Chapter 37

The client with acquired immune deficiency syndrome (AIDS) asks the nurse why he must take so many medications. What is the best response by the nurse? 1. "To decrease the possibility of the virus developing resistance to the medications." 2. "Research has shown single medications to be ineffective." 3. "Because the earlier we start multiple medications, the better for you." 4. "To provide you with the most effective treatment for your illness."

1

The nurse is caring for a client receiving darunavir (Prezista). The nurse would observe for adverse effects of 1. nausea. 2. constipation. 3. dizziness. 4. increased urinary output.

1

The nurse teaches clients with acquired immune deficiency syndrome (AIDS) about the importance of taking their medications as prescribed. What does the nurse recognize as the primary factor for medication noncompliance in the acquired immune deficiency syndrome (AIDS) population? 1. The necessity of having to take multiple medications throughout the day 2. A lack of understanding for the reason to take the medications 3. The weight gain associated with the medications 4. The difficulty with availability of medications to treat acquired immune deficiency syndrome (AIDS)

1

Which drug is most likely to be ordered for the client with herpes simplex virus? 1. Acyclovir (Zovirax) 2. Zidovudine (Retrovir) 3. Nystatin (Fungizone) 4. Metronidazole (Flagyl)

1

A patient has recovered from hepatitis B. Which discharge information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "You are now immune to getting hepatitis B again." 2. "Chronic hepatitis B may take years to develop." 3. "You should get hepatitis B vaccines annually." 4. "You should get hepatitis immunoglobulin annually." 5. "You should get one dose of interferon to boost your immunity to hepatitis B."

1,2

A nurse is preparing an education session for a group of public school teachers regarding prevention of influenza. What topics should be included in this session? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. They need to discuss immunization with their personal health care providers due to contact with children. 2. Encourage students and staff to stay home if they are ill. 3. Encourage frequent handwashing for all students and staff. 4. There is little we can do to prevent a pandemic. 5. Anti-influenza drugs should be reserved only for adults who have been diagnosed with influenza.

1,2,3

A pregnant woman who is HIV positive is taking zidovudine. She is very concerned about her infant and says, "My doctor said they won't even test my baby until she is 2 weeks old. I wish they would do it when she is born." What responses, by the nurse, are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "Since you are taking zidovudine, a test at birth will not be accurate." 2. "The tests are much more accurate when your baby gets to be 2 weeks old." 3. "You can expect your baby to be tested at 1 month of age." 4. "Testing will continue until your baby is 1 year old." 5. "The most sensitive test is one done at 1 week of age."

1,2,3,4

The client receives zidovudine (Retrovir) for treatment of human immunodeficiency virus (HIV) infection. The nurse would increase assessment surveillance for which adverse reactions from this treatment? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Fatigue and generalized weakness 2. New onset headache 3. Constipation 4. Edema 5. Liver palpable on physical examination

1,2,5

The nurse plans to teach a client with human immunodeficiency virus (HIV) infection about zidovudine (Retrovir). What will the best plan by the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Zidovudine (Retrovir) will need to be stopped if bone marrow depression occurs. 2. Zidovudine (Retrovir) will slow the disease, but not cure it. 3. Zidovudine (Retrovir) prevents spread of the virus through sexual contact. 4. Zidovudine (Retrovir) is only administered to male patients. 5. Zidovudine (Retrovir) therapy frequently results in the development of anemia.

1,2,5

A nurse manager is discussing employment requirements with a group of potential employees. One person says, "I am not certain I want to get a hepatitis shot." What information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "Working in a hospital puts you at higher risk for being exposed to hepatitis B." 2. "You can be protected from hepatitis B with this one quick immunization." 3. "Children get this immunization before they are 2 years old." 4. "If you don't get this vaccine, you must wear gloves at all times." 5. "The vaccine is about 50% effective."

1,3

A patient has developed chronic hepatitis after being exposed to hepatitis C. The nurse is discussing treatment of this condition. What information should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "There are some new medications that help keep the HCV virus from reproducing in your system." 2. "There is not much we can do except support your general health." 3. "Most current research supports the use of multidrug therapy." 4. "A new drug called pegylation has been shown to prevent liver damage." 5. "You should advise your family to take the hepatitis C vaccine."

1,3

The nurse educates clients with acquired immune deficiency syndrome (AIDS) about the nature of viruses. The nurse evaluates that learning has occurred when the clients make which responses? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "Viruses are nonliving particles." 2. "The structure of viruses is complex." 3. "Viruses can infect plants as well as animals." 4. "A virion is a mature virus." 5. "Viruses are intracellular parasites."

1,3,4,5

A client has just recovered from a long course of therapy for shingles. The client says, "What can I do to keep from having that again?" What information should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Try to find healthy outlets for your stress. 2. Once you have had shingles, you are not likely to get it again. 3. Try to keep as physically healthy as possible. 4. There is little you can do to prevent outbreaks. 5. Try to keep your immune system strong by taking good care of your physical and emotional health.

1,3,5

The client asks the nurse why there aren't better drugs for human immunodeficiency virus (HIV) infection when so much money is spent on research. What is the best response by the nurse? 1. "Antiviral drugs are almost impossible to create." 2. "Developing new drugs is difficult because the virus mutates so readily." 3. "Developing new drugs is difficult because people think acquired immune deficiency syndrome (AIDS) is a rare disease." 4. "Developing new drugs is difficult because we still do not understand the virus."

