chapter 35 prepu test 3
An HIV-infected patient presents at the clinic for a scheduled CD4+ count. The results of the test are 45 cells/μL, and the nurse recognizes the patient's increased risk for Mycobacterium avium complex (MAC disease). The nurse should anticipate the administration of what drug?
Azithromycin
The nurse is preparing to start an IV for a client who is combative. What precautionary measure should the nurse take in order to avoid a needlestick?
ask for assistant
A nurse is completing a nutritional status of a patient who has been admitted with AIDS-related complications. What components should the nurse include in this assessment?
A) Serum albumin level B) Weight history D) Body mass index E) Blood urea nitrogen (BUN) level
A nurse is assessing a client with HIV who has been admitted with pneumonia. In assessing the client, which of the following observations takes immediate priority?
Tachypnea and restlessness
The mother of two young children has been diagnosed with HIV and expresses fear of dying. How should the nurse best respond to the patient?
"Can you tell me what concerns you most about dying?
The nurse receives a phone call at the clinic from the family of a patient with AIDS. They state that the patient started "acting funny" after complaining of headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member?
"The patient may have cryptococcal meningitis and will need to be evaluated by the physician."
A patient is beginning an antiretroviral drug regimen shortly after being diagnosed with HIV. What nursing action is most likely to increase the likelihood of successful therapy?
Addressing possible barriers to adherence
A hospital client is immunocompromised because of stage 3 HIV infection and the physician has ordered a chest radiograph. How should the nurse most safely facilitate the test?
Arrange for a portable x-ray machine to be used.
A client has come into contact with HIV. As a result, HIV glycoproteins have fused with the client's CD4+ T-cell membranes. This process characterizes what phase in the HIV life cycle?
Attachment
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?
Avoid fibrous foods, lactose, fat, and caffeine.
A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client?
Bank autologous blood.
A client with a history of IV drug use is HIV-positive. The client has been following an antiretroviral medication regimen faithfully and is doing well, attending college to get a social work degree, and focused on a bright future. In regular CD counts, what factor will indicate that this client has progressed from HIV to AIDS?
CD count
Which is usually the most important consideration in the decision to initiate antiretroviral therapy?
CD4+ counts
A patient with 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 patient has developed?
Candidiasis
The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is:
Chronic diarrhea.
A public health nurse is preparing an educational campaign to address a recent local increase in the incidence of HIV infection. The nurse should prioritize which of the following interventions?
Educational programs that focus on control and prevention
A nurse is teaching a health education class to a group of young adults and perceives that misinformation exists about the signs, symptoms, and trajectory of HIV infection. The nurse should inform participants that the first symptoms of HIV exposure include:
Fever, headache, and malaise
The nurse is reviewing the medical record of a client who is positive for human immunodeficiency virus (HIV). The nurse notes that the client is classified as HIV asymptomatic based on which CD4+ T lymphocyte count?
Greater than 500/mm3
A client who has AIDS has been admitted for the treatment of Kaposi sarcoma. What nursing diagnosis should the nurse associate with this complication of AIDS?
Impaired Skin Integrity Related to Kaposi Sarcoma
A nurse is planning the care of a patient with AIDS who is admitted to the unit with Pneumocystis pneumonia (PCP). Which nursing diagnosis has the highest priority for this patient?
Ineffective Airway Clearance
A patient with AIDS is admitted to the hospital with AIDS-related wasting syndrome and AIDS-related anorexia. What drug has been found to promote significant weight gain in AIDS patients by increasing body fat stores?
Megestrol
A patient has been diagnosed with AIDS complicated by chronic diarrhea. What nursing intervention would be appropriate for this patient?
Obtain a stool culture to identify possible pathoge
The nurse is caring for a client who has been admitted for the treatment of AIDS. In the morning, the client tells the nurse that he experienced night sweats and recently "coughed up some blood." What is the nurse's most appropriate action?
Place the client on respiratory isolation and inform the physician.
A patient with 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 patient?
Pneumocystis pneumonia
The nurse's plan of care for a patient with stage 3 HIV addresses the diagnosis of Risk for Impaired Skin Integrity Related to Candidiasis. What nursing intervention best addresses this risk?
Providing thorough oral care before and after meals
A hospital nurse has experienced percutaneous exposure to an HIV-positive patient's blood as a result of a needlestick injury. The nurse has informed the supervisor and identified the patient. What action should the nurse take next?
