote a feeling of well-being in the patient. b. prevent transmission of the virus to others. c. improve the patient's immune function. d. increase the patient's strength and self-care ability.
C Rationale: The primary goal for the patient with HIV infection is to increase immune function, and these interventions will promote a healthy immune system. They may also promote a feeling of well-being and increase strength, but these are not the priority goals for HIV-positive patients. These activities will not prevent the risk for transmission to others because the patient will still be HIV positive. Cognitive Level: Comprehension Text Reference: p. 265 Nursing Process: Planning NCLEX: Physiological Integrity
A patient who tested positive for HIV 3 years ago is admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP). Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC), the patient is diagnosed as having a. early chronic infection. b. HIV infection. c. AIDS. d. intermediate chronic infection.
C. AIDS Rationale: Development of PCP pneumonia meets the diagnostic criterion for AIDS. The other responses indicate an earlier stage of HIV infection than is indicated by the PCP infection. Cognitive Level: Comprehension Text Reference: p. 253 Nursing Process: Assessment NCLEX: Physiological Integrity
The nurse is seeing clients at a drop in primary health clinic. Which client does the nurse teach about the risks of acquiring HIV? a.Middle-aged woman with a new sexual partner b.Young male who has male sexual partners c.All clients who come to the clinic d.Young woman having her first gynecologic examination
C. All clients who come to the clinic
The nurse is completing a health history for a client and begins to obtain a sexual history. What is the nurse's best opening question? a."How long have you been sexually active?" b."Are you in a monogamous relationship with your spouse?" c."How do you feel about answering questions about your sexual history?" d."Have you noticed any problems with your ability to have or enjoy sex?
C. How do you feel about answering questions about your sexual history?
The nurse asks a young adult client if she is sexually active. The client asks why the nurse needs to know. That is the nurse's best response? a."I just need to make sure that the information you are providing is reliable." b."I have to fill in answers to all of the questions on the health history form." c."If you are sexually active, we should talk about ways to prevent getting HIV." d."I will have to notify your partner if you have a sexually transmitted disease."
C. If you are sexually active, we should talk about ways to prevent getting HIV
A client with HIV who is taking highly active antiretroviral therapy (HAAART) medications is in radiology waiting for a chest x-ray when medications are due. What action by the nurse is best a.Call radiology to see when the client will be brought back to the nursing unit. b.Send the nursing assistant to radiology to bring the client back to the nursing unit. c.Take the client's medications to radiology and administer them there if possible d.Stagger the next dose of the medication if the current dose is given late.
C. Take the client's medications to radiology and administer them there if possible.
When obtaining a sexual history from a client in a clinic setting, the nurse notes that the client appears very uncomfortable and pauses for long periods before answering the nurse's questions. What is the nurse's best response? a."I am sorry that my questions are making you very uncomfortable." b."Don't worry. We'll be done with these questions in no time at all." c."Take your time. I realize that this is a very private topic to talk about." d."These questions are making you uncomfortable, so we'll finish next time."
C. Take your time. I realize that this is a very private topic to talk about.
Which is the most common HIV-related neurological complication? A. Tuberculosis B. Kaposi's sarcoma C. Toxoplasmosis D. Lymphoma
C. Toxoplasmosis
The nurse is working with a client at a public health clinic. The client says to the nurse, The doctor said that my CD4+ count is 450. Is that good?" What is the nurse's best response? a."Your count is high so you can cut back on your medication." b."Your count is normal because your medications are working well." c."Your count is a bit low and you are susceptible to infection." d."Your count is very low and you actually now have AIDS."
C. Your count is a bit low and you are susceptible to infection.
Human Papiloma Virus in AIDS patients is manifested as: A. cough, evening fever, night sweats, weight loss and anemia B. persistant fever, tachypnoea, hypoxia, cyanosis and tachycardia. C. genital warts, flat warts, skin warts, neoplasia of cervix, vagina and penis D. watery diarrhoea, abdominal pain, nausea and vomiting
C. genital warts, flat warts, skin warts, neoplasia of cervix, vagina and penis
A patient has recently tested positive for HIV and asks the nurse about drug therapy for HIV infection. The nurse informs the patient that a. drug therapy for HIV is indicated only for patients whose CD4+ cell counts indicate that AIDS has developed. b. medication therapy is delayed as long as possible to prevent development of viral resistance to the drugs. c. treatment is individualized based on CD4+ counts, the amount of virus in the blood, and the patient's wishes. d. ART is typically started soon after HIV diagnosis to prevent progression of the disease.