2

The client receives acyclovir (Zovirax) for treatment of genital herpes. What is a priority assessment by the nurse? 1. Auditory and visual hallucinations 2. Increased serum creatinine 3. Respiratory distress 4. Thrombocytopenia

2

The client receives efavirenz (Sustiva) as treatment for acquired immune deficiency syndrome (AIDS). The nurse assesses the client for which serious adverse effect? 1. Cardiac arrest 2. Rash 3. Bone marrow suppression 4. Seizures

2

The nurse is aware that the major characteristic of viruses is that they are 1. extracellular parasites. 2. intracellular parasites. 3. extracellular bacteria. 4. intracellular bacteria.

2

The nurse provides care for clients with acquired immune deficiency syndrome (AIDS). Which laboratory test is the best indicator of effective treatment with antiviral medications? 1. CD4 count 2. Viral load 3. T4 lymphocyte count 4. Absolute neutrophil count

2

The primary purpose of agents for herpes viruses is to 1. inhibit HIV protease. 2. prevent viral DNA synthesis. 3. bind directly to reverse transcriptase DNA. 4. create a defective DNA strand.

2

The purpose of general pharmacotherapy for human immunodeficiency virus (HIV)/AIDS is to 1. eliminate viral load. 2. relieve symptoms for a longer period of time. 3. cure the disease. 4. kill the virus.

2

A client has been prescribed oseltamivir (Tamiflu) after complaining of influenza-like symptoms. What information should the nurse provide for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. This medication is given by inhalation. 2. Get this prescription filled and begin taking the medication immediately. 3. This medication will keep you from getting the flu. 4. This is an expensive medication. 5. This medication will be helpful if you have influenza or a cold.

2,4

The client has acquired immune deficiency syndrome (AIDS) and has just learned she is pregnant. She tearfully asks the nurse if her baby will die of acquired immune deficiency syndrome (AIDS). What is the nurse's best response? 1. "There are special tests that we can do to see if your baby is positive before birth." 2. "I know that is a great worry for all of us." 3. "Drug therapy can help prevent your child from contracting the virus." 4. "There are drugs that can be given after birth to reverse AIDS."

3

The client has just begun highly active antiretroviral therapy (HAART) for the treatment of acquired immune deficiency syndrome (AIDS). Which teaching point is a priority for this client? 1. Medications must be taken for 3 years after viral load is not measurable. 2. The goal of highly active antiretroviral therapy (HAART) is to reduce plasma human immunodeficiency virus (HIV) ribonucleic acid (RNA) to the lowest possible level. 3. Taking medications as scheduled is vital to successful treatment. 4. Know which medications target which phases of the human immunodeficiency virus (HIV) replication cycle.

3

The client receives acyclovir (Zovirax) as treatment for herpes simplex type 1 virus (genital herpes). What is the best expected outcome for this client? 1. The client will prevent a reoccurrence of infection in the affected area. 2. The client will identify the names of sexual contacts in the past month. 3. The client will report decreased pain using the approved pain scale. 4. The client will report a decrease in the number of lesions in the affected area.

3

The nurse does health teaching with a client who has acquired immune deficiency syndrome (AIDS) and who has been started on antiviral medications. The nurse recognizes that teaching has been effective when the client makes which statement? 1. "I will need to limit my travel to avoid people with other infections." 2. "I will need to be on a high-calorie diet to enhance the effect of the medication." 3. "I will still need to take precautions to avoid spreading the virus to others." 4. "I will not be able to continue working at my high-stress job anymore."

3

Which laboratory test best evaluates HIV disease? 1. Platelets 2. Liver function studies 3. CD4 count 4. Complete blood count

3

A nurse is preparing to administer prescribed medication to a client exposed to hepatitis A. Which information should the nurse provide to this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. I am giving you HAV vaccine. 2. You will likely need another injection, or booster, in 6 months. 3. I am giving you hepatitis A immunoglobulin (HAIg). 4. This injection may keep you from contracting hepatitis A. 5. You will not need to worry about contracting hepatitis A for the next 5 to 8 years.

3,4

The nurse accidentally sticks herself with a needle after starting an intravenous (IV) line on a client with acquired immune deficiency syndrome (AIDS). The nurse tells the supervisor about the accident. What is the best initial response by the supervisor to decrease anxiety in the nurse? 1. "If you are started on medications soon, it will decrease the severity of the disease." 2. "Workers compensation will cover the cost of your illness and medications." 3. "Did you use the hospital protocols for starting intravenous (IV) lines on a client with acquired immune deficiency syndrome (AIDS)?" 4. "Fortunately, the chances of you contracting human immunodeficiency virus (HIV) after the stick are very small."

4

The nurse is preparing to discharge a client on an antiretroviral agent. Which instruction should the nurse include? 1. Take your blood pressure daily. 2. Weigh yourself daily. 3. Take your pulse daily. 4. Practice good handwashing.

4

The nurse is discussing the seriousness of a patient's hepatitis C diagnosis. The nurse says, "One of the problems you will face is that about ________% of patients with hepatitis C go on to develop chronic hepatitis.

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