Question 1

A young adult female patient who is human immunodeficiency virus (HIV)positive has a new prescription for efavirenz (Sustiva). Which information is most important to include in the medication teaching plan?

A)Take this medication on an empty stomach.
B)Take this medication with a full glass of water.
C)You may have vivid and bizarre dreams as a side effect.
D)Continue to use contraception while taking this medication.

Accepted Answer

To prevent harm,it is most critical to inform patients that efavirenz can cause fetal anomalies and should not be used in patients who may be or may become pregnant. The other information is also accurate,but it does not directly prevent harm. The medication should be taken on an empty stomach with water and patients should be informed that many people who use the drug have reported vivid and sometimes bizarre dreams.

Question 2

Which patient exposure by the nurse is most likely to require postexposure prophylaxis when the patient's human immunodeficiency virus (HIV)status is unknown?&#10;A)Needle stick injury with a suture needle during a surgery&#10;B)Splash into the eyes while emptying a bedpan containing stool&#10;C)Needle stick with a needle and syringe used for a venipuncture&#10;D)Contamination of open skin lesions with patient vaginal secretions

Accepted Answer

Puncture wounds are the most common means for workplace transmission of blood-borne diseases,and a needle with a hollow bore that had been contaminated with the patient's blood would be a high-risk situation. The other situations described would be much less likely to result in transmission of the virus.

Question 3

A patient who is human immunodeficiency virus (HIV)-infected has a CD₄+ cell count of 400/µL. Which factor is most important for the nurse to determine before the initiation of antiretroviral therapy (ART)for this patient?

A)CD₄+ cell count trajectory
B)HIV genotype and phenotype
C)Patient's tolerance for potential medication side effects
D)Patient's ability to follow a complex medication regimen

Accepted Answer

Drug resistance develops quickly unless the patient takes ART medications on a strict,regular schedule. In addition,drug resistance endangers both the patient and community. The other information is also important to consider,but patients who are unable to manage and follow a complex drug treatment regimen should not be considered for ART.

Question 4

The nurse is advising a clinic patient who was exposed a week ago to human immunodeficiency virus (HIV)through unprotected sexual intercourse. The patient's antigen and antibody test has just been reported as negative for HIV. What instructions should the nurse give to this patient?

A)"You will need to be retested in 2 weeks."
B)"You do not need to fear infecting others."
C)"Since you don't have symptoms and you have had a negative test, you do not have HIV)."
D)"We won't know for years if you will develop acquired immunodeficiency syndrome (AIDS)."

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Accepted Answer

HIV screening tests detect HIV-specific antibodies or antigens,but typically it takes a several week delay after initial infection before HIV can be detected on a screening test. Combination antibody and antigen tests (also known as fourth-generation tests)decrease the window period to within 3 weeks after infection. It is not known based on this information whether the patient is infected with HIV or can infect others.

Question 5

Which information about a patient population would be most useful to help the nurse plan for human immunodeficiency virus (HIV)testing needs?&#10;A)Age&#10;B)Lifestyle&#10;C)Symptoms&#10;D)Sexual orientation

Accepted Answer

The current Centers for Disease Control and Prevention policy is to offer routine testing for HIV to all individuals age 13 to 64 years. Although lifestyle,symptoms,and sexual orientation may suggest increased risk for HIV infection,the goal is to test all individuals in this age range.

Question 6

Eight years after seroconversion,a human immunodeficiency virus (HIV)-infected patient has a CD₄+ cell count of 800/µL and an undetectable viral load. What is the priority nursing intervention at this time?

A)Encourage adequate nutrition, exercise, and sleep.
B)Teach about the side effects of antiretroviral agents.
C)Explain opportunistic infections and antibiotic prophylaxis.
D)Monitor symptoms of acquired immunodeficiency syndrome (AIDS).

Accepted Answer

The CD₄+ level for this patient is in the normal range,indicating that the patient is the stage of asymptomatic chronic infection when the body is able to produce enough CD₄+ cells to maintain a normal CD₄+ count. Maintaining healthy lifestyle behaviors is an important goal in this stage. AIDS and increased incidence of opportunistic infections typically develop when the CD₄+ count is much lower than normal. Although the initiation of ART is highly individual,it would not be likely that a patient with a normal CD₄+ level would receive ART.

Question 7

A patient who has a positive test for human immunodeficiency virus (HIV)antibodies is admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP)and a CD4? T-cell count of less than 200 cells/mL. Based on diagnostic criteria established by the Centers for Disease Control and Prevention (CDC),which statement by the nurse is correct?

A)"The patient will develop symptomatic HIV infection within 1 year."
B)"The patient meets the criteria for a diagnosis of acute HIV infection."
C)"The patient will be diagnosed with asymptomatic chronic HIV infection."
D)"The patient has developed acquired immunodeficiency syndrome (AIDS)."

