Management of Patients with Immune Deficiency Disorders

A child has just been diagnosed with a primary immune deficiency. The parents state, "Oh, no. Our child has AIDS." Which response by the nurse would be most appropriate? A. "Although AIDS is an immune deficiency, your child's condition is different from AIDS." B. "We need to do some more testing before we will know if your child's condition is AIDS." C. "Your child's condition is extremely serious. Like AIDS, it will most likely be fatal." D. "Your child does not have AIDS but this condition pouts your child at risk for it later in life."

A. "Although AIDS is an immune deficiency, your child's condition is different from AIDS."

The nurse educator is preparing to discuss immunodeficiency disorders with a group of fellow nurses. What would the nurse identify as the most common secondary immunodeficiency disorder? A. AIDS B. SCID C. CVID D. DAF

A. AIDS

A client with acquired immunodeficiency syndrome (AIDS) informs the nurse of difficulty eating and swallowing, and shows the nurse white patches in the mouth. What problem related to AIDS does the nurse understand the client has developed? A. Candidiasis B. Wasting syndrome C. MAC D. Kaposi's sarcoma

A. Candidiasis

The client received 2 units of packed red blood cells while in the hospital with rectal bleeding. Three days after discharge, the client experienced an elegiac response and began to itch and break out in hives. What type of reaction does he nurse understand could be occurring? A. Delayed hypersensitivity response B. In immediate hypersensitivity response C. Anaphylactic reaction D. Sensitization

A. Delayed hypersensitivity response

A majority of clients with CVID develop which type of anemia? A. Pernicious B. Sickle-cell C. Macrolytic D. Hemolytic

A. Pernicious

A client with human immunodeficiency virus (HIV) develops a nonproductive cough, shortness of breath, a fever of 101 F and an O2 saturation of 92%. What infection caused by Pneumocystis jiroveci does the nurse know could occur with this client? A. Pneumocystis pneumonia B. Mycobacterium avium-complex (MAC) C. Community-acquired pneumonia D. Tuberculosis

A. Pneumocystis pneumonia

Cryptococcus meningitis is suspected in a client with HIV. Which manifestations would be consistent with cryptococcus meningitis? (Select all that apply.) A. Stiff neck B. Hyperreflexia C. Psychomotor slowing D. Seizures E. Vacant stare

A. Stiff neck D. Seizures

A client with AIDS has become forgetful with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms? A. Candidiasis B. AIDS dementia complex (ADC) C. Distal sensory polyneuropathy (DSP) D. Cytomegalovirus (CMV)

B. AIDS dementia complex (ADC)

A client who has AIDS reports having diarrhea after every meal, and wants to know what can be done to stop this symptom. What should the nurse advise? A. Increase intake of iron & zinc B. Avoid fibrous foods, lactose, fat, and caffeine C. Commute large, high-fat meals D. Reduce food intake

B. Avoid fibrous foods, lactose, fat, and caffeine

A client is taking a corticosteroid for the treatment of systemic lupus erythematosus. When the nurse is providing instructions about the medication to the client, what priority information should be included? A. The client should be alert for joint aches B. Be alert for signs and symptoms of infection and report them immediately to the physician C. If the client experiences nausea, omit the dose D. This medication is commonly used for many inflammatory reactions and is relatively safe

B. Be alert for signs and symptoms of infection and report them immediately to the physician

Kaposi sarcoma (KS) is diagnosed through: A. Computed tomography (CT) B. Biopsy C. Visual assessment D. Skin scraping

B. Biopsy

Which adverse effect(s) should the nurse closely monitor in a client who has secondary immunodeficiencies due to immunosuppressive therapy? A. Depression, memory impairment, and coma B. Respiratory or urinary system infections C. Cardiac dysrhythmias and heart failure D. Rheumatoid arthritis

B. Respiratory or urinary system infections

A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority? A. Bathing or hygiene self-care deficit B. Risk for injury C. Ineffective cerebral tissue perfusion D. Complicated grieving

B. Risk for injury

A client has been diagnosed with HIV and has been placed on antiretroviral therapy. What does the nurse inform the client will be required for determining he progression of the disease as well as guided drug therapy? A. The client will be required to stop the medication for 2 weeks and then have laboratory studies drawn to determine if the antiretroviral therapy has cured the disease B. Viral load and T-4 counts will performed every 2 to 3 months C. More antiretroviral medication will be added every 2 to 3 months D. The Western blot test will be monitored every 6 months to see if the virus is still present

