Deck 16: Care of the Patient With HIV-Aids

Question 1

A patient is concerned about telling others he has HIV infection. In discussing his concerns, which response by the nurse is most appropriate?

A) Care providers and sexual partners should be told about his diagnosis.
B) There is no reason to hide his disease.
C) Secrecy is a poor idea because it will lower his self-esteem.
D) His diagnosis will be obvious to most people with whom he will come into contact.

Answer 1

Care providers and sexual partners should be told about his diagnosis.

Question 2

A patient states that he feels terrific, but a blood test shows that he is HIV-positive. It is important for the nurse to discuss with him that HIV may remain dormant for several years. During this time, the patient

A) is not dangerous to anyone.
B) experiences minor symptoms only.
C) experiences decreased immunity.
D) is contagious.

Answer 2

is contagious.

Question 3

A 28-year-old married attorney with one child is in the first trimester of her second pregnancy. A colleague states that she is at no risk for HIV, so she would not need to be counseled about testing for HIV. The nurse's most appropriate response would be

A) "She's a professional woman in a monogamous relationship. She obviously is not at risk."
B) "Women are not at great risk. The greatest risk is with gay men."
C) "The fastest-growing segment of the population with AIDS is women and children. We need to assess her risks."
D) "We need to review her chart to determine if her first child was infected."

Answer 3

"The fastest-growing segment of the population with AIDS is women and children. We need to assess her risks."

Question 4

The nurse clarifies that the least likely method for children to contract AIDS is

A) during intrauterine life with an HIV-positive mother.
B) during the birth process of an HIV-positive mother.
C) from other children who have AIDS.
D) from receiving transfusions contaminated with the HIV virus.

Question 5

Interventions such as promotion of nutrition, exercise, and stress reduction should be undertaken by the nurse for patients who have HIV infection, primarily because these interventions will

A) promote a feeling of well-being in the patient.
B) improve immune function.
C) prevent transmission of the virus to others.
D) increase the patient's strength and ability to care for him- or herself.

Question 6

To be diagnosed as having AIDS, the patient must be HIV-positive, have a compromised immune system without known immune system disease or recent organ transplant, and present with

A) opportunistic infection.
B) a positive ELISA or Western blot test.
C) weight loss, fever, and generalized lymphedema.
D) CD₄+ lymphocyte count below 200 mm³.

Question 7

Kaposi's sarcoma is a common problem in patients with AIDS. The nurse should instruct the patient who is diagnosed with AIDS to report which sign of Kaposi's sarcoma?

A) Reddish-purple skin lesions
B) Open, bleeding skin lesions
C) Blood-tinged sputum
D) Watery diarrhea

Question 8

A young gay patient being treated for his third sexually transmitted disease does not see why he should use condoms, because "they don't work." The nurse's most appropriate response would be

A) "Condoms may not provide 100% protection, but when used correctly and consistently with every act of sexual intercourse they reduce your risk of getting infected with HIV or other sexually transmitted diseases."
B) "You are correct. Condoms don't always work, so your best protection is to limit your number of partners."
C) "Condoms do not provide 100% protection, so you should always discuss with your sexual partners their HIV status or ask if they have any STD."
D) "Condoms do not provide 100% protection, but when used with a spermicide you can be assured of complete protection against HIV and other STDs."

Question 9

In reviewing a patient's chart to determine whether she has progressed from HIV disease to AIDS, the nurse should look for

A) CD₄+ count below 500, chronic fatigue, night sweats.
B) HIV-positive test result, CD₄+ count below 200, history of opportunistic disease.
C) weight loss, persistent generalized lymphadenopathy, chronic diarrhea.
D) fever, chills, CD₄+ count below 200.

Question 10

The HIV patient asks the nurse about what to expect in terms of disease progression. The nurse tells this patient that although the disease can vary greatly among individuals, the usual pattern of progression includes

A) viremia, clinical latency, opportunistic diseases, and death.
B) asymptomatic phase, clinical latency, ARC, and AIDS.
C) acute retroviral syndrome, early infection, early symptomatic disease, and AIDS.
D) transitional viral syndrome, inactive disease, early symptomatic infection, and opportunistic diseases.

Question 11

A patient is advised to be tested for HIV because of his multiple sexual partners and injectable drug use. The nurse should ensure that this patient understands the test by informing him that:

A) The blood is tested with the highly sensitive test called the Western blot.
B) The blood is tested with an ELISA; if positive, it is tested again with an ELISA, followed by a Western blot if the second ELISA is positive.
C) A series of HIV tests is performed to confirm if the patient has AIDS.
D) If the HIV tests are seronegative, John can be assured that he is not infected.

Question 12

A 21-year-old male who has been an IV heroin user has been experiencing fever, weight loss, and diarrhea and has been diagnosed as having AIDS. At this time, he has a low-grade fever, severe diarrhea, and a productive cough. He is admitted with Pneumocystis jiroveci. When caring for the patient, the nurse should

A) use a gown, mask, and gloves when assisting the patient with his bath.
B) wear a gown when assisting the patient to use the bedpan.
C) use a gown, mask, and gloves to administer oral medications.
D) use a mask when taking the patient's temperature.

Question 13

While teaching community groups about AIDS, the nurse informs people that the most common method of transmission of the HIV virus currently is

A) sexual contact with an HIV-infected partner.
B) perinatal transmission.
C) exposure to contaminated blood.
D) nonsexual exposure to saliva and tears.

Question 14

A patient has just been told by his physician that he is HIV-positive. He asks the nurse, "When will I get AIDS?" The nurse's response should be

A) "Most people get AIDS within 3 to 12 weeks after they are infected with HIV."
B) "Don't worry. You may never get AIDS if you eat properly, exercise, and get plenty of rest."
C) "It varies with every individual, but the average time is 8 to 10 years from the time a person is infected, and some go much longer."
D) "You can expect to develop signs and symptoms of AIDS within 6 months."