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Accepted Answer

Development of PCP meets the diagnostic criteria for AIDS. The other responses indicate earlier stages of HIV infection than is indicated by the PCP infection.

Question 8

The nurse prepares to administer the following medications to a hospitalized patient with human immunodeficiency (HIV). Which medication is most important to administer at the scheduled time?&#10;A)Nystatin tablet&#10;B)Oral acyclovir (Zovirax)&#10;C)Oral saquinavir (Invirase)&#10;D)Aerosolized pentamidine (NebuPent)

Accepted Answer

It is important that antiretrovirals be taken at the prescribed time every day to avoid developing drug-resistant HIV. The other medications should also be given as close as possible to the correct time,but they are not as essential to receive at the same time every day.

Question 9

The nurse will most likely prepare a medication teaching plan about antiretroviral therapy (ART)for which patient? A)Patient who is currently HIV negative but has unprotected sex with multiple partners B)Patient who was infected with HIV 15 years ago and now has a CD₄+ count of 840/µL C)HIV-positive patient with a CD₄+ count of 160/µL who drinks a fifth of whiskey daily D)Patient who tested positive for HIV 2 years ago and now has cytomegalovirus (CMV) retinitis

Accepted Answer

CMV retinitis is an AIDS-defining illness and indicates that the patient is appropriate for ART even though the HIV infection period is relatively short. An HIV-negative patient would not be offered ART. A patient with a CD₄+ count in the normal range would not typically be started on ART. A patient who drinks alcohol heavily would be unlikely to be able to manage the complex drug regimen and would not be appropriate for ART despite the low CD₄+ count.

Question 10

A patient informed of a positive rapid antibody test result for human immunodeficiency virus (HIV)is anxious and does not appear to hear what the nurse is saying. What action by the nurse is most important at this time?

A)Teach the patient how to reduce risky behaviors.
B)Inform the patient about the available treatments.
C)Remind the patient about the need to return for retesting to verify the results.
D)Ask the patient to identify individuals who had intimate contact with the patient.

Accepted Answer

After an initial positive antibody test result,the next step is retesting to confirm the results. A patient who is anxious is not likely to be able to take in new information or be willing to disclose information about the HIV status of other individuals.

Question 11

To evaluate the effectiveness of antiretroviral therapy (ART),which laboratory test result will the nurse review?&#10;A)Viral load testing&#10;B)Enzyme immunoassay&#10;C)Rapid HIV antibody testing&#10;D)Immunofluorescence assay

Accepted Answer

The answer of To evaluate the effectiveness of antiretroviral therapy...

Question 12

A patient who uses injectable illegal drugs asks the nurse about preventing acquired immunodeficiency syndrome (AIDS). Which response by the nurse is best?&#10;A)&#34;Clean drug injection equipment before each use.&#34;&#10;B)&#34;Ask those who share equipment to be tested for HIV.&#34;&#10;C)&#34;Consider participating in a needle-exchange program.&#34;&#10;D)&#34;Avoid sexual intercourse when using injectable drugs.&#34;

Accepted Answer

The answer of A patient who uses injectable illegal drugs...

Question 13

Which of these patients who have arrived at the human immunodeficiency virus (HIV)clinic should the nurse assess first? A)Patient whose rapid HIV-antibody test is positive B)Patient whose latest CD₄+ count has dropped to 250/µL C)Patient who has had 10 liquid stools in the last 24 hours D)Patient who has nausea from prescribed antiretroviral drugs

Accepted Answer

The answer of Which of these patients who have arrived...

Question 14

A pregnant woman with asymptomatic chronic human immunodeficiency virus (HIV)infection is seen at the clinic. The patient states,"I am very nervous about making my baby sick." Which information will the nurse include when teaching the patient?

A)The antiretroviral medications used to treat HIV infection are teratogenic.
B)Most infants born to HIV-positive mothers are not infected with the virus.
C)Because it is an early stage of HIV infection, the infant will not contract HIV.
D)Her newborn will be born with HIV unless she uses antiretroviral therapy (ART).

Accepted Answer

The answer of A pregnant woman with asymptomatic chronic human...

Question 15

A patient with human immunodeficiency virus (HIV)infection has developed Mycobacterium avium complex infection. Which outcome would be appropriate for the nurse to include in the plan of care?&#10;A)The patient will be free from injury.&#10;B)The patient will receive immunizations.&#10;C)The patient will have adequate oxygenation.&#10;D)The patient will maintain intact perineal skin.

Accepted Answer

The answer of A patient with human immunodeficiency virus (HIV)infection...

Question 16

A patient treated for human immunodeficiency virus (HIV)infection for 6 years has developed fat redistribution to the trunk with wasting of the arms,legs,and face. What recommendation will the nurse give to the patient?

