MedSurg Ch. 37

A client with suspected HIV has had two positive enzyme-linked immunosorbent assay tests. What diagnostic test would be run next?

Western Blot

Postexposure prophylaxis (PEP) medications should be started within __________ after exposure, but no longer than __________, to offer any benefit. It must be taken for __________.

1 hour; 72 hours; 4 weeks

When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following?

Antibodies to HIV are not present in his blood.

A patient receiving antiretroviral therapy is complaining of "not urinating enough." What is the nurse's best action?

Assess BUN and creatinine.

The nurse identifies a nursing diagnosis of ineffective airway clearance related to pneumocystis pneumonia and increased bronchial secretions for a client with AIDS. Which of the following would be appropriate for the nurse to include in the client's plan of care?

Assist with chest physiotherapy every 2 to 4 hours.

A nurse is preparing an in-service presentation about human immunodeficiency virus (HIV) for a group of new graduate nurses. As part of the presentation, the nurse is planning to describe the events that occur once HIV enters the host cell. Which of the following would the nurse describe as the first step?

Attachment

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.

Diagnosis of Kaposi's sarcoma (KS) is made by which of the following?

Biopsy

Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy?

CD4 counts

During assessment of a patient with Kaposi's sarcoma, the nurse knows to look for the initial sign of:

Deep purple cutaneous lesions.

Which of the following options should the nurse encourage to replace fluid and electrolyte losses in a patient with AIDS?

Liquids

HIV is harbored within which type of cell?

Lymphocyte

The nurse advises a patient who has received a negative test result from his HIV antibody test that he:

May be infected but antibodies are not currently present.

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?

Testing the client for the presence of HIV

A client has undergone diagnostic testing for human immunodeficiency virus (HIV) using the enzyme immunoassay (EIA) test. The results are positive and the nurse prepares the client for additional testing to confirm seropositivity. The nurse would prepare the client for which test?

Western blot assay

The lower the patient's viral load,

the longer the survival time.

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.

• Blood • Semen • Breast milk • Vaginal secretions

The nurse teaches the patient that lowering his or her viral load will have what effect?

A longer survival time

Which assessment finding is not likely to cause noncompliance with antiretroviral treatment?

Past substance abuse

The period from infection with HIV to the development of antibodies to HIV is known as which of the following?

Primary infection

A client is beginning highly active antiretroviral therapy (HAART). The client demonstrates an understanding of the need for follow up when he schedules a return visit for viral load testing at which time?

6 weeks Viral load tests are measured immediately before initiating antiretroviral therapy and then again in 2 to 8 weeks. In most clients, adherence to a regimen of potent antiretroviral agents should result in a large decrease in the viral load by 2 to 8 weeks. Therefore, a return visit at 6 weeks would be in this time frame. By 16 to 20 weeks, the viral load should continue to decline, dropping below detectable levels.

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?

AIDS dementia complex (ADC)

Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm?

CDC category A: HIV asymptomatic

A client taking abacavir (ABC) has developed fever and rash. What is the priority nursing action?

Call the health care provider to report.

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.

When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by ____.

HIV-1 is more prevalent than HIV-2 subtypes

Which of the following indicates that a client with HIV has developed AIDS?

Herpes simplex ulcer persisting for 2 months

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?

Perform a Western blot test for confirmation of diagnosis.

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

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 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?

Report the incident to the supervisor

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?

Reverse transcriptase inhibitors

A new nursing graduate is working at the hospital in the medical-surgical unit. The preceptor observes the nurse emptying a patient's wound drain without gloves on. What important information should the preceptor share with the new graduate about standard precautions?

Standard precautions should be used with all patients to reduce the risk of transmission of bloodborne pathogens.

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?

Stool specimen for ova and parasites

Which of the following statements reflects the treatment of HIV infection?

Treatment of HIV infection for an individual patient is based on the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).

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?

Trimethoprim-sulfamethoxazole (Bactrim, Septra)

A client is given a nursing diagnosis of social isolation related to withdrawal of support systems and stigma associated with AIDS. Which outcomes would indicate that the nurse's plan of care was effective? Select all that apply.

• Client demonstrates beginning participation in events and activities. • Client identifies appropriate sources of assistance and support. • Client verbalizes feelings related to the changes imposed by the disease.