Report to the emergency department or employee health department.
The nurse teaches the client that reducing the viral load will have what effect?
long survival
A patient with HIV is admitted to the hospital because of chronic severe diarrhea. The nurse caring for this patient should expect the physician to order what drug for the management of the patient's diarrhea?
Sandostatin
HIV is harbored within which type of cell?
lymphocyte
The nurse is gathering data from laboratory studies for a client who has HIV. The clients T4-cell count is 200/mm³, and the client has been diagnosed with pneumocystis pneumonia. What does this indicate to the nurse?
The client has converted from HIV infection to AIDS.
A patient is in the primary infection stage of HIV. What is true of this patient's current health status?
The patient is infected with HIV but lacks HIV-specific antibodies.
A client with HIV has a nursing diagnosis of Risk for Impaired Skin Integrity. What nursing intervention best addresses this risk?
Utilize a pressure-reducing mattress.
A client who is HIV positive is taking zidovudine. Which adverse effects should the nurse closely monitor for in this client?
diarrhea and abdominal pain
The lower the client's viral load,
the longer the survival time.
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?
trimethoprim-sulfamethoxazole
Nursing students are reviewing the pathophysiology of human immunodeficiency virus (HIV). They demonstrate understanding of the information when they state which of the following as containing the genetic viral material?
Ribonucleic acid (RNA)
A patient had unprotected sex with an HIV-infected person and arrives in the clinic requesting HIV testing. Results determine a negative HIV antibody test and an increased viral load. What stage does the nurse determine the patient is in?
Primary infection
The nurse completes a history and physical assessment on a patient with AIDS who was admitted to the hospital with respiratory complications. The nurse knows to assess for the most common infection in persons with AIDS (80% occurrence). This is:
Pneumocystis pneumonia.
A nurse is assessing the skin integrity of a patient who has AIDS. When performing this inspection, the nurse should prioritize assessment of what skin surfaces?
Perianal region and oral mucosa
A client has discussed therapy for HIV-positive status. The goal of antiretroviral therapy is to:
keep the CD4 cell count above 350/mm3 and viral load undetectable.
A patient's primary infection with HIV has subsided and an equilibrium now exists between HIV levels and the patient's immune response. This physiologic state is known as which of the following
viral set point
A client asks a nurse, "What can I use to decrease my risk of exposure to HIV?" Which of the following would the nurse include as effective in reducing the risk of HIV exposure? Select all that apply.
1. Sexual abstinence 2. Latex male condoms 3. Polyurethane female condoms 4. Dental dams
A patient was tested for HIV using enzyme immunoassay (EIA) and results were positive. The nurse should expect the primary care provider to order what test to confirm the EIA test results?
Western blot test Explanation: The Western blot test detects antibodies to HIV and is used to confirm the EIA test results. The viral load test measures HIV RNA in the plasma and is not used to confirm EIA test results, but instead to track the progression of the disease process. The CD4/CD8 ratio test evaluates the ratio of CD4 and CD8 cells but is not used to confirm results of EIA testing.
A patient's current antiretroviral regimen includes nucleoside reverse transcriptase inhibitors (NRTIs). What dietary counseling will the nurse provide based on the patient's medication regimen?
Take this medication without regard to meals
A client on antiretroviral drug therapy admits to skipping medication doses, sometimes for days at a time. What can occur when medications are not taken as prescribed?
The client is risking the development of drug resistance and drug failure.
An 18-year-old pregnant female has tested positive for HIV and asks the nurse if her baby is going to be born with HIV. What is the nurse's best response?
"It's possible that your baby could contract HIV, either before, during, or after delivery."
A client with a recent diagnosis of HIV infection expresses an interest in exploring alternative and complementary therapies. How should the nurse best respond?
"Many clients with HIV use some type of alternative therapy and, as with most health treatments, there are benefits and risks."
A nurse is working with a patient who was diagnosed with HIV several months earlier. The nurse should recognize that a patient with HIV is considered to have AIDS at the point when the CD4+ T-lymphocyte cell count drops below what threshold?
200 cells/mm3 of blood
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 the progression of the disease as well as guiding drug therapy?
Viral load and T4-cell counts will be performed every 2 to 3 months.
Which condition is an early manifestation of HIV encephalopathy?
Headache