C. treatment is individualized based on CD4+ counts, the amount of virus in the blood, and the patient's wishes. Rationale: ART is typically considered when the CD4+ count drops below normal levels or the viral load is high in patients who are appropriate for ART and desire ART. ART is used to prevent the progression to AIDS and is used in patients who have AIDS. ART is not delayed as long as possible but can be started when the CD4+ counts are relatively high in some patients. ART is not started soon after HIV diagnosis; rather, it is started when CD4+ count, viral load, or patient symptoms indicate that it will be beneficial. Cognitive Level: Application Text Reference: pp. 256-257 Nursing Process: Implementation NCLEX: Physiological Integrity
At the health promotion level of care for HIV infection, which question is most appropriate for the nurse to ask? a. "Are you having any symptoms such as severe weight loss or confusion?" b. "Are you experiencing any side effects from the antiretroviral medications? c. "Do you need any assistance to obtain antiretroviral drugs or other treatments?" d. "Do you use any injectable drugs or have sexual activity with multiple partners?"
D Rationale: At the health-promotion level, the nurse screens for behaviors that might increase the risk for HIV infection and implements interventions to prevent infection (or, in the case of an already infected patient, implement interventions to prevent progression of the disease to AIDS). The other questions would be appropriate at the acute intervention level, when the patient already has significant immune compromise. Cognitive Level: Application Text Reference: pp. 260-261 Nursing Process: Assessment NCLEX: Health Promotion and Maintenance
The nurse is preparing to give the following medications to an HIV-positive patient who is hospitalized with PCP. Which is most important to administer at the right time? a. Nystatin (Mycostatin) tablet for vaginal candidiasis b. Aerosolized pentamadine (NebuPent) for PCP infection c. Oral acyclovir ((Zovirax to treat systemic herpes simplex d. Oral saquinavir (Inverase) to suppress HIV infection
D Rationale: It is important that antiretrovirals be taken at the prescribed time every day to avoid developing drug-resistant HIV. The other medications should also be given as close as possible to the correct time, but they are not as essential to receive at the same time every day. Cognitive Level: Application Text Reference: pp. 258, 264-265 Nursing Process: Implementation NCLEX: Physiological Integrity
A patient who is diagnosed with AIDS and has developed Kaposi's sarcoma tells the nurse, "I have lots of thoughts about dying. Do you think I am just being morbid?" Which response by the nurse is most appropriate? a. "Thinking about dying will not improve the course of AIDS." b. "Although your diagnosis is serious, there are more treatments available now." c. "Try to focus on the good things in life because stress impairs the immune system." d. "Tell me what kind of thoughts you have about dying."
D Rationale: More assessment of the patient's psychosocial status is needed before taking any other action. The statements, "Thinking about dying will not improve the course of AIDS" and "Try to focus on the good things in life ..." discourage the patient from sharing any further information with the nurse and decrease the nurse's ability to develop a trusting relationship with the patient. The statement, "Although your diagnosis is serious, there are more treatments available now" is correct, but without further assessment, it is impossible to know whether this responds to the patient's concerns. Cognitive Level: Application Text Reference: pp. 260, 265, 267 Nursing Process: Implementation NCLEX: Psychosocial Integrity
While teaching community groups about AIDS, the nurse informs people that the most common method of transmission of the HIV virus currently is a. perinatal transmission to the fetus. b. sharing equipment to inject illegal drugs. c. transfusions with HIV-contaminated blood. d. sexual contact with an infected partner.
D Rationale: Sexual contact with an infected partner is currently the most common mode of transmission, although HIV is also spread through perinatal transmission, through sharing drug injection equipment, and through transfusions with HIV-infected blood. Cognitive Level: Comprehension Text Reference: p. 250 Nursing Process: Assessment NCLEX: Health Promotion and Maintenance
The decision to begin antiretroviral therapy is based on: A. the CD4 cell count B. the plasma viral load C. the intensity of the patient's clinical symptoms. D. All of the above.
