Ch. 19 HIV/AIDS Study Questions

Rank the safety of sexual practices, with 1 being the safest practice and 6 being the least safe. a) mutual masturbation with latex gloves b) oral sex without condom c) abstinence d) vaginal sex with male condom use e) monogamy f) unprotected anal sex

1- c) abstinence 2- e) monogamy 3- a) mutual masturbation with latex gloves 4- d) vaginal sex with male condom use 5- b) oral sex without condom 6- f) unprotected anal sex

A patient is diagnosed with Pneumocystis jiroveci pneumonia. Which s/s does the nurse expect to find when assessing the patient? a) dyspnea, tachypnea, persistent dry cough, fever b) cough with copious thick sputum, fever, dyspnea c) substernal chest pain and difficulty swallowing d) fever, persistent cough, vomiting blood

a) dyspnea, tachypnea, persistent dry cough, fever

Which laboratory results are expected to decrease in a patient who has untreated HIV/AIDS? Select all that apply. a) CD4+ b) CD8+ c) WBC count d) lymphocytes e) HIV antibodies f) viral load

a) CD4+ c) WBC count d) lymphocytes

Which age-related change increases the likelihood that the older adult will develop the infection after an HIV exposure? a) decline in the overall efficiency of the immune system b) belief that HIV is not an issue for older people c) reluctance to seek medical treatment for sexual problems d) mistaking s/s as normal part of aging

a) decline in the overall efficiency of the immune system

A patient is an IV drug user who regularly shares needles and syringes with friends. What information does the nurse provide to decrease the patient's risk of HIV through shared needles and syringes after each use? a) fill and flush needle and syringe with water, then fill syringe with bleach, shake approximately 30-60 seconds, and rinse with water b) fill and flush needle and syringe with water, then fill syringe with soap and hot water, shake 2 minutes, and rinse with cold water c) soak needles and syringes after each use with a bleach/hot water solution overnight, then allow to air dry d) never reuse needles; rinse syringes after each use with rubbing alcohol or bleach solution. then rinse with hot water

a) fill and flush needle and syringe with water, then fill syringe with bleach, shake approximately 30-60 seconds, and rinse with water

The HIV-positive patient is receiving combination antiretroviral therapy drugs. Why is it essential that the drugs be taken every day at the same time? a) missing or delaying doses decreases the blood concentration needed to inhibit viral replication b) missing or delaying doses decreases the risk of developing opportunistic infections c) missing or delaying doses decreases the effectiveness of the viral replication d) missing or delaying doses decreases the risk of developing HIV-resistant mutations

a) missing or delaying doses decreases the blood concentration needed to inhibit viral replication

Which nursing actions can the nurse delegate to UAP who will be giving mouth care to a patient with HIV/AIDS? Select all that apply. a) offer the patient mouth rinses with sodium bicarbonate and sterile water several times a day b) assess the patient's mouth for increased presence of sores or white plaques c) encourage the patient to drink plenty of fluids d) assist the patient to brush teeth with a soft toothbrush e) apply an oral analgesic gel to gums as needed f) offer an alcohol-based mouthwash if the patient reports "funny" taste in mouth

a) offer the patient mouth rinses with sodium bicarbonate and sterile water several times a day c) encourage the patient to drink plenty of fluids d) assist the patient to brush teeth with a soft toothbrush

The nurse hears in shift report that the patient has toxoplasmosis encephalitis. The nurse is most likely to perform which types of focused assessments? a) perform a mental status examination and assess for headache b) auscultate heart sounds and monitor for cardiac arrhythmias c) palpate the abdomen for tenderness and listen for bowel sounds d) monitor intake and urine output and palpate the bladder

a) perform a mental status examination and assess for headache

The home health nurse is assisting a family who lives with and cares for a member who is HIV positive. Which item would the nurse instruct the family not to share in order to decrease the risk of accidental exposure to HIV? a) safety razor b) household utensils c) towels d) toilet

a) safety razor

Which practices are generally recommended to prevent sexual transmission of HIV? Select all that apply. a) use of latex/polyurethane condoms for genital and anal intercourse b) use of natural-membrane condoms for genital and anal intercourse c) use of an appropriate water-based lubricant with a latex condom d) use of antiviral medication taken on a precise schedule e) use of a latex barrier for genital and anal intercourse f) use of latex gloves for finger or hand contact with the vagina or rectum

a) use of latex/polyurethane condoms for genital and anal intercourse c) use of an appropriate water-based lubricant with a latex condom e) use of a latex barrier for genital and anal intercourse f) use of latex gloves for finger or hand contact with the vagina or rectum

