Deck 22: Coordinating Care for Patients With Hiv

Question 1

Which finding in the history of a patient prescribed to receive Truvada for pre-exposure prophylaxis (PrEP) requires the nurse to contact the provider who ordered the medication?
1)Hepatitis A
2)Hepatitis B
3)Hepatitis C
4)Hepatitis D

Answer 1

2

Question 2

In evaluating an HIV-positive patient's response to antiviral therapy, which data indicates a positive response?
1)Increased viral load
2)Increased BUN
3)Increased CD4⁺ count
4)Increased creatinine

Answer 2

3

Question 3

A home health nurse is conducting home visits for several patients who are diagnosed with acquired immunodeficiency syndrome (AIDS). Which patient would the nurse see first?
1)A patient who is receiving antiviral therapy because of a diagnosis of a low CD4 cell count
2)A patient with Pneumocystis carinii pneumonia (PCP) who called the office this morning to report a new onset of fever, cough, and shortness of breath
3)A patient with weight loss who needs modifications and education regarding dietary changes
4)A patient who is receiving IV antibiotics daily for toxoplasmosis

Answer 3

2

Question 4

The nurse provides care to a patient who is diagnosed with HIV. Which assessment finding necessitates immediate notification to the healthcare provider?
1)Weakness
2)Nausea and vomiting
3)Temperature of 102.2°F (39°C)
4)Weight drops from 150 to 140 lbs. (68 to 63.5 kg)

Question 5

The nurse is providing care to a patient, diagnosed with human immunodeficiency virus (HIV), with a CD4⁺ count of 300 cells/ $\mu$ L. The nurse documents this as which stage of HIV infection?

A)Pre-HIV
B)Stage 1
C)Stage 2
D)Stage 3

Question 6

What is the recommendation for HIV testing in HIV-negative individuals who are at high risk for HIV infection?
1)Every 3 months
2)Every 6 months
3)Every 12 months
4)Every 24 months

Question 7

Which immunization should the nurse encourage for a patient who is diagnosed with stage 2 HIV?
1)Measles, mumps, and rubella (MMR) vaccine
2)Oral polio vaccine (OPV)
3)Influenza vaccine
4)Varicella vaccine

Question 8

The nurse is providing care to a patient diagnosed with human immunodeficiency virus (HIV). Because the patient's CD4⁺ count is greater than 500 cells/ $\mu$ L, the nurse monitors for which complication?

A)Toxoplasmosis
B)Herpes zoster virus
C)Vaginal candidiasis
D)Severe bacterial infection

Question 9

The nurse is screening patients for the risk of developing HIV infection. The nurse considers which patient at greatest risk?
1)African American female with a history of intravenous drug use
2)African American male with a history of sex with men
3)Caucasian female with a history of multiple blood transfusions
4)Caucasian male with a history of multiple heterosexual partners

Question 10

Which is the priority action for a nurse who is exposed to a needle-stick injury while providing patient care?
1)Washing the injury under running water
2)Squeezing the site to remove the patient's blood
3)Taking two or three drugs for 28 days
4)Consenting to an HIV test

Question 11

A nurse is performing an admission assessment on a patient with clinical manifestations that indicate human immunodeficiency virus (HIV). Which question from the nurse addresses a major risk factor for contracting HIV?
1)"Has your partner been experiencing these symptoms?"
2)"When was your first sexual experience?"
3)"Have you had any fever, diarrhea, or chills over the last 48 hours?"
4)"Have you ever experimented with intravenous drugs?"

Question 12

In completing discharge teaching for a patient recently diagnosed with HIV infection, the nurse instructs the patient to have tuberculosis (TB) screening at what interval?
1)Every 6 months
2)Every 12 months
3)Every 18 months
4)Every 24 months

Question 13

The nurse is assessing a patient diagnosed with human immunodeficiency virus (HIV) who presents with a rash. Which assessment question is most important?
1)"Are you taking Bactrim?"
2)"Have you recently used a new soap?"
3)"What have you eaten in the last few days?"
4)"Did you have unprotected sex within the last week?"

Question 14

A nurse is developing a plan of care for a patient diagnosed with human immunodeficiency virus (HIV). The patient states, "I don't plan on giving up sex just because I am HIV positive." Based on this data, which is the priority nursing diagnosis for this patient?
1)Risk for Infection
2)Anxiety
3)Knowledge Deficit
4)Social Isolation

Question 15

The nurse is providing care to a patient diagnosed with human immunodeficiency virus (HIV). The patient's CD4⁺ count is currently 480 cells/ $\mu$ L. Which complication is this patient at risk for developing?

A)Toxoplasmosis
B)Herpes zoster virus
C)Pneumocystis carinii pneumonia (PCP)
D)Severe bacterial infection

Question 16

The nurse is providing care to a patient, diagnosed with human immunodeficiency virus (HIV), with a CD4⁺ count of 500 cells/ $\mu$ L. The nurse documents this as which stage of HIV infection?