D. All of the above.
Which of the following listed drugs is a protease inhibitors group of ARVs? A. Zidovudine (AZT) B. Efavirenz (EFZ) C. Nevirapine (NVP) D. Indinavir ( IDV)
D. Indinavir ( IDV)
An HIV positive client verbalizes concerns about the high cost of antiretroviral medications. What is the nurse's best response? a."The medications are actually less expensive than they used to be." b."These medications are the best course of treatment for you." c."You should be glad the medications will help prolong your life." d."Let's talk to the social worker about getting financial assistance for you."
D. Let's talk to the socal worker about getting financial assistance for your
The nurse has been exposed to HIV through splashing of urine from a client who is HIV positive with a low viral load. The urine came into contact with the nurse's face. Which drug regimen does the nurse prepare to initiate? a.Retrovir (zidovudine) for 14 days b.Retrovir (zidovudine) for 28 days c.Retrovir (zidovudine) and Epivir (lamivudine) for14 days d.Retrovir (zidovudine) and Epivir (lamivudine) for 28 days
D. Rerovir (zidovudine) and Epivir (lamivudine) for 28 days
The client is admitted with pneumocystis carinii pneumonia. The nurse is aware that the physician will most likely order: A. Zidovudine (Ritrovir) B. Nivirapine (Viramune) C. Efavirenz (Sustiva) D. Sulfamethoxazole (Septra)
D. Sulfamethoxazole (Septra)
When assessing an individual who has been diagnosed with early chronic HIV infection and has a normal CD4+ count, the nurse will a. ask about problems with diarrhea. b. examine the oral mucosa for lesions. c. check neurologic orientation. d. palpate the regional lymph nodes.
D. palpate the regional lymph nodes. Rationale: Persistent generalized lymphadenopathy is common in the early stage of chronic infection. Diarrhea, oral lesions, and gait abnormalities would occur in the later stages of HIV infection. Cognitive Level: Application Text Reference: p. 252 Nursing Process: Assessment NCLEX: Physiological Integrity
During posttest counseling for a patient who has positive testing for HIV, the patient is anxious and does not appear to hear what the nurse is saying. At this time, it is most important that the nurse a. inform the patient how to protect sexual and needle-sharing partners. b. teach the patient about the medications available for treatment. c. ask the patient to notify individuals who have had risky contact with the patient. d. remind the patient about the need to return for retesting to verify the results.
D. remind the patient about the need to return for retesting to verify the results. Rationale: After an initial positive antibody test, the next step is retesting to confirm the results. A patient who is anxious is not likely to be able to take in new information or be willing to disclose information about HIV status of other individuals. Cognitive Level: Application Text Reference: pp. 256, 264 Nursing Process: Implementation NCLEX: Psychosocial Integrity
Four years after seroconversion, an HIV-infected patient has a CD4+ cell count of 800/µl and a low viral load. The nurse teaches the patient that a. the patient is at risk for development of opportunistic infections because of CD4+ cell destruction. b. the patient is in a clinical and biologic latent period, during which very few viruses are being replicated. c. anti-HIV antibodies produced by B cells enter CD4+ cells infected with HIV to stop replication of viruses in the cells. d. the body currently is able to produce an adequate number of CD4+ cells to replace those destroyed by viral activity.
D. the body currently is able to produce an adequate number of CD4+ cells to replace those destroyed by viral activity. Rationale: The patient is the early chronic stage of infection, when the body is able to produce enough CD4+ cells to maintain the CD4+ count at a normal level. The risk for opportunistic infection is low because of the normal CD4+ count. Although the viral load in the blood is low, intracellular reproduction of virus still occurs. Anti-HIV antibodies produced by B cells attack the viruses in the blood, but not intracellular viruses. Cognitive Level: Application Text Reference: pp. 252, 257 Nursing Process: Implementation NCLEX: Physiological Integrity
Drug therapy is being considered for an HIV-infected patient who has a CD4+ cell count of 400/µl. The nursing assessment that is most important in determining whether therapy will be used is the patient's a. social support system offered by significant others and family. b. socioeconomic status and availability of medical insurance. c. understanding of the multiple side effects that the drugs may cause. d. willingness and ability to comply with stringent medication schedules.