B. Viral load and T-4 counts will be performed every 2 to 3 months

A client is infected with human immunodeficiency virus (HIV) after sharing needles with another intravenous (IV) drug user. Upon infection with HIV, the immune system response by making antibodies against the virus, usually within how many weeks after infection? A. 6 to 18 weeks B. 3 to 6 weeks C. 3 to 12 weeks D. 1 to 2 weeks

C. 3 to 12 weeks

A nurse is preparing an in-service presentation about human immunodeficiency virus (HIV) for a group of new graduate nurses. As part of the presentation, the nurse is planning to describe the events that occur once HIV enter the host cell. What would the nurse describe as the first step? A. Uncoating B. Budding C. Attachment D. Cleavage

C. Attachment

A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis? A. Blood specimen for electrolyte studies B. Urine specimen for culture and sensitivity C. Stool specimen for ova and parasites D. Sputum specimen for acid fast bacillus

C. Stool specimen for ova and parasites

A client taking fosamprenavir reports "getting fat." What is the nurse's best action? A. Assess the client's diet B. Have the client increase exercise C. Teach the client about medication side effects D. Arrange for a psychological counseling

C. Teach the client about medication side effects

A client with acquired immunodeficiency syndrome (AIDS) is brought to the clinic by a family member. The family member tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms? A. Distal sensory polyneuropathy (DSP) B. Candidiasis C. Cytomegalovirus (CMV) D. HIV encephalopathy

D. HIV encephalopathy

A client who is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. Jiroveci. What medication will the client take for the treatment of this infection? A. Amphotericin B B. Nystatin C. Fluconazole D. Trimethoprim-sulfamethoxazole

D. Trimethoprim-sulfamethoxazole

A nurse is assessing a client with a primary immunodeficiency. Afterward the nurse documents tha the client displayed ataxia. The nurse makes this documentation because the client has: A. An inability to understand the spoken word B. Vascular lesions caused by dilated blood vessels C. Difficulty swallowing D. Uncoordinated muscle movement

D. Uncoordinated muscle movement

A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection? A. Trimethoprim-sulfamethoxazole B. Nystatin C. Amphotericin B D. Fluconazole

A. Trimethoprim-sulfamethoxazole

A client is prescribed didanosine as part of a highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client? A. "You should take the drug with an antacid." B. "It doesn't matter if you take this drug with or without food." C. "Be sure to take this drug about 1/2 before or 2 hours after you eat." D. "When you take this drug, eat a high-fat meal immediately afterwards."

C. "Be sure to take this drug about 1/2 before or 2 hours after you eat."

The nurse is obtaining an assessment and health history from the parents of a 6-month-old infant with an elevated temperature. Which statement by the parents alerts the nurse to a possible immunodeficiency disorder? A. "My husband's family has a history of hemophilia; could this be a problem?" B. "I usually feed my baby a bottle every 4 to 6 hours during the day." C. "This is the third infection with a high fever the baby has had in the past month." D. "I had a good prenatal care and vaginal birth, although they had to use forceps."

C. "This is the third infection with a high fever the baby has had in the past month."

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. Nuclei acid sequence-based amplification B. OraSure test C. Western blot assay D. p24 antigen capture assay

C. Western blot assay

Which is usually the most important consideration in the decision to initiate antiretroviral therapy? A. ELISA B. Western blot assay C. HIV RNA D. CD4+ counts

D. CD4+ counts

A client with end-stage acquired immunodeficiency syndrome (AIDS) has profound manifestations of Cryptosporidium infection caused by the Protozoa. What client need should the nurse focus on when planing this client's care? A. High-calorie nutrition B. Pain management C. Antiretroviral therapy D. Fluid replacement

D. Fluid replacement

A client with acquired immunodeficiency syndrome (AIDS) is exhibiting shortness of breath, cough, and fever. What type of infection will the nurse likely suspect? A. Cytomegalovirus B. Mycobacterium avium complex C. Legionella D. Pneumocystis jiroveci

D. Pneumocystis jiroveci

What does the nurse understand will result if the patient has a deficiency in the normal level of complement? A. Risk of stroke B. Increased susceptibility of infections C. Decrease in vascularity to the extremities D. Development of congestive heart failure

B. Increased susciptibility to infections

Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS? A. Sucrose B. Liquids C. Iron & zinc D. Gluten

B. Liquids