hiv Med-Surg Chapter 35
Which tests tell the physician what the viral load is in a client with HIV/AIDS? Select all that apply. A) T4/T8 ratio B) polymerase chain reaction C) Western blot D) p24 antigen test E) ELISA test
b,d
A client who is HIV positive is taking zidovudine. Which adverse effects should the nurse closely monitor for in this client? A) Anemia and granulocytopenia B) Numbness in the extremities C) Alterations in the renal function D) Pancreatitis
a
A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wartlike lesions on my vagina. This is happening quite often." What should the nurse consult with the physician regarding? A) Testing the client for the presence of HIV B) Instructing the client to wear cotton underwear C) Having the client abstain from sexual activity for 6 weeks while the medication is working D) Using a medicated douche in order to keep the vaginal pH normal
a
A healthcare worker has been exposed to the blood of an HIV-positive client and is awaiting the results of an HIV test. In the meantime, what precautions must the healthcare worker take to prevent the spread of infection? A) Limit interactions with people who are not HIV infected. B) Limit interactions with people who are already HIV infected. C) Follow the same sexual precautions as someone who has been diagnosed with AIDS. D) Quit his job and admit himself to a hospital or a cancer treatment center.
c
A male client is having sexual relations with another male as well as using methamphetamine and has contracted HIV. What concern does the nurse have for this client? A) The client is a drug addict and needs to stop using. B) The client may infect other people because of his drug use. C) The client may develop AIDS in a shorter period of time. D) The client will remain HIV positive for a longer period of time.
c
A client has discussed therapy for his HIV-positive status. What does the nurse understand is the goal of antiretroviral therapy? A) Reverse the HIV+ status to a negative status. B) Treat mycobacterium avium complex. C) Eliminate the risk of AIDS. D) Keep the CD4 cell count above 350/mm3 and viral load undetectable.
d
A client who had sexual contact with a partner who is HIV+ recently develops flulike symptoms such as a low grade fever, headache, and muscle pain. What does the nurse suspect this client is experiencing? A) Pneumocystis pneumonia B) Influenza C) AIDS D) Acute retroviral syndrome
d
A client who is HIV/AIDS positive has orders for laboratory tests to be performed. What precautions should the nurse observe whenever there is a risk of exposure to the blood and body fluids of an infected client? A) Avoid any physical contact with the client. B) Avoid cleaning up spilled urine and feces. C) Wear barrier garments for as long as possible after leaving a client's room. D) Transport the specimens of body fluids in leak-proof containers.
d
A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection? A) Trimethoprim-sulfamethoxazole (Bactrim, Septra) B) Nystatin (Mycostatin) C) Amphotericin B (Fungizone) D) Fluconazole (Diflucan)
a
A client with AIDS has been tested for cytomegalovirus (CMV) with positive titers. What severe complication should the nurse be alert for with cytomegalovirus? A) Diarrhea B) Hearing impairment C) Blindness D) Fatigue
c
The client comes to the clinic to obtain the results from the test to determine if he is infected with HIV. The physician informs the client that he has a CD4 cell count of 300 cells/mm3 and a high viral load. What does the nurse anticipate the physician will discuss with the client? A) Retroviral therapy is not warranted at this time. B) The initiation of antibiotic therapy to prevent the development of an opportunistic infection C) The administration of an antifungal medication to prevent the development of an opportunistic fungal infection D) The initiation of antiretroviral therapy
d
A client on antiretroviral drug therapy is discussing with the nurse that sometimes he "forgets to take his meds for a few days." What should the nurse inform the client can occur when the medications are not taken as prescribed? A) The funding for the medications will cease if the client is not taking the meds correctly. B) The client is risking the development of drug resistance and drug failure. C) The client will have to take the drugs intravenously to ensure compliance. D) The client will have to take higher doses of the antiviral medications.
b
A client will be having a hysterectomy and wants her daughter to donate the blood for directed donor donation. What factor would eliminate her daughter from donating the blood? A) The daughter is 15 years of age. B) The daughter weighs 124 lb. C) The daughter is negative for HIV. D) The physician has been notified of the procedure.
a
A female client informs the nurse that she is considering beginning sexual relations and wants to know the best way to protect herself from a sexually transmitted infection and HIV. What is the best response by the nurse? A) "Using a condom (latex) and spermicidal jelly is one of the most effective ways to decrease the risk of transmission of an STI and HIV." B) "Using a diaphragm with spermicidal jelly will also kill the bacteria and viruses that transmit STIs and HIV." C) "Using a lamb skin condom will be the most effective way to decrease transmission of STIs and HIV." D) "Douching immediately after intercourse will be the most effective way to kill bacteria and viruses."
a
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? A) The client has converted from HIV infection to AIDS. B) The client has advanced HIV infection. C) The client's T4-cell count has decreased due to the Pneumocystis pneumonia. D) The client has another infection present that is causing a decrease in the T4-cell count.
a
The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluids does the nurse inform them will transmit the virus? Select all that apply. A) Semen B) Urine C) Breast milk D) Blood E) Vaginal secretions
a,c,d,e
A 17-year-old client with a diagnosis of HIV presents at the public health clinic complaining of pharyngitis, rash on the palms and soles of his feet, and diarrhea. What would the nurse suspect the client is suffering from? A) AIDS dementia complex (ADC) B) Acute retroviral syndrome (ARS) C) Distal sensory polyneuropathy (DSP) D) AIDS-related complex (ARC)
b
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? A) Sign a refusal of blood transfusion form so the client will not receive the transfusion. B) Bank autologous blood. C) Ask people to donate blood. D) Using volume expanders in case blood is needed.