Which conditions may be the first signs of HIV in women? Select all that apply. a) vaginal candidiasis b) bladder infection c) spontaneous abortion d) pelvic inflammatory disease e) mononucleosis f) genital herpes

a) vaginal candidiasis d) pelvic inflammatory disease f) genital herpes

The nurse is orienting a newly graduated RN to the medical unit. Which point should be included about protecting self from HIV exposure when caring for patients? a) wear gloves when in contact with patients' mucous membranes or nonintact skin b) wear full protective gear when providing any care to HIV-positive patients c) always wear a mask when entering an HIV-positive patient's room d) talk to the employee health nurse about starting preexposure prophylaxis

a) wear gloves when in contact with patients' mucous membranes or nonintact skin

The patient with HIV has pain and burning along sensory nerve tracts, and the nurse observes fluid-filled blisters with crusts. Which question is the nurse most likely to ask in making the diagnosis of shingles caused by the varicella zoster virus? a) "Are you allergic to any types of antibiotics?" b) "Did you have chickenpox during childhood?" c) "Are you having any trouble with your vision?" d) "Did you notice any pruritis or perineal irritation?"

b) "Did you have chickenpox during childhood?"

A young male has just been diagnosed as HIV positive. He tells the nurse that he suspects contracting the virus from a female several weeks ago and that he had sex with his girlfriend several days ago. What is the nurse's BEST response? a) "The virus needs time to replicate, so your girlfriend is probably okay, but she should get tested." b) "Even in the early phase, it is possible to pass the HIV virus; both women should be notified." c) "HIV always progresses to AIDS. You and your girlfriend need to start medication right away." d) "You should tell your girlfriend about you being HIV positive; the health department will notify the other woman."

b) "Even in the early phase, it is possible to pass the HIV virus; both women should be notified."

The nurse is teaching a group of college students about preventing HIV infection through sexual contact. Which statement made by one of the students indicates effective teaching? a) "A latex condom with spermicide provides the best protection against getting infected with HIV." b) "Mutually monogamous sex with a noninfected partner if the best method to prevent HIV infection." c) "Contraceptive methods like implants and injections are recommended to prevent HIV transmission." d) "If my same sex partner and I are both HIV positive, then there is no point in using a condom."

b) "Mutually monogamous sex with a noninfected partner if the best method to prevent HIV infection."

The UAP comes to the nurse crying and upset because "Some of the patient's spit got on my arm when I was helping him with oral hygiene and he is HIV positive." What is the nurse's best response? a) "You'll be okay; don't worry about it. A little bit of saliva is no big deal." b) "Wash your arm; saliva is not infectious with HIV unless it is bloody." c) "Let's use chlorhexidine to wash your arm and send you for HIV testing." d) Did you wash your arm? Next time, stand back during the swish and spit."

b) "Wash your arm; saliva is not infectious with HIV unless it is bloody."

The patient with HIV/AIDS appears emaciated and has diarrhea, anorexia, mouth lesions, and persistent weight loss. What condition does the nurse suspect this patient is developing? a) AIDS dementia complex b) AIDS wasting syndrome c) AIDS gastrointestinal opportunistic infection d) AIDS candidiasis opportunistic infection

b) AIDS wasting syndrome

Based on the concept of Treatment as Prevention, which outcome statement indicates that the goal of combination antiretroviral therapy is being met? a) Patient states understanding of medication regimen b) Patient's viral load is at an undetectable level c) Patient is classified as Stage Unknown d) Patient has no signs of opportunistic infection

b) Patient's viral load is at an undetectable level

The patient with HIV/AIDS develops manifestations of tuberculosis. What type of precautions does the nurse institute at this time? a) standard precautions b) airborne precautions c) enteric precautions d) neutropenic precautions

b) airborne precautions

A pregnant woman who is HIV positive arrives at the labor and delivery unit in active labor. The patient tells the nurse that she has been consistently taking her antiretroviral therapy but did not have access to prenatal care. Which situation is the L&D team most likely to prepare for? a) birth of a distressed infant who is most likely to manifest opportunistic infections b) birth of a premature infant who is likely to have a low birth weight c) excessive bleeding and high risk for septicemia in the mother d) a vaginal delivery with isolation precautions for the infant

