Deck 15: Disorders of Motor Function

Question 1

While teaching about HIV/AIDS to a group of high school seniors, the school health nurse will begin by explaining the basic facts that will likely include which of the following information?

A) Like all viruses, HIV is a genetic material made from DNA with long molecules that carry genetic information.
B) HIV is different from other viruses since it is a retrovirus that selectively attacks the body's immune cells.
C) There are two types of HIV, but the one that is endemic to the United States is HIV type 2.
D) HIV type 1 for some reason rarely develops into full-blown AIDS.

Answer 1

HIV is different from other viruses since it is a retrovirus that selectively attacks the body's immune cells.

Question 2

As part of her prenatal education, a 29-year-old woman who is pregnant with her first child is receiving teaching from her primary care provider. Which of the following statements by the woman reflects an accurate understanding of HIV transmission?

A) "I know my baby is safe from HIV while in the womb, but the delivery will place him or her at real risk."
B) "It's discouraging to know that my breast milk can pass on HIV to my baby."
C) "I know it's possible, but it's comforting that the chances of my child contracting my HIV are actually very low."
D) "I'm relieved to learn that a caesarean delivery will protect my baby from being born HIV positive."

Answer 2

"It's discouraging to know that my breast milk can pass on HIV to my baby."

Question 3

A potential donor is angry at the personal nature of the questions about HIV risk factors that he is required to answer at a blood collection center and states that simple blood testing should suffice. How can the nurse at the center best respond?

A) "There are some very uncommon subtypes of the HIV virus that are not detectable by current testing methods."
B) "There's a chance that persons who are asymptomatic, but HIV positive can have their antibodies missed by serum testing."
C) "There's a period shortly after someone is infected with HIV when blood tests might still be negative."
D) "Even though blood tests are completely accurate, the high stakes of blood donation and transfusion mean that double measures are appropriate."

Answer 3

"There's a period shortly after someone is infected with HIV when blood tests might still be negative."

Question 4

A 40-year-old male who has been HIV positive for 6 years is experiencing a new increase in his viral load along with a corresponding decrease in his CD4⁺ count. Which of the following aspects of his immune system is likely to remain most intact?

A) Presentation of major histocompatibility molecules on body cells
B) Orchestration of natural killer cells as part of cell-mediated immunity
C) Activation of B lymphocytes
D) Phagocytic function of monocytes and macrophages

Question 5

A 19-year-old intravenous drug user was exposed to the HIV 3 weeks ago and is experiencing a rapid proliferation in viral load. Which of the following statements best captures an aspect of the process of HIV replication that underlies this proliferation?

A) Free HIV RNA is able to attach to the cell coat of CD4⁺ cells.
B) The cytoplasm of CD4⁺ cells provides a protected environment for the replication of RNA by HIV.
C) Expression of reverse transcriptase by CD4⁺ cells allows replication of HIV cells rather than new lymphocytes.
D) HIV is able to change its RNA into DNA to allow for replication by CD4⁺ cells.

Question 6

Utilizing the World Health Organization (WHO) framework of clinical categories for persons with acquired immunodeficiency syndrome (AIDS) over 15 years of age, a visitor to the United States goes to a city clinic complaining of diarrhea, weight loss of 20 lb, and feeling like he is running a temperature.These manifestations have been occurring for the past 5 weeks. The nurse would identify this patient to be in which clinical stage?

A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4

Question 7

Which of the following patients would be considered to be in the latent period of HIV infection?

A) A 16-year-old prostitute who has open sores on her labia that drain purulent secretions
B) A 33-year-old heroin drug abuser who has numerous enlarged lymph nodes in his axilla and cervical neck region for the past 4 months
C) A 45-year-old alcohol abuser who is complaining of excessive vomiting of blood that started 2 weeks ago
D) A 24-year-old college student who has developed a chronic cough that will not go away, even after taking two courses of antibiotics.

Question 8

A person who has been diagnosed with HIV infection 12 years ago and still has a CD4⁺cell count of 800 cells/µL and a low viral load is considered clinical to be a

A) rapid progressor.
B) typical progressor.
C) slow progressor.
D) long-term nonprogressor

Question 9

A 39-year-old female with HIV infection has been characterized as a typical progressor by her care team and is experiencing an increase in her manifestations and health complaints as her CD4⁺ count declines. Which of the following health problems would her care team most likely attribute to a cause other than her HIV?

A) Her recent diagnosis of bacterial pneumonia
B) Her esophagitis that has been linked to herpes simplex infection
C) Her decreased bone density and recent fractures
D) Her increasing confusion and disorientation

Question 10

A patient comes into a clinic complaining of cough, fever, and shortness of breath. The patient informs the health care provider that he is HIV positive. Upon physical exam, the family nurse practitioner (FNP) may note which of the following clinical manifestations of suspected Pneumocystis jiroveci pneumonia (PCP)? Select all that apply.

