Quiz 16: HIV/AIDs
A pregnant woman who is HIV-positive arrives at the labor and delivery unit and 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 labor and delivery nurse most likely to prepare for? A. Birth of a distressed infant who is 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 precaution
B. Education
A mother with the diagnosis of AIDS states that she has been caring her baby even though she has not been felling well. What important information should the nurse determine? A. If she has kissed the baby B. If the baby is breastfeeding C. When the baby last received antibiotics D. How long she has been caring for the baby
B. If the baby is breastfeeding
The HIV-positive patient tells the nurse that his HIV-negative partner will be using preexposure prophylaxis (PrPE) emtricitab. Which statement indicates to the nurse the need for additional teaching about this drug? 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"
A client asks the nurse, "Should I tell my partner that I just found out I'm HIV positive?" What is the nurse's most appropriate response? A. "This is a decision you alone can make" B. "Do not tell your partner unless asked" C. "You are having difficulty deciding what to say" D. "Tell your partner that you don't know how you became sick"
C. "You are having difficulty deciding what to say"
Although there is a wide range of time from 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 female C. Adult male who is transfused with HIV-contaminated blood D. Older nurse who is stuck by HIV-contaminated needle at work
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 healthcare 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. Anti-tubercular 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 action at this time? A. Instruct the unlicensed assistive personnel to assist patient with oral hygiene B. Place the patient in a high Fowler's and restrict oral intake C. Examine mouth and throat for white plaques or inflammation D. Collaborate with the dietitian to provide a soft diet
C. Examine mouth and throat for white plaques or inflammation
A nurse is caring for a client with a diagnosis of AIDS. The IV infiltrates and needs to be restarted. What is necessary to protect the nurse when restarting the IV? SATA A. Mask B. Gown C. Gloves D. Face shield E. Hand hygiene
C. Gloves E. Hand hygiene
During an AIDS education class a client states, "Vaseline works great when I use condoms." Which conclusion about the client's knowledge of condom use can the nurse draw from this statement? A. An understanding of safer sex B. An ability to assume self-responsibility C. Ignorance related to correct condom use D. Ignorance concerning the transmission of HIV
C. Ignorance related to correct condom use
A patient who is HIV positive has been taking combination antiretroviral therapy (cART) for several years. Today the nurse sees that the test results show a CD4+ T-cell count of less than 200 cells/mm. 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. Signs/symptoms of opportunistic infections D. Practice of safe versus risk sexual behaviors
C. Signs/symptoms of opportunistic infections
What is a clinically significant feature for patients who are identified as non-progressive? 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
The patient reports numbness or tingling on the lips that occurred 24 hours ago, and now there is a painful lesion. Which action is the nurse most likely to take? A. Ask the patient if he ate undercooked meat because of the 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 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 groups are experiencing increased numbers of new HIV infections in the United States 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 needle-stick 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 postexposure 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 infection 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 adhering to a medication schedule
D. To educate HIV patients about the importance of adhering to a medication schedule
Which person is the most likely candidate for combination antiretroviral therapy as postexposure 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
A client who abused intravenous drugs was diagnosed with the human immunodeficiency virus (HIV) several years ago. The nurse explains that the diagnostic criterion for acquired immunodeficiency syndrome (AIDS) has been met when the client: A. contracts HIV-specific antibodies B. develops acute retroviral syndrome C. is capable of transmitting the virus to others D. has a CD4+ T lymphocyte level of less than 200 cells/ul
D. has a CD4+ T lymphocyte level of less than 200 cells/ul
Rank the safety of sexual practices with 1 being the safest practice and 6 being the least safe. Mutual masturbation with latex gloves Oral sex without condoms Abstinence Vaginal sex with male condom use Monogamy Unprotected anal sex
1. Abstinence 2. Monogamy 3. Mutual masturbation with latex gloves 4. Vaginal sex with male condom use 5. Oral sex without condoms 6. Unprotected anal sex
The healthcare provider prescribed an integrase inhibitor drug for the patient with HIV. The patient asks the nurse how this drug works. What is the nurse's best response? A. "It reduces 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 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 unlicensed assistive personnel 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 chlorohexidine 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"