b) birth of a premature infant who is likely to have a low birth weight

What is the most important means of preventing HIV spread or transmission? a) genetic research b) education c) medication therapy d) standard precautions

b) education

The patient with AIDS comes to the emergency department and reports a cough, dyspnea, chest pain, fever, chills, night sweats, weight loss, and anorexia. He tells the nurse that he recently had a tuberculosis (TB) skin test (purified protein derivative [PPD]), which was negative. What should the nurse do first? a) complete the assessment and notify the health care provider b) initiate airborne precautions and assess respiratory status c) seek out validation of the patient's negative PPD test results d) obtain order for automated nucleic acid amplification test for TB

b) initiate airborne precautions and assess respiratory status

The health care provider tells the nurse that the patient is considered Stage 1 according to the Centers for Disease Control and Prevention case definition for HIV disease. What would the nurse expect to find when assessing the patient? a) s/s associated with Kaposi's sarcoma b) no s/s of AIDS-defining illness c) respiratory symptoms d/t pneumonia d) symptoms of AIDS wasting syndrome

b) no s/s of AIDS-defining illness

HIV is most commonly transmitted through which routes? Select all that apply. a) oral b) sexual c) parenteral d) airborne e) perinatal f) enteral

b) sexual c) parenteral e) perinatal

Which statements about the transmission of HIV are true? Select all that apply. a) HIV may be transmitted only during the end stages of disease. b) those with recent HIV infection and high viral load are very infectious c) those with end-stage HIV and no drug therapy are very infectious d) HIV is transmitted through touching an infected person e) all people infected with HIV can easily infect others with AIDS f) an undetectable viral load requires greater or multiple exposures

b) those with recent HIV infection and high viral load are very infectious c) those with end-stage HIV and no drug therapy are very infectious f) an undetectable viral load requires greater or multiple exposures

A patient diagnosed with HIV is receiving combination antiretroviral therapy. Which laboratory test is the best for determining the effectiveness of the therapy? a) Western blot analysis b) viral load testing c) enzyme-linked immunosorbent assay d) 4th generation testing

b) viral load testing

The health care provider prescribed an integrase inhibitor drug for the patient with HIV. The patient asks how the nurse how this drug works. What is the nurse's best response? a) "It reduces the efficiency of converting human genetic material into HIV genetic material." b) "It reinforces your immune system's ability to fight off an HIV infection." c) "It prevents viral deoxyribonucleic acid (DNA) from integrating into your DNA." d) "It will prevent your HIV infection from progressing to AIDS."

c) "It prevents viral deoxyribonucleic acid (DNA) from integrating into your DNA."

The HIV-positive patient tells the nurse that his HIV-negative partner will be using preexposure prophylaxis (PrEP) emtricitab. Which statement indicates to the nurse the need for additional teaching? a) "My partner will need to be tested for HIV every 3 months." b) "This drug will decrease the chances of my partner becoming HIV positive." c) "Once we start using emtricitab I will no longer need to use a condom." d) "My partner will need to be monitored for any side effects of this drug."

c) "Once we start using emtricitab I will no longer need to use a condom."

Although there is a wide range of time from the beginning of HIV infection to the development of AIDS, which patient is most likely to develop AIDS very quickly? a) adult female who has one-time sex with an HIV positive partner b) older male who has vaginal sex with an HIV-positive partner c) adult male who is transfused with HIV-contaminated blood d) older nurse who is stuck by an HIV-contaminated needle

c) adult male who is transfused with HIV-contaminated blood

The nurse reads in the chart that the patient has Candida stomatitis. Which concept is the nurse most likely to consider in planning interventions for this patient? a) gas exchange b) cellular regulation c) comfort d) elimination

c) comfort

A patient who has HIV/AIDS and tuberculosis (TB) was recently started on the combination antiretroviral therapy (cART) regimen. The TB symptoms worsen and the nurse informs the health care provider, who makes the diagnosis of immune reconstitution inflammatory syndrome (IRIS). Which therapy is the provider most likely to order to treat IRIS? a) bronchodilators b) adjustment of cART c) corticosteroids d) antitubercular drugs

c) corticosteroids

The patient with HIV/AIDS tells the nurse that food tastes funny and it is difficult to swallow. What is the nurse's priority at this time? a) instruct UAP to assist patient with oral hygiene b) place patient in a high Fowler's and restrict oral intake c) examine mouth and throat for white plaques or inflammation d) collaborate with the dietician to provide a soft diet

