Deck 15: Infection and Human Immunodeficiency Virus Infection

Question 1

Which of these patients will the nurse working in an HIV testing and treatment clinic anticipate teaching about ART?

A) A patient who is HIV negative but has unprotected sex with multiple partners
B) A patient who has been HIV positive for 5 years and has cytomegalovirus (CMV) retinitis
C) A patient who was infected with HIV 15 years ago and has a CD4 count of 740/µl
D) An HIV-positive patient with a CD4 count of 120/µl who drinks a fifth of whiskey daily

Answer 1

A patient who has been HIV positive for 5 years and has cytomegalovirus (CMV) retinitis

Question 2

To evaluate the effectiveness of ART, the nurse will schedule the patient for

A) viral load testing.
B) enzyme immunoassay.
C) rapid HIV antibody testing.
D) immunofluorescence assay.

Answer 2

viral load testing.

Question 3

When teaching a patient with HIV infection about ART, the nurse explains that these drugs

A) work in various ways to decrease viral replication in the blood.
B) boost the ability of the immune system to destroy the virus.
C) destroy intracellular virus as well as lowering the viral load.
D) increase the number of CD4+ cells available to fight the HIV.

Answer 3

work in various ways to decrease viral replication in the blood.

Question 4

During posttest counseling for a patient who has positive testing for HIV, the patient is anxious and does not appear to hear what the nurse is saying. At this time, it is most important that the nurse

A) inform the patient how to protect sexual and needle-sharing partners.
B) teach the patient about the medications available for treatment.
C) ask the patient to notify individuals who have had risky contact with the patient.
D) remind the patient about the need to return for retesting to verify the results.

Question 5

At the health promotion level of care for HIV infection, which question is most appropriate for the nurse to ask?

A) "Are you having any symptoms such as severe weight loss or confusion?"
B) "Are you experiencing any side effects from the antiretroviral medications?
C) "Do you need any assistance to obtain antiretroviral drugs or other treatments?"
D) "Do you use any injectable drugs or have sexual activity with multiple partners?"

Question 6

A 24-year-old woman who uses injectable illegal drugs asks the nurse about preventing AIDS. The nurse informs the patient that the best way to reduce the risk of HIV infection from drug use is to

A) participate in a needle-exchange program.
B) clean drug injection equipment before use.
C) ask those who share equipment to be tested for HIV.
D) avoid sexual intercourse when using injectable drugs.

Question 7

The occupational health nurse will teach the nursing staff that the highest risk of acquiring HIV from an HIV-infected patient is

A) a needlestick with a suture needle during a surgical procedure.
B) contamination of open skin lesions with vaginal secretions.
C) a needlestick with a needle and syringe used to draw blood.
D) splashing the eyes when emptying a bedpan containing stool.

Question 8

A patient has recently tested positive for HIV and asks the nurse about drug therapy for HIV infection. The nurse informs the patient that

A) drug therapy for HIV is indicated only for patients whose CD4+ cell counts indicate that AIDS has developed.
B) medication therapy is delayed as long as possible to prevent development of viral resistance to the drugs.
C) treatment is individualized based on CD4+ counts, the amount of virus in the blood, and the patient's wishes.
D) ART is typically started soon after HIV diagnosis to prevent progression of the disease.

Question 9

A patient who has been treated for HIV infection for 7 years has developed fat redistribution to the trunk, with wasting of the arms, legs, and face. The nurse will anticipate teaching the patient about

A) treatment with antifungal agents.
B) a change in antiretroviral therapy.
C) foods that are higher in protein.
D) the benefits of daily exercise.

Question 10

Drug therapy is being considered for an HIV-infected patient who has a CD4+ cell count of 400/µl. The nursing assessment that is most important in determining whether therapy will be used is the patient's

A) social support system offered by significant others and family.
B) socioeconomic status and availability of medical insurance.
C) understanding of the multiple side effects that the drugs may cause.
D) willingness and ability to comply with stringent medication schedules.

Question 11

A patient with HIV infection has developed Mycobacterium avium complex infection. An appropriate outcome for the patient is that the patient will

A) be free from injury.
B) maintain intact perineal skin.
C) have adequate oxygenation.
D) receive immunizations.