A nurse is planning to provide discharge teaching to the family of a client with AIDS. Which statement should the nurse include in the teaching plan? A. "Wash used dishes in hot, soapy water" B. "Let dishes soak in hot water for 24 hours before washing" C. "You should boil the client's dishes for 30 minutes after use" D. "Have the client eat from paper plates so they can be discarded"
A. "Wash used dishes in hot, soapy water"
Which laboratory results are expected to decrease in a patient who has untreated HIV/AIDS? SATA A. CD4+ B. CD8+ C. White blood cell count D. Lymphocytes E. HIV antibodies F. Viral load
A. CD4+ C. White blood cell count D. Lymphocytes
Which age-related change increase 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 treatment for sexual problems D. Mistaking signs/symptoms as normal part of aging
A. Decline in the overall efficiency of the immune system
A patient is diagnosed with Pneumocystis jiroveci pneumonia. Which signs/symptoms does the nurse expect to find when assessing the patient? A. Dyspnea, tachypnea, persistent dry cough, and fever B. Cough with copious thick sputum, fever, and dyspnea C. Substernal chest pain and difficulty swallowing D. Fever, persistent cough, and vomiting blood
A. Dyspnea, tachypnea, persistent dry cough, and fever
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 syringes 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 in a bleach and hot water solution overnight, and then allow to air dry D. Never reuse needles; rinse syringes after each use with rubbing alcohol or bleach solution, and then rinse them with hot water
A. Fill and flush needle and syringes with water, then fill syringe with bleach, shake approximately 30-60 seconds, and rinse with water
A nurse is caring for a client who is HIV positive. For which complication associated with this diagnosis is it most important for the nurse to teach prevention strategies? A. Infection B. Depression C. Social isolation D. Kaposi sarcoma
A. Infection
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 mutations 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 unlicensed assistive personnel who will be giving mouth care to a patient with HIV/AIDS? SATA 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 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 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. Toilets
A. Safety razor
Which practices are generally recommended to prevent sexual transmission of HIV? SATA A. Use of latex or 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 medications 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 or 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? SATA 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 patient's mucous membranes or non-intact skin B. Wear full protective gear when providing nay 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 patient's mucous membranes or non-intact skin
The patient with HIV/AIDS appears emaciated and has diarrhea, anorexia, mouth lesions, and persistent weight loss. What conditions 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
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
The patient with HIV has pain and burning along sensory nerve tracts, and the nurse observes fluid-filled blisters and crusts. Which question is the nurse most likely to ask to assist the healthcare provider 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 trouble with your vision?" D. "Did you notice any pruritus or perineal irritation?"
B. "Did you have chickenpox during childhood?"
A young male has just be 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 says 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 phases, 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 being HIV positive, the health department will contact the other woman"
B. "Even in the early phases, 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 infection with HIV" B. "Mutually monogamous sex with a non-infected partner is 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 non-infected partner is the best method to prevent HIV infection"
The patient with AIDS come 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 nuclei acid amplification test for TB
B. Initiate airborne precautions and assess respiratory status
The healthcare provider tells the nurse that the patient is considered Stage I according to the Center for Disease Control and Prevention case definition for HIV disease. What would the nurse expect to find when assessing the patient? A. Signs/symptoms associated with Kaposi's sarcoma B. No signs/symptoms of AIDS-defining illness C. Respiratory symptoms due to pneumonia D. Symptoms of AIDS wasting syndrome
B. No signs/symptoms of AIDS-defining illness
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
HIV is most commonly transmitted by which routes? SATA 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? SATA A. HIV may be transmitted only during the end stages of the 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 F. An undetectable viral load requires greater 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 multiple exposures
A patient is 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
Which person should be advised to have periodic screening for HIV? A. An 18-year-old college student who recently starting 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 cryptosporidosis. What is the priority assessment for this patient? A. Assess breath sounds and monitor respiratory status B. Assess neurologic 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 healthcare 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
