(adult health/medsurg 2) Ch 22: Multiple Choice

B (Live virus vaccines are generally contraindicated in HIV+ patients but it is important that patients maintain up to date immunizations to protect from infection.)

The nurse has received the following orders for a patient with AIDS who has recently been admitted to the unit. Which order should the nurse question? A. Hepatitis B vaccine—third dose B. Live virus infuenza vaccine C. Tetanus vaccine D. Pneumovax vaccine

A

The nurse is caring for a patient who is receiving antiretroviral therapy (ART) for treatment of HIV. Which assessment best indicates that the patient's condition is improving? a.Decreased viral load b.Increased drug resistance c.Decreased CD4+ T-cell count Increased aminotransferase levels

d

The nurse is teaching a newly diagnosed 34-year-old male about his HIV infection. Which statement by the patient would indicate the patient needs additional education? a."I will need to take my HIV medication daily for the rest of my life." b."Although I only take one pill, it has multiple medications combined into a single tablet." c."I should notify my HIV provider if I get fevers that do not go away with Tylenol or aspirin." d."Once my viral load is undetectable I don't have to worry about taking my medication every day."

c (OIs generally occur with a CD4 count of 200 cells/μL or less. Diagnostic tests for HIV screen for antibodies for the virus. A CD4+ count of at least 500 cells/μl indicates stage 1 HIV infection. Prophylaxis against OIs is started before ART if the patient's CD4 count is less than 200 cells/μl.)

The nurse understands the correct statement about HIV disease is which of the following? A. HIV disease is diagnosed by determining viral load. B. A CD4+ count of 600 cells/μL or more indicates HIV, not AIDS. C. A CD4+ count of 200 cells/μL or less increases the chances for opportunistic infections. D. ART is started immediately after diagnosis if the CD4+ count is less than 200 cells/μL.

C (A positive PPD indicates previous exposure to TB with possibility of latent TB being activated in a HIV+ person)

Which of the following HIV+ patients is at greatest risk of developing TB? A patient with: A. A CD4+ count greater than 200 B. A cough and fever C. A positive PPD D. Recent pneumonia

A (: It can take up to 6 months for a person to test positive for HIV. Safe sex is always recommended as a prevention strategy.)

You are counseling a patient who has just tested negative for a possible HIV exposure. Which of the following statements indicates your teaching has been effective? A. "I need to get tested again in 6 months." B. "I won't need to continue using protection." C. "Because I am negative, I don't have HIV." D. "Because I tested negative, I can't infect anyone."

B (Diagnosis of HIV is known to cause depression. There are no real dietary restrictions. Universal precautions, not reverse isolation, are utilized with HIV+ patients. Weight maintenance or gain strategies should be reinforced.)

You are providing care for a patient newly diagnosed with HIV. Which nursing intervention is an essential priority in your plan of care? A. Dietary restriction for a soft diet B. Evaluating behaviors for depression C. Reverse isolation to reduce infection risk D. Teaching exercise and weight loss strategies

B (Difficulty swallowing is a symptom of esophageal candidiasis, an OI-related to a low CD4 count. Diarrhea is common in HIV+ patients. If acute and extensive it could lead to hypovolemia. Chronic diarrhea should just be monitored. Missing 1 dose is not an emergency but the patient should be encouraged to maintain regular doses. A nondetectable viral load is good.)

A nurse in the clinic has assessed several patients. It is a priority for the nurse to suggest follow-up to which of the following patients? The patient that reports: A. Chronic intermittent diarrhea for 6 months B. Difficulty swallowing food for 3 days C. Missing one dose of ART in the past week D. Nondetectable HIV viral load 3 months ago

C (Rapid tests utilizing blood or oral fluids can be used in settings where a quick answer for the presence or absence of HIV antibodies is required, do not require a laboratory to perform the test, and the results are available in 5 to 30 minutes depending on the test used.)

A nurse is caring for a patient in the emergency department. The patient asks for an HIV test. The nurse explains that a screening test can provide quick results and determine whether more testing is necessary. That test is a: A. CD4+ count B. ELISA C. Rapid test D. Viral load

A

A nurse is screening patients for their risk of developing HIV. The nurse should consider which patient at greatest risk? A. African American man B. Asian woman C. Caucasian man D. Latino woman

B (Support groups are available in many communities. These groups are familiar with the positive and negative attitudes/concerns of HIV+ individuals in the community.)

A patient newly diagnosed with HIV asks about community support groups. What should the nurse do? A. Contact psychiatry for an evaluation for depression. B. Provide a list of groups in a neighboring community. C. Request a referral to the social work department. D. Suggest the family contact the physician.

A (Current recommendations state that providers should offer opt-out screening for patients between the ages of 15-65. Yearly testing is recommended for "at risk" individuals.)

A patient states she has recently been treated for gonorrhea. Her last HIV test was 18 months ago. When you review the orders, you notice that an HIV test has been ordered. What do you do? A. Explain that the test has been ordered and she can opt out. B. No discussion is necessary; just do the test. C. Obtain her written consent for the test. D. Provide pretest counseling before getting consent.