D. willingness and ability to comply with stringent medication schedules. Rationale: Drug resistance develops quickly unless the patient takes multiple drugs on a stringent schedule, and this endangers both the patient and the community. The other information is also important to consider, but patients who are unable to manage and follow a complex drug treatment regimen should not be considered for ART. Cognitive Level: Comprehension Text Reference: pp. 264-265 Nursing Process: Assessment NCLEX: Health Promotion and Maintenance
(Select All) The nurse is caring for a hospitalized client who has AIDS and is severly immune compromised. Which interventions are used to help prevent infection in this client?
Provide and incentive spirometer to encourage coughing and deep breathing by the client. Keep a blood pressure cuff, thermometer, and stethoscope in the clint's room for his/her use only. Request that the family take home the freesh flowers that are at the client's bedside. Assist the client with meticulous oral care after meals and at bedtime.
When designing a program to decrease the incidence of HIV infection in the community, the nurse will prioritize education about a. how to prevent transmission between sexual partners. b. methods to prevent perinatal HIV transmission. c. ways to sterilize needles used by injectable drug users. d. means to prevent transmission through blood transfusions.
A Rationale: Sexual transmission is the most common way that HIV is transmitted. The nurse should also provide education about perinatal transmission, needle sterilization, and blood transfusion, but the rate of HIV infection associated with these situations is lower. Cognitive Level: Application Text Reference: pp. 250, 260-263 Nursing Process: Planning NCLEX: Physiological Integrity
Effectiveness of antiretroviral therapy is determined by: A. a fall in the plasma viral load and an increase in the CD4 count. B. a rise in red blood cell count and hemoglobin level. C. a rise in plasma HIV antibodies level. D. a reduction in opportunistic infections.
A. a fall in the plasma viral load and an increase in the CD4 count.
The nurse is caring for a newly diagnosed HIV-positive client who will be taking enfuvirtide (Fuzeon). Which precaution is important for the nurse to communicate to this client? A."Stop taking the medication if you develop a fever." B ."Rotate the sites where you will be giving the injections." C. "Take this medication with a snack or a small meal." D. "Do not drive or operate machinery while taking this drug."
B. Rotate the sites where you will be giving the injections.
Goals of ART includes all, EXCEPT; A. Prolongation of life and improvement of Quality of Life. B. Greatest possible reduction in viral load for as long as possible. C. Rational sequencing of drugs, limiting drug toxicity, and facilitation of adherence. D. Elimination of HIV entirely from the body.
D. Elimination of HIV entirely from the body.
The nurse is teaching a client who has AIDS how to avoid infection at home. Which statement indicates that additional teaching is needed? a."I will wash my hands whenever I get home from work." b."I will make sure to have my own tube of toothpaste at home." c."I will run my toothbrush through the dishwasher every evening." d."I will be sure to eat lots of fresh fruits and vegetables every day.
D. I will be sure to eat lots of fresh fruits and vegetables every day.
The nurse is caring for an HIV positive client. What assessment finding assists the nurse in confirming progression of the client's diagnosis to AIDS a.Generalized lymphadenopathy b.HIV-positive status for 8 years c.Low-grade fever for the last 10 days d.Thick white patches on the client's tongue
D. Thick white patches on the client's tongue Rapid weight loss. Recurring fever or profuse night sweats. Extreme and unexplained tiredness. Prolonged swelling of the lymph glands in the armpits, groin, or neck. Diarrhea that lasts for more than a week. Sores of the mouth, anus, or genitals. Pneumonia.
A client with acquired immunodeficiency syndrome (AIDS) has been started on therapy with zidovudine (AZT, Retrovir). A nurse carefully assesses which of the following as toxic effect of the drug? a) netropenia b) pancreatitis c) yellowish discoloration of the skin d) oliguria
a) netropenia occurs when you have too few neutrophils, a type of white blood cells
The client with acquired immunodeficiency syndrome (AIDS) has oral candidiasis. Who among these clients can safely be roomed-in with the client? a) the client with chronic renal failure who is undergoing hemodialysis b) the client with hepatitis B (HBV) infection c) the client who is human immunodeficiency virus (HIV) positive with streptococcal infection d) the client with viral pneumonia
b) the client with hepatitis B (HBV) infection
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?"
b. Women in your age ghroup are teh fastes growing poulation of AIDS clients today