c) examine mouth and throat for white plaques or inflammation

A patient who is HIV positive has been taking combination antiretroviral therapy (cART) for several years. Today the nurse sees that test results now show a CD4+ T-cell count of less than 200 cells/mm3. Which intervention is the nurse most likely to perform? a) reinforce patient's successful compliance with medication regimen b) assess patient's understanding of the importance of medication schedule c) provide emotional support when patient is informed about AIDS diagnosis d) emphasize need to practice safe sex because risk of transmission is high

c) provide emotional support when patient is informed about AIDS diagnosis

The nurse is assessing a patient whose lifestyle creates a high risk for HIV/AIDS. Which assessment is the nurse MOST LIKELY to perform to differentiate HIV from AIDS? a) history of substance or alcohol abuse b) history of any occupational exposure to HIV c) s/s of opportunistic infections d) practice of safe vs. risky sexual behaviors

c) s/s of opportunistic infections

What is a clinically significant feature for patients who are identified as nonprogressors? a) they rarely ever convert to full-blown AIDS b) they do not transmit virus to sexual partners c) viral load is either undetectable or very low d) opportunistic infections never manifest

c) viral load is either undetectable or very low

Which malignancy is most common in patients with HIV/AIDS? a) Non-Hodgkin's B-cell lymphoma b) anal cancer c) primary brain cancer d) Kaposi's sarcoma

d) Kaposi's sarcoma

Which person should be advised to have periodic screening for HIV? a) an 18-year-old college student who recently started dating a new person b) a 65-year-old widower who may be moving in with a homosexual friend c) a 28-year-old woman who plans to get pregnant in a few years d) a 23-year-old man who plans to enjoy serial monogamy for a few years

d) a 23-year-old man who plans to enjoy serial monogamy for a few years

The nurse is caring for a patient with AIDS who has been admitted for treatment of exacerbation of cryptosporidiosis. What is the priority assessment for this patient? a) assess breath sounds and monitor respiratory status b) assess neurological status and monitor for headaches c) assess for difficulty in swallowing and pain behind the sternum d) assess for signs of dehydration and monitor electrolytes

d) assess for signs of dehydration and monitor electrolytes

What is the most common route for health care providers to be exposed to the HIV virus? a) getting blood on exposed skin of hands or arms b) touching infected body fluids with bare hands c) having body fluid splashed on mucous membranes d) getting stuck with a contaminated needle

d) getting stuck with a contaminated needle

The patient reports numbness or tingling on the lip that occurred 24 hours ago and now there is a painful lesion. Which action is the nurse most likely to take? a) ask patient if he ate undercooked meat because of potential exposure to Toxoplasma gondii b) obtain an order for ketoconazole because patient is developing candidal esophagitis c) check for fever and palpate lymph nodes because the patient may have histoplasmosis d) instruct caregiver to wear gloves during oral hygiene because of suspected herpes simplex virus

d) instruct caregiver to wear gloves during oral hygiene because of suspected herpes simplex virus

Which groups are experiencing increased numbers of new HIV infections in the US and Canada? a) white homosexual men and women b) older heterosexual men and women c) Asian women who have sex with men d) persons of color: African and Hispanic

d) persons of color: African and Hispanic

A nursing student sustains a needlestick from a hollow-bore needle while attempting to establish a peripheral intravenous (IV) catheter. What should the student do first? a) finish the procedure and establish the IV b) go to the employee clinic for post-exposure prophylaxis c) inform the nursing instructor or charge nurse d) thoroughly scrub and flush the puncture site

d) thoroughly scrub and flush the puncture site

What is the BEST rationale for the nurse to be familiar with the HIV infectious viral particle process? a) to help patients to identify the timeframe of greatest risk for infection b) to teach HIV-positive patients about how they became infected with the virus c) to assist in identifying nonprogressors from those who will progress to AIDS d) to educate HIV patients about the importance of adherence to a medication schedule

d) to educate HIV patients about the importance of adherence to a medication schedule

Which person is the most likely candidate for combination antiretroviral therapy as post-exposure prophylaxis? a) person who routinely injects recreational drugs with friends b) nursing student who was stuck with a needle from a known HIV-negative source c) college student who had consensual sex with an HIV-negative partner d) woman who was raped by an assailant with unknown HIV status

d) woman who was raped by an assailant with unknown HIV status