A)Pre-HIV
B)Stage 1
C)Stage 2
D)Stage 3

Question 17

A nurse working in an intensive care unit (ICU) is assigned a patient diagnosed with acquired immunodeficiency syndrome (AIDS). Based on this data, which type of precaution does the nurse implement when providing direct care?
1)Droplet
2)Reverse
3)Standard
4)Contact

Question 18

The nurse is discharging a patient who was recently diagnosed with acquired immunodeficiency syndrome (AIDS). Because the patient has a young child at home, which immunization is contraindicated for the child at this time?
1)Varicella vaccine
2)Haemophilus influenzae type B (HIB conjugate vaccine)
3)Hepatitis B vaccine (hep B)
4)Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP)

Question 19

The nurse is caring for an HIV-positive patient who has been on prophylaxis to reduce the risk of opportunistic infections. In reviewing the patient's health record, the nurse correlates that prophylaxis can be stopped based on which data?

A)CD4⁺ count greater than 50 cells/ $\mu$ L for at least 2 months
B)CD4⁺ count greater than 100 cells/ $\mu$ L for at least 3 months
C)CD4⁺ count greater than 200 cells/ $\mu$ L for at least 3 months
D)CD4⁺ count greater than 500 cells/ $\mu$ L for at least 2 months

Question 20

The nurse is providing care to a patient, diagnosed with human immunodeficiency virus (HIV), with a CD4⁺ count of less than 200 cells/ $\mu$ L. The nurse documents this as which stage of HIV infection?

A)Pre-HIV
B)Stage 1
C)Stage 2
D)Stage 3

Question 21

In administering antiretroviral therapy medications to patients with HIV infections, the nurse correlates the mechanism of action of preventing viral RNA from becoming viral DNA by impacting the enzyme reverse transcriptase to which classes of medication? Select all that apply.
1)CCR5 antagonists
2)Fusion inhibitors
3)Non-nucleoside reverse transcriptase inhibitor (NNRTI)
4)Nucleoside reverse transcriptase inhibitors (NRTI)
5)Protease inhibitors

Question 22

The nurse is providing care to a patient diagnosed with human immunodeficiency virus (HIV). Which patient statement indicates the need for further education regarding HIV management?
1)"I will eat small, frequent meals."
2)"I will use condoms for every sexual encounter."
3)"It important that I take my medications as scheduled at least 90% of the time."
4)"It is important that I ask my spouse to clean the cat litter."

Question 23

In providing care to an HIV-positive patient, the nurse correlates which finding to a therapeutic response to antiretroviral therapy (ART) medications?
1)90% adherence with medical regimen
2)Increased CD4+ count
3)Increased viral load
4)Increased white blood cell count

Question 24

Place the progression of human immunodeficiency virus (HIV) in sequential order. (Enter the number of each step in the proper sequence; do not use punctuation or spaces. Example: 1234)
1) Symptomatic/AIDS
2) Death
3) Seroconversion
4) Viral transmission
5) Acute viral infection 6. Asymptomatic chronic infection

Question 25

The nurse is planning care for a patient diagnosed with human immunodeficiency virus (HIV). The nurse selects Risk for Infection as a priority nursing diagnosis for this patient. Based on this nursing diagnosis, which actions by the nurse are appropriate? Select all that apply.
1)Administering tuberculosis skin tests every 6 months
2)Teaching proper food-handling techniques to the family
3)Instructing on the importance of using nonbleach cleaners for blood spills at home
4)Assessing the health status of all visitors
5)Monitoring hand-washing techniques used by the family

Question 26

The nurse correlates which comorbidities as impacting length of time from infection to death in patients who are not receiving treatment for human immunodeficiency virus (HIV) infection? Select all that apply.
1)Asthma
2)Malaria
3)Malnutrition
4)Pancreatitis
5)Tuberculosis

Question 27

According to the Centers for Disease Control and Prevention, which states in the United States have the highest incidence of HIV infections? Select all that apply.
1)California
2)Georgia
3)Louisiana
4)Nevada
5)New York

Question 28

In preparing an education program for staff about human immunodeficiency virus (HIV), the nurse includes which information? Select all that apply.
1)In HIV-infected patients who do not receive treatment, the time from infection and death is approximately 12 years.
2)In HIV-infected patients from resource-limited countries, the time from infection to death is less than 2 years.
3)Malnutrition is a comorbidity of HIV infection.
4)In adults, HIV is categorized into three different stages.
5)With treatment for HIV, patients may be categorized into a less severe stage.

Question 29

In providing care to a patient with HIV who initially weighed 50 kg, at what weight does the nurse determine that the patient's condition is deteriorating and requires immediate attention regarding weight loss? (Express as the number of kilograms.)

Question 30

The nurse provides care to a patient diagnosed with HIV. Which clinical manifestations cause the nurse to ask the patient if sulfamethoxazole/trimethoprim (Bactrim) was prescribed prophylactically within the last 2 weeks? Select all that apply.
1)Emesis
2)Nausea
3)Anemia
4)Diarrhea
5)Skin rash