Question 15

The patient, age 21, has been treated for chlamydia and has a history of recurrent herpes. What should the nurse plan to do next?

A) Counsel this patient about her sexual history, risk reduction measures, and testing for HIV.
B) Refer this patient to a family planning clinic.
C) Counsel this patient about testing for HIV and what the test results mean.
D) Counsel this patient about abstinence and a monogamous relationship.

Question 16

Members of the local emergency medical service unit have just transported an accident victim to the emergency department. They tell the ED nurse that the victim has AIDS, and they have blood on their hands and clothing. The nurse advises them to wash their hands and to change any clothing that is wet with blood. The nurse talks to them about getting a baseline HIV test and about future testing. They ask the nurse how long it will take before they will know if they are infected. The nurse's response should be

A) "You will need to be tested in 6 weeks and regularly for the next 10 years, because that is the average length of time it takes to detect the virus by testing."
B) "You will need to be tested in 3 months and again in 6 months, because 95% of people seroconvert to antibody-positive in 3 months and 99% in 6 months."
C) "Transmission by occupational exposure is rare. There is no need for you to be concerned."
D) "You will need to be tested in 3 weeks, because most people seroconvert in that length of time."

Question 17

A patient, age 28, has a history of IV drug use and has tested positive for HIV. About 2 weeks ago, she delivered a baby who has tested positive for HIV. This patient will not care for the baby because she believes the baby will die soon. In counseling her about the care of her infant, which approach by the nurse is most appropriate?

A) Agree with her that the baby will develop AIDS and refer her to a local AIDS support group.
B) Inform her that although infants of HIV-infected mothers may test positive for HIV antibodies, not all infants are infected with the virus.
C) Remind her that she has not yet developed AIDS and that it is possible the baby won't develop AIDS for many years.
D) Inform her that if the infant is started on zidovudine (AZT) within the first month after delivery, AIDS can be prevented.

Question 18

A patient, age 25, has just been admitted to the unit with a diagnosis of AIDS. The nurse's colleague says, "I'm pregnant. It is not safe for me or my baby if I am assigned to his case." The nurse's response should be

A) "This patient would not be a risk for your baby if you use standard precautions and avoid direct contact with blood or body fluids."
B) "You should ask for a transfer to another unit because contact with this patient would put you and your baby at risk for AIDS."
C) "Wear a mask, gown, and gloves every time you go into his room and use disposable trays, plates, and utensils to serve his meals."
D) "We should recommend that this patient be transferred to an isolation unit."

Question 19

A patient asks the nurse, "How does HIV cause AIDS?" The nurse's response should be

A) "HIV attacks the immune system, a system that protects the body from foreign invaders, making it unable to protect the body from organisms that cause diseases."
B) "HIV breaks down the circulatory system, making the body unable to assimilate oxygen and nutrients."
C) "HIV attacks the respiratory system, making the lungs more susceptible to organisms that cause pneumonia."
D) "HIV attacks the digestive system, decreasing the absorption of essential nutrients and causing weight loss and fatigue."

Question 20

For most people who are HIV-positive, marker antibodies are usually present 10 to 12 weeks after exposure. The development of these antibodies is called

A) immunocompetence.
B) seroconversion.
C) opportunistic infection.
D) immunodeficiency.

Question 21

In addition to handwashing, what important precaution must the nurse take when changing the dressing of an AIDS patient?

A) Wearing mask
B) Wearing gown and gloves
C) Wearing gloves
D) Strict isolation

Question 22

Which nutritional intake will assist the patient in regaining lost weight? (Select all that apply.)

A) Increase fluid intake
B) Limit protein and fat intake
C) Offer nutritional supplements (Boost, Sustacal, etc.)
D) Eat several small meals during the day
E) Provide referrals to dietitians and social workers
F) Weigh patient monthly

Question 23

Snacks such as bananas and apricot nectar, which are high in potassium, are recommended because

A) electrolytes are lost through fever.
B) diarrhea is a common problem.
C) snacks help fight fatigue.
D) potassium helps fight infection.

Question 24

HIV patients who are suffering from depression should be frequently assessed for

A) physical decline.
B) fear of death.
C) support systems.
D) suicidal ideation.

Question 25

Most children with AIDS contracted their disease (Select all that apply.)

A) during intrauterine life with an HIV-positive mother.
B) during the birth process of an HIV-positive mother.
C) from other children who are HIV positive.
D) from receiving a transfusion contaminated with the HIV virus.
E) from breast feeding by an HIV-positive mother.

Question 26

What is the best way to prevent transmission of HIV to a fetus or infant?

A) Use of condoms
B) Avoidance of pregnancy
C) Use of anti-HIV therapy given during pregnancy
D) Use of anti-HIV therapy to the infant for the first 6 weeks of life

Question 27

Which are signs and symptoms of HIV infection? (Select all that apply.)

A) Dry mouth
B) Weight loss
C) Sore throat
D) Vaginal dryness
E) Nausea
F) Dyspnea

Question 28

A nursing intervention to help infected HIV patients regain lost weight is

A) schedule procedures that are painful, stressful, or nauseating immediately before a meal.
B) eat small meals throughout the day.
C) eat three big meals a day to provide for proper rest.
D) weigh the patient weekly to prevent frustration.

Question 29

Nutritional management can help control diarrhea. Which foods would be recommended on a diarrhea diet? (Select all that apply.)

A) Bananas and apricot nectar
B) Ensure
C) Broccoli
D) Cooked fruits and vegetables
E) Red meat
F) Raw fruits and vegetables

Question 30

______________ is a type of sexual option classified as "no risk" for a person to become infected with HIV virus.