b
The nurse is preparing to start an IV for a patient who is combative. What precautionary measure should the nurse take in order to avoid a needlestick? A) Have the patient placed in restraints so that he will not move. B) Ask for assistance. C) Refuse to start the IV. D) Give the client a sedative prior to starting the IV.
b
When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by ____. A) Means of transmission B) HIV-1 is more prevalent than HIV-2 subtypes C) The fact that it is a mutated virus originally thought to be bovine in nature D) Cure rate of the virus
b
A client requires a blood transfusion for anemia and informs the nurse that he refuses because he doesn't want to contract acquired immune deficiency syndrome (AIDS). What is the best response by the nurse? A) "It's always a possibility." B) "You don't want to die, do you?" C) "The blood is screened very carefully; the risk is 1 in 2,000,000. D) "If you don't have the transfusion, you are taking a greater risk."
c
A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis? A) Urine specimen for culture and sensitivity B) Blood specimen for electrolyte studies C) Stool specimen for ova and parasites D) Sputum specimen for acid fast bacillus
c
A client with AIDS is brought to the clinic by his family. The family tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms? A) Distal sensory polyneuropathy (DSP) B) Candidiasis C) AIDS dementia complex (ADC) D) Cytomegalovirus (CMV)
c
A client with HIV will be started on a medication regimen of three medications. Which medication will be given that will interfere with the virus's ability to make a genetic blueprint. What drug will the nurse instruct the client about? A) Protease inhibitor B) Integrase inhibitors C) Reverse transcriptase inhibitors D) Hydroxyurea (Hydrea)
c
A client with cytomegalovirus infection tells the nurse at the clinic that he is starting to have difficulty seeing and his glasses don't seem to be working as they used to. The physician determines that the client is developing CMV retinitis. What medication does the nurse anticipate the client will receive for this? A) Zidovudine (AZT) B) Fluconazole (Diflucan) C) Azithromycin (Zithromax) D) Foscarnet (Foscavir)
d
The nurse has four clients that come to the clinic for healthcare. Which one of these clients has the highest risk factor for HIV infection? A) A 46-year-old female who has been in a monogamous relationship for 9 years B) A 22-year-old heterosexual male who has had one relationship for 2 years C) A 34-year-old female who has donated blood on several occasion D) A 26-year-old inmate who receives tattoos in prison
d
A client visits the nurse complaining of diarrhea every time he eats. The client has AIDS and wants to know what he can do to stop having diarrhea. What should the nurse advise? A) Avoid fibrous foods, lactose, fat, and caffeine. B) Encourage large, high-fat meals. C) Reduce food intake. D) Increase the intake of iron and zinc.
a
The nurse is administering an injection to a client with AIDS and, when finished, attempts to recap the needle and sustains a needlestick to the finger. What is the priority action by the nurse? A) Obtain counseling. B) Call the lab to draw the nurse's blood. C) Fill out a risk management report. D) Report the incident to the supervisor
d
A client is informed that he will have to start on antiretroviral therapy, and the client is concerned that he will not be able to afford the therapy. What can the nurse inform the client is the largest source of public funding for HIV/AIDS care? A) Medicaid B) Medicare C) Blue Cross/Blue Shield D) AIDS Drug Assistance Program
a
A client tells the nurse, "You know I have AIDS. I still cannot afford to tell my employer because they will probably cancel my health insurance, then what would I do?" What is the best response by the nurse? A) "An employer cannot cancel your currently active health insurance on the basis of AIDS." B) "I just wouldn't tell them. It is none of their business." C) "You have to tell them, it is not your right to allow them exposure to you. What if you give it to someone?" D) "I understand your dilemma, but I think you should tell them. I would want to know."
a
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? A) The client will be required to stop the medication for 2 weeks and then have laboratory studies drawn to determine if the antiretroviral therapy has cured the disease. B) Viral load and T4-cell counts will be performed every 2 to 3 months. C) More antiretroviral medication will be added every 2 to 3 months. D) The Western blot test will be monitored every 6 months to see if the virus is still present.
b
A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay with positive results twice. What is the next step for the nurse to explain to the patient for confirmation of the diagnosis? A) Perform the p24 antigen test for confirmation of diagnosis. B) Perform a Western blot test for confirmation of diagnosis. C) Perform a polymerase chain reaction test for confirmation of diagnosis. D) Perform a T4-cell count for confirmation of diagnosis.
b
A public health nurse is giving an informational presentation on HIV/AIDS at a nearby college. How would the nurse best define AIDS? A) Acquired immunodeficiency syndrome is an infection by the human immunodeficiency virus. B) Acquired immunodeficiency syndrome is a fatal infection that profoundly weakens the immune system. C) Acquired immunodeficiency syndrome is a sexually transmitted disease. D) Acquired immunodeficiency syndrome is an infectious disease transmitted in blood and body fluids.
b
The nurse is collecting objective data for a client with AIDS at the clinic. The nurse observes white plaques in the client's oral cavity, on the tongue, and buccal mucosa. What does the nurse understand this finding indicates? A) Kaposi's sarcoma B) Candidiasis C) Hairy leukoplakia D) Coccidiomycosis
b
A woman infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV? A) Rashes on the face, trunk, palms, and soles B) Muscle and joint pain C) Gynecologic problems D) Weight loss
c
