Deck 15: Infection and Human Immunodeficiency Virus Infection

Question 1

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

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

Answer 1

palpate the regional lymph nodes.

Question 2

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

A) acute infection.
B) early chronic infection.
C) intermediate chronic infection.
D) late chronic infection or AIDS.

Answer 2

late chronic infection or AIDS.

Question 3

When the nurse is caring for a patient whose HIV status in unknown, which of these patient exposures is most likely to require postexposure prophylaxis?

A) Needle stick with a needle and syringe used to draw blood