Question 12

A patient who seeks health care for vague symptoms of fatigue and headaches has HIV testing and is found to have a positive enzyme immunoassay (EIA) for HIV antibodies. In discussing the test results with the patient, the nurse informs the patient that

A) the enzyme immunoassay test will need to be repeated to verify the results.
B) a viral culture will be done to determine the progress of the disease.
C) it will probably be 10 or more years before the patient develops AIDS.
D) the Western blot test will need to be done to determine whether AIDS has developed.

Question 13

The nurse is preparing to give the following medications to an HIV-positive patient who is hospitalized with PCP. Which is most important to administer at the right time?

A) Nystatin (Mycostatin) tablet for vaginal candidiasis
B) Aerosolized pentamadine (NebuPent) for PCP infection
C) Oral acyclovir ((Zovirax to treat systemic herpes simplex
D) Oral saquinavir (Inverase) to suppress HIV infection

Question 14

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

A) perinatal transmission to the fetus.
B) sharing equipment to inject illegal drugs.
C) transfusions with HIV-contaminated blood.
D) sexual contact with an infected partner.

Question 15

A pregnant woman with a history of asymptomatic HIV infection is seen at the clinic. Which information will the nurse include when teaching the patient?

A) Although infants of HIV-infected mothers always test positive for HIV antibodies, most infants are not infected with the virus.
B) Because she has not developed AIDS, the infant will not contract HIV during intrauterine life.
C) The infant will be started on zidovudine (AZT) after delivery to prevent HIV infection.
D) It is likely that her newborn will develop HIV infection unless she takes antiretroviral drugs during the pregnancy.

Question 16

A patient who is diagnosed with AIDS and has developed Kaposi's sarcoma tells the nurse, "I have lots of thoughts about dying. Do you think I am just being morbid?" Which response by the nurse is most appropriate?

A) "Thinking about dying will not improve the course of AIDS."
B) "Although your diagnosis is serious, there are more treatments available now."
C) "Try to focus on the good things in life because stress impairs the immune system."
D) "Tell me what kind of thoughts you have about dying."

Question 17

When assessing an individual who has been diagnosed with early chronic HIV infection and has a normal CD4+ count, the nurse will

A) ask about problems with diarrhea.
B) examine the oral mucosa for lesions.
C) check neurologic orientation.
D) palpate the regional lymph nodes.

Question 18

A patient who tested positive for HIV 3 years ago is admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP). Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC), the patient is diagnosed as having

A) early chronic infection.
B) HIV infection.
C) AIDS.
D) intermediate chronic infection.

Question 19

Interventions such as promotion of nutrition, exercise, and stress reduction should be promoted 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) prevent transmission of the virus to others.
C) improve the patient's immune function.
D) increase the patient's strength and self-care ability.

Question 20

Four years after seroconversion, an HIV-infected patient has a CD4+ cell count of 800/µl and a low viral load. The nurse teaches the patient that

A) the patient is at risk for development of opportunistic infections because of CD4+
Cell destruction.
B) the patient is in a clinical and biologic latent period, during which very few viruses are being replicated.
C) anti-HIV antibodies produced by B cells enter CD4+ cells infected with HIV to stop replication of viruses in the cells.
D) the body currently is able to produce an adequate number of CD4+ cells to replace those destroyed by viral activity.

Question 21

The nurse explains to the patient newly diagnosed with HIV that prophylactic measures that should be taken as early as possible during the course of the infection include which the following (Select all that apply.)?

A) Hepatitis A vaccine
B) Hepatitis B vaccine
C) Pneumococcal vaccine
D) Influenza virus vaccine
E) Trimethoprim-sulfamethoxazole
F) Varicella zoster immune globulin

Question 22

When designing a program to decrease the incidence of HIV infection in the community, the nurse will prioritize education about

A) how to prevent transmission between sexual partners.
B) methods to prevent perinatal HIV transmission.
C) ways to sterilize needles used by injectable drug users.
D) means to prevent transmission through blood transfusions.