A) Interstitial infiltrates on chest x-ray
B) Respiratory rate of 32 with normal breath sounds
C) Stridor when taking a deep breath
D) Use of abdominal muscles to breathe while sitting on the exam table
E) Night sweats that require clothing changes frequently throughout the night

Question 11

Members of an AIDS support group who have more advanced cases are sharing some of their recent health problems with a member who has just been diagnosed. Which of the member's statements is most accurate?

A) "One of the scariest things out there now is the huge increase in drug-resistant tuberculosis."
B) "The eradication of Pneumocystis jiroveci pneumonia (PCP) has helped extend the life expectancy of a lot of persons living with AIDS."
C) "Those of us with HIV are so much more prone to loss of vision and hearing."
D) "As people with HIV live longer, most of us are eventually succumbing to the cancers that are associated with HIV."

Question 12

A 48-year-old man who has been HIV positive for 6 years has just learned that he has been diagnosed with Kaposi sarcoma (KS). Which of the following facts most accurately conveys an aspect of his diagnosis?

A) An opportunistic Epstein-Barr virus underlies the man's KS.
B) He is likely to have lesions on his skin, mouth, or GI tract.
C) Intense pain was probably his first manifestation of KS.
D) Heterosexual contact most likely underlies his HIV and subsequent KS.

Question 13

Which of the following signs and diagnostic findings are recognized components of the metabolic and morphologic changes that occur with HIV infection accompanied with lipodystrophy? Select all that apply.

A) Hyperlipidemia
B) Insulin resistance
C) Deficiencies of anterior pituitary hormones
D) Increased abdominal girth
E) Breast enlargement

Question 14

When counseling a male patient with suspected HIV, the nurse informs him that if the enzyme-linked immunosorbent assay (ELISA) comes back positive, then

A) no further testing is required since this confirms HIV infection.
B) a second test known as the Western blot assay will be ordered to confirm positive HIV status.
C) he will be sent to an infectious disease physician for a tissue biopsy to confirm infection.
D) if the second test, the Western blot, returns negative, he has not developed a case of full-blown AIDS.

Question 15

A school nurse is teaching high school students about HIV and AIDS in the context of the school's sexual health curriculum. Which of the students' following statements would the nurse most likely want to correct or clarify?

A) "They have to take a blood sample from you in order to test you for AIDS."
B) "Drugs for AIDS reduce the virus in your body, but they don't get rid of it."
C) "Lots more heterosexual people get HIV these days than they used to."
D) "Condoms provide really good protection from AIDS."

Question 16

Which of the following individuals would most likely be placed on highly active antiretroviral therapy (HAART) if he or she were not yet receiving the treatment? Select all that apply.

A) A 35-year-old female sex trade worker who is HIV negative but who has a documented history of sharing needles for heroin use
B) A 46-year-old male with long-standing HIV and a CD4⁺ count of 125 cells/mL
C) A 16-year-old female who was diagnosed with HIV 2 days prior and is asymptomatic with normal CD4⁺ levels
D) A 38-year-old woman who has a CD4⁺ count of 250 cells/mL and is keen to begin HAART
E) Prophylactically to a health care worker who incurred a laceration from a scalpel used in surgery but has no abnormal lab results

Question 17

A 37-year-old male with HIV who has recently become symptomatic has begun highly active antiretroviral therapy (HAART). Among the numerous medications that the man now regularly takes are several that inhibit the change of HIV RNA to DNA in a CD4⁺ cell. Which of the following classes of medications addresses this component of the HIV replication cycle?

A) Entry inhibitors
B) Protease inhibitors
C) Integrase inhibitors
D) Non-nucleoside reverse transcriptase inhibitors

Question 18

All antiretroviral medications interfere with some stage of the HIV life cycle. What stage do protease inhibitors prevent?

A) Cleavage of the polyprotein chain into the individual proteins that will be used to make new virus
B) Addition of more nucleosides to the DNA chain
C) Killing of the CD4⁺ T cell to release virions into the bloodstream
D) Attachment of the virus to CD4 cell receptors

Question 19

A 23-year-old HIV-positive woman in the United States with routinely low viral loads and robust CD4⁺ cell counts is planning to get pregnant. Which precaution would her care giver eliminate from her care?

A) Offer her HAART that includes zidovudine
B) Counsel her not to breast-feed
C) Give her single-dose perinatal nevirapine
D) Give the infant trimethoprim-sulfamethoxazole, starting at 4 to 6 weeks of age

Question 20

While volunteering in an HIV clinic in a big city, the nurse notices a new mom and her baby (a 6-month-old male) in the waiting room. Upon assessing the infant for possible HIV infection, the nurse will be assessing for which of the following clinical manifestations of HIV infection? Select all that apply.

A) Weighing him to determine if he is gaining 1.5 to 2 lb/month
B) Observing to see if he can roll over from back to stomach
C) Lack of coordination to play with toys/stuffed animals
D) History of repeated episodes of bacterial pneumonia and ear infections
E) Listlessness and poor eye contact