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

Accepted Answer

The answer of A patient treated for human immunodeficiency virus...

Question 17

The nurse palpates enlarged cervical lymph nodes on a patient diagnosed with acute human immunodeficiency virus (HIV)infection. Which action would be appropriate for the nurse to take?&#10;A)Instruct the patient to apply ice to the neck.&#10;B)Explain to the patient that this is an expected finding.&#10;C)Request that an antibiotic be prescribed for the patient.&#10;D)Advise the patient that this indicates influenza infection.

Accepted Answer

The answer of The nurse palpates enlarged cervical lymph nodes...

Question 18

Which nursing action will be most useful in assisting a college student to adhere to a newly prescribed antiretroviral therapy (ART)regimen?&#10;A)Give the patient detailed information about possible medication side effects.&#10;B)Remind the patient of the importance of taking the medications as scheduled.&#10;C)Encourage the patient to join a support group for students who are HIV positive.&#10;D)Check the patient's class schedule to help decide when the drugs should be taken.

Accepted Answer

The answer of Which nursing action will be most useful...

Question 19

The nurse is caring for a patient who is human immunodeficiency virus (HIV)positive and taking antiretroviral therapy (ART). Which information is most important for the nurse to address when planning care?

A)The patient complains of feeling "constantly tired."
B)The patient can't explain the effects of indinavir (Crixivan).
C)The patient reports missing some doses of zidovudine (AZT).
D)The patient reports having no side effects from the medications.

Accepted Answer

The answer of The nurse is caring for a patient...

Question 20

A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS)tells the nurse,&#34;I feel obsessed with morbid thoughts about dying.&#34; Which response by the nurse is appropriate?&#10;A)&#34;Thinking about dying will not improve the course of AIDS.&#34;&#10;B)&#34;Do you think that taking an antidepressant might be helpful?&#34;&#10;C)&#34;Can you tell me more about the thoughts that you are having?&#34;&#10;D)&#34;It is important to focus on the good things about your life now.&#34;

Accepted Answer

The answer of A patient who is diagnosed with acquired...

Question 21

The registered nurse (RN)caring for an HIV-positive patient admitted with tuberculosis can delegate which action to unlicensed assistive personnel (UAP)?&#10;A)Teach the patient how to dispose of tissues with respiratory secretions.&#10;B)Stock the patient's room with the necessary personal protective equipment.&#10;C)Interview the patient to obtain the names of family members and close contacts.&#10;D)Tell the patient's family members the reason for the use of airborne precautions.

Accepted Answer

The answer of The registered nurse (RN)caring for an HIV-positive...

Question 22

According to the Center for Disease Control and Prevention (CDC)guidelines,which personal protective equipment will the nurse put on before assessing a patient who is on contact precautions for Clostridium difficile diarrhea ?

A)Mask
B)Gown
C)Gloves
D)Shoe covers
E)Eye protection

Accepted Answer

The answer of According to the Center for Disease Control...

Question 23

The nurse designs a program to decrease the incidence of human immunodeficiency virus (HIV)infection in the adolescent and young adult populations. Which information should the nurse assign as the highest priority?

A)Methods to prevent perinatal HIV transmission
B)Ways to sterilize needles used by injectable drug users
C)Prevention of HIV transmission between sexual partners
D)Means to prevent transmission through blood transfusions

Accepted Answer

The answer of The nurse designs a program to decrease...

Question 24

An older adult with chronic human immunodeficiency virus (HIV)infection who takes medications for coronary artery disease and hypertension has chosen to begin early antiretroviral therapy (ART). Which information will the nurse include in patient teaching?

A)Many drugs interact with antiretroviral medications.
B)HIV infections progress more rapidly in older adults.
C)Less frequent CD₄+ level monitoring is needed in older adults.
D)Hospice care is available for patients with terminal HIV infection.

Accepted Answer

The answer of An older adult with chronic human immunodeficiency...

Question 25

The nurse plans a presentation for community members about how to decrease the risk for antibiotic-resistant infections. Which information will the nurse include in the teaching plan ?&#10;A)Antibiotics may sometimes be prescribed to prevent infection.&#10;B)Continue taking antibiotics until all of the prescription is gone.&#10;C)Unused antibiotics that are more than a year old should be discarded.&#10;D)Antibiotics are effective in treating influenza associated with high fevers.&#10;E)Hand washing is effective in preventing many viral and bacterial infections.

Accepted Answer

The answer of The nurse plans a presentation for community...

Question 26

The nurse is caring for a patient infected with human immunodeficiency virus (HIV)who has just been diagnosed with asymptomatic chronic HIV infection. Which prophylactic measures will the nurse include in the plan of care ?

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

Accepted Answer

The answer of The nurse is caring for a patient...

Deck 14: Infection and Human Immunodeficiency Virus Infection