Ch. 27 NCLEX Review

A client diagnosed with human papillomavirus (HPV) states to the nurse, "I'm not concerned; I know the lesions disappear after a while." The nurse should counsel the client on which of the following? (Select all that apply.)

The link between HPV and cervical cancer The need to surgically remove tumors, if present The lack of a cure The complications of HPV infection are especially serious for women. The link between HPV infection and cervical cancer has been established and is associated with specific types of the virus. Pap smears are important because they allow for microscopic examination of cells to detect HPV and tumors. The tumors can often be surgically removed if found early. HPV is exacerbated during pregnancy and in immune-related disorders; it may infect a fetus, and there is no cure. The goal is to eliminate the lesions, despite the disappearance over time, through surgical removal, cytotoxic agents, or immunotherapies.

Nurses in community health conducting health education classes for populations vulnerable to HIV/AIDS should explain the natural history of the progression of human immunodeficiency virus (HIV). Of particular importance is the fact that the disease may go undetected during the primary infection phase because:

antibody tests are typically negative Individuals may experience symptoms of a flu-like syndrome (i.e., lymphadenopathy, myalgias, sore throat, lethargy, rash, and fever) during the primary infection phase of HIV. An antibody test in this phase is usually negative, so it is often not recognized as HIV

The nurse in community health is aware that HIV-infected children should attend school, because the benefit of attendance far outweighs the risk of transmitting or acquiring infections. School attendance should be reconsidered when there is evidence of:

cases of measles Attendance at school may be inadvisable if cases of childhood infections are in the school, since the immunosuppressed child is at greater risk for suffering complications. Alternative arrangements, such as homebound instruction, might be instituted if a child is unable to control body secretions or displays biting behavior.

A strategy that may improve compliance with tuberculosis (TB) treatment is the:

expansion of directly observed therapy To prevent TB, the CDC works with public health agencies in other countries to improve screening and reporting of cases and to improve treatment strategies. This includes coordination of treatment for infected individuals who migrate to the United States. Nurses administer tuberculin skin tests and provide education on the importance of compliance to long-term therapy. They may also be involved in directly observed therapy (DOT) and contact investigations of cases in the community.

A client presents at the local clinic with acute symptoms of fever, nausea, lack of appetite, malaise, and abdominal discomfort. During the course of the assessment, the nurse determines that the client is a health care aide working at a day care center. These facts are important because:

hepatitis A outbreaks are common in facilities where staff change diapers Hepatitis A virus (HAV) is most often transmitted through the fecal-oral route. It remains one of the most frequently reported vaccine-preventable diseases. Outbreaks are common in day care centers whose staff must change diapers, among household members and sexual contacts of infected individuals, and among travelers to countries where HAV is endemic.

A young female client visits a local clinic, seeking treatment for a urinary tract infection (UTI). During the assessment, the nurse conducts an extensive sexual history/activity screening to determine the risk for a sexually transmitted disease and potential complication of:

pelvic inflammatory disease (PID) Chlamydia is the most common reportable infectious disease in the United States. Women are often asymptomatic and therefore do not seek treatment, placing them at greater risk for developing pelvic inflammatory disease (PID), a serious infection involving the fallopian tubes (salpingitis).

During the last stage of AIDS, many opportunistic infections proliferate in persons with weakened immune systems. HIV-infected individuals who live near one another in long-term care facilities, drug treatment facilities, and prisons should be carefully screened before admission because they are at greater risk for acquiring:

pulmonary tuberculosis (TB) Opportunistic infections may be caused by bacteria, fungi, viruses, or protozoa. The most common opportunistic diseases are Pneumocystis carinii pneumonia and oral candidiasis; other diseases are pulmonary TB, invasive cervical cancer, or recurrent pneumonia. TB can spread rapidly among immunosuppressed individuals. Thus HIV-infected individuals who live near one another, such as in long-term care facilities, correctional facilities, drug treatment facilities, or other settings, must be carefully screened and deemed noninfectious before admission to such settings.

Many behaviors place individuals of all ages, genders, ethnicities, or any other factors at greater risk for sexually transmitted diseases (STDs). The nurse should include primary prevention interventions in all client encounters through the discussion of:

safer sex Sexual abstinence is the best way to prevent STDs. However, for many people, sexual abstinence is not realistic; therefore teaching about how to make sexual behavior safer is critical. Safer sexual behavior includes masturbation, dry kissing, touching, fantasy, and vaginal and oral sex with a condom. Nurses should not base assessments or knowledge on age, gender, ethnicity, or any other factors and should discuss safe sex in all client encounters.

The primary prevention of hepatitis C virus (HCV) includes:

screening of blood products Primary prevention of HCV infection includes screening blood products and donor organs and tissue; risk-reduction counseling and services, including obtaining the sexual and injection drug use (IDU) history; and infection control practices.

A population-level tertiary prevention intervention typically performed by nurses and aimed at controlling communicable diseases is:

standard precautions teaching The importance of teaching caregivers about infection control in home care is vital. The nurse treating an HIV client in the home environment should teach caregivers about standard precautions. Some clients, families, friends, and other groups may have concerns about transmission of HIV. Others, who may not have concerns about transmission, may not take adequate precautions or may believe myths that they may not become infected.