Chapter 14

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? "I will need to take my HIV medication daily for the rest of my life." "Although I only take one pill, it has multiple medications combined into a single tablet." "I should notify my HIV provider if I get fevers that do not go away with Tylenol or aspirin." "Once my viral load is undetectable I don't have to worry about taking my medication every day."

"Once my viral load is undetectable I don't have to worry about taking my medication every day."

What is a primary reason that the normal immune response fails to contain the HIV infection? a. CD4 T cells become infected with HIV and are destroyed b. The virus inactivates B cells, preventing the production of HIV antibodies c. Natural killer cells are destroyed by the virus before the immune system can be activated d. Monocytes ingest infected cells, differentiate into macrophages, and shed viruses in body tissues

CD4 T cells become infected with HIV and are destroyed

A patient with diarrhea has been diagnosed with Clostridium difficile. Along with standard precautions, which kind of transmission-based precautions will be used when the nurse is caring for this patient? a. Droplet precautions b. Contact precautions c. Isolation precautions d. Airborne precautions

Contact precautions

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

Decreased viral load

A patient comes to the clinic and requests testing for HIV infection. Before administering testing, what is the most important for the nurse to do? a. Ask the patient to identify all sexual partners b. Determine when the patient thinks exposure to HIV occurred c. Explain that all test results must be repeated at least twice to be valid d. Discuss prevention practices to prevent transmission of the HIV to others

Determine when the patient thinks exposure to HIV occurred

The rapid HIV antibody testing is performed on a patient at high risk for HIV infection. What should the nurse explain about this test? a. The test measures the activity of the HIV and reports viral loads as real numbers b. This test is highly reliable, and in 5 minutes the patient will know if HIV infection is present c. If the results are positive, another blood test and a return appointment for results will be necessary d. This test detects drug-resistant viral mutations that are present in viral genes to evaluate resistance to antiretroviral drugs

If the results are positive, another blood test and a return appointment for results will be necessary

Which opportunistic disease associated with AIDs is characterized by vascular lesions of the skin, mucous membranes and viscera? a. Kaposi sarcoma b. Candida albicans c. Herpes simplex type 1 infection d. Varicella-zoster virus infection

Kaposi sarcoma

Which characteristics describe Pneumocystis jiroveci infection, an opportunistic disease that can be associated with HIV? a. May cause fungal meningitis b. Diagnosed by lymph node biopsy c. Pneumonia with dry, nonproductive cough d. Viral retinitis, stomatitis, esophagitis, gastritis or colitis

Pneumonia with dry, nonproductive cough

A patient admitted with possible stroke has been aphasic for 3 hours, and his current blood pressure (BP) is 174/94 mm Hg. Which order by the health care provider should the nurse question? a. Keep head of bed elevated at least 30 degrees. b. Infuse normal saline intravenously at 75 mL/hr. c. Start a labetalol drip to keep BP less than 140/90 mm Hg. d. Administer tissue plasminogen activator (tPA) intravenously per protocol.

Start a labetalol drip to keep BP less than 140/90 mm Hg.

A patient identified as HIV antibody positive 1 year ago manifests asymptomatic HIV infection but does not want to start ART at this time. What is the best nursing intervention for the patient at this stage of illness? a. Assist with end-of-life issues b. Provide care during acute exacerbations c. Provide physical care for chronic diseases d. Teach the patient about immune enhancement

Teach the patient about immune enhancement

Which characteristic corresponds with the acute stage of HIV infection? a. Burkitt's lymphoma b. Temporary fall of CD4 T cells c. Persistent fevers and night sweats d. Pneumocystis jiroveci pnumonia

Temporary fall of CD4 T cells

What is one of the most significant factors in determining when to start ART in a patient with HIV infection? a. Whether the patient has high levels of HIV antibodies b. Confirmation that the patient has contracted HIV infection c. The patient readiness to commit to a complex, lifelong, uncomfortable drug regimen d. Whether the patient has a support system to help manage the treatment regimen and costs

The patient readiness to commit to a complex, lifelong, uncomfortable drug regimen

Why do opportunistic diseases develop in an individual with AIDs? a. They are side effects of drug treatment of AIDS b. They are sexually transmitted to individuals during exposure to HIV c. They are characteristic in individuals with stimulated B and T lymphocytes d. These infections or tumors occur in a person with an incompetent immune system

These infections or tumors occur in a person with an incompetent immune system

The nurse informs the patient with a bacterial pneumonia that the most important factor in antibiotic treatment is antibiotics should have been used to prevent pneumonia. all of the supplied antibiotics should be taken even when symptoms have resolved. enough antibiotics for 2 days' treatment should be reserved in case symptoms recur. patients should request antibiotics for upper respiratory infections to prevent development of streptococcal-related diseases.

all of the supplied antibiotics should be taken even when symptoms have resolved.

A female patient who had a stroke 24 hours ago has expressive aphasia. An appropriate nursing intervention to help the patient communicate is to a. ask questions that the patient can answer with "yes" or "no." b. develop a list of words that the patient can read and practice reciting. c. have the patient practice her facial and tongue exercises with a mirror. d. prevent embarrassing the patient by answering for her if she does not respond.

ask questions that the patient can answer with "yes" or "no."

Which finding supports the diagnosis of acquired immunodeficiency syndrome in the individual with HIV? a. flu-like symptoms b. oral hairy leukoplakia c. CD4 T cells 200-500 u/L d. cytomegalovirus retinitis

cytomegalovirus retinitis

An 82 year old male patient with cardiac disease who is in the intensive care unit is beginning to have decreased cognitive function. What should the nurse first suspect as a potential cause of this change? a. fatigue b. infection c. ICU psychosis d. medication allergy

infection

A 78 year old patient has developed an infection caused by Haemophilus influenza. In addition to standard precautions, what should the nurse use to protect herself when working within 3 feet of the patient? a. mask b. gown c. shoe covers d. particulate respirator

mask

A diagnosis of AIDS can be made for a patient with HIV with CD4+ T-cell count <500/µL. WBC count <3000/µL (3 × 109/L). development of oral candidiasis (thrush). onset of Pneumocystis jiroveci pneumonia.

onset of Pneumocystis jiroveci pneumonia.

After a patient experienced a brief episode of tinnitus, diplopia, and dysarthria with no residual effects, the nurse anticipates teaching the patient about a. cerebral aneurysm clipping. b. heparin intravenous infusion. c. oral low-dose aspirin therapy. d. tissue plasminogen activator (tPA).

oral low-dose aspirin therapy.

A patient arrives in the emergency department with hemiparesis and dysarthria that started 2 hours previously, and health records show a history of several transient ischemic attacks (TIAs). The nurse anticipates preparing the patient for a. surgical endarterectomy. b. transluminal angioplasty. c. intravenous heparin drip administration. d. tissue plasminogen activator (tPA) infusion.

tissue plasminogen activator (tPA) infusion.

Prophylactic measures that are routinely used as early as possible in HIV infection to prevent opportunistic and debilitating secondary problems include the administration of a. isoniazid to prevent tuberculosis b. zoster virus vaccination to prevent shingles c.trimethoprim/sulfamethoxazole for toxoplasmosis d. vaccines for pneumococcal pneumonia, influenza, and hepatitis A and B

vaccines for pneumococcal pneumonia, influenza, and hepatitis A and B