Deck 15: Immunodeficiency Disorders

Question 1

When planning health education programming, the public health nurse is aware that the most common cause of secondary immunodeficiency disorders is:

A) nutritional deficiencies.
B) infection.
C) aging.
D) selected malignancies.

Answer 1

nutritional deficiencies.

Question 2

When planning care, the nurse recognizes that which primary immunodeficiency disorder (PID) is a pediatric emergency?

A) Selective IgA deficiency
B) X-linked agammaglobulinemia
C) Transient hypogammaglobulinemia of infancy
D) Severe combined immunodeficiency

Answer 2

Severe combined immunodeficiency

Question 3

How should a nurse respond when a patient with human immunodeficiency virus (HIV) asks about the course of the disease?

A) "The disease will progress to AIDS within a few years."
B) "You will probably be relatively asymptomatic for 20 years."
C) "The disease has a variable progression, so it's hard to know right now."
D) "Death typically occurs within 10 to 15 years."

Answer 3

"The disease has a variable progression, so it's hard to know right now."

Question 4

The school nurse is talking with a high school class about sexual transmission of HIV. Which of the following would the nurse advise the students?

A) "Oral-penile intercourse carries the highest risk of transmission."
B) "Penile-vaginal and penile-anal intercourse most efficiently transmit the virus."
C) "HIV-infected females cannot transmit HIV to their partners."
D) "Kissing can transmit HIV."

Question 5

When counseling about HIV transmission, which patients does the nurse recognize as being at greatest risk for being newly diagnosed with HIV?

A) Black men who have sex with men
B) White men who have sex with men
C) Black heterosexual men
D) Black heterosexual women

Question 6

Which of the following is the nurse most likely to expect in a newborn with DiGeorge syndrome?

A) Reduced B-cells
B) Hyperplasia of the parathyroid glands
C) Hypoplasia of the thymus gland
D) Hypercalcemia

Question 7

When taking a health history from a patient during the period of chronic HIV, the nurse would expect to find:

A) no clinical manifestations of HIV infection.
B) nonspecific symptoms including fever, fatigue, headache, lymphadenopathy, arthralgias, and rash.
C) fever, night sweats, diarrhea, and mucocutaneous abnormalities.
D) opportunistic infections and malignancies.

Question 8

Which patient statement indicates to the nurse that more teaching regarding early highly active antiretroviral therapy (HAART) is needed?

A) "Early HAART can have negative effects."
B) "Early HAART can preserve my immune function."
C) "Early HAART can reduce the risk of viral transmission."
D) "Early HAART reduces the potential for developing drug-resistant strains."

Question 9

In response to an HIV-infected patient asking about tuberculosis (TB), the nurse should explain that:

A) TB is often transmitted at the time of HIV transmission.
B) HIV infection increases the risk of acquiring TB.
C) HIV suppresses the activation of latent TB.
D) TB is the leading cause of death in HIV-infected people.

Question 10

In the initial stages of distal symmetric polyneuropathy (DSP) in an HIV-infected patient, the nurse would expect to find on physical assessment:

A) a diminished brachioradialis reflex.
B) a diminished ankle reflex.
C) a hyperreflexive patellar reflex
D) a positive Babinski sign

Question 11

A 1-year-old baby is being seen at the clinic because his parents are worried that he is always sick. The healthcare team is concerned that the baby may have a primary immunodeficiency (PI). Which assessment data would support a diagnosis of PI?

A) Four or more new ear infections within 1 year and failure to gain weight normally
B) One bout of pneumonia in a year and failure to gain weight normally
C) One month on antibiotics with little effect and failure to gain weight normally
D) One serious sinus infection in a year and failure to gain weight normally

Question 12

The nurse is teaching an HIV-infected patient about highly active antiretroviral therapy (HAART). The nurse should consider the teaching effective if the patient says:

A) "HAART reduces antiretroviral drug toxicity."
B) "HAART includes drugs from two different antiretroviral drug classes."
C) "HAART with a minimum of three antiretroviral medications reduces the chance of developing viral resistance."
D) "Therapy starts with one medication with others added as needed."

Question 13

An HIV-infected patient has cytomegalovirus (CMV) retinitis and a CD4+ lymphocyte count of 150 cells/mm3. How should the nurse interpret this data?

A) The patient has primary HIV infection.
B) The patient is in the chronic stage of HIV infection.
C) The patient has symptomatic HIV.
D) The patient has AIDS.

Question 14

The nurse is instructing an HIV-infected patient who is starting HAART. Which statement indicates that the teaching has been effective?

A) "I will not stop taking my medication without contacting my doctor."
B) "If side effects develop, I will stop the medication until symptoms subside."
C) "I can stop my medication once my viral load is undetectable."
D) "I cannot transmit the virus while I am taking my medication."

Question 15

The nurse is teaching a patient about the use of early HAART to treat HIV. Which statement by the patient indicates that he does not understand the teaching?

A) "Early HAART increases the risk of drug toxicities that will limit treatment options in the future."
B) "Early HAART can increase the risk of developing drug-resistant mutants that will limit treatment options for symptomatic disease."
C) "Early HAART does not affect the ability to transmit drug-resistant mutants to uninfected people."
D) "Early HAART reduces the risk of transmitting HIV to uninfected people."

Question 16

What finding should alert the nurse to a potential cytomegalovirus (CMV) infection in an HIV-infected patient?

A) Blurry vision
B) Burning on urination (dysuria)
C) Sore throat
D) Muscle aches

Question 17

Which laboratory test results would the nurse check to determine the effectiveness of an antiretroviral medication in an HIV-infected patient?

A) Western blot
B) HIV RNA
C) HIV ELISA
D) Phenotypic resistance analyses

Question 18

Laboratory results indicate that the viral load of a newly diagnosed, untreated HIV-infected client has stabilized. The nurse explains to the patient that:

A) he has primary HIV infection.
B) he is experiencing seroconversion.
C) he has reached the viral set point.
D) he has chronic HIV.

Question 19

Which combination of antiretroviral drugs would the nurse be most likely to administer in a patient when antiviral drug resistance testing is not available?

A) Ritonavir-boosted protease inhibitors (RTV-boosted PIs) and nucleoside reverse transcriptase inhibitors (NRTIs)
B) Nonnucleoside reverse transcriptase inhibitors (NNRTIs) and NRTIs
C) Protease inhibitors and fusion inhibitors
D) Early inhibitors and integrase strand transfer inhibitors (INSTIs)

Question 20

When assessing a patient with HIV-related lipodystrophy, the nurse would expect to find:

A) truncal obesity and hypoglycemia.
B) dyslipidemia and insulin resistance.
C) hypoglycemia and dyslipidemia.
D) increased subcutaneous fat deposits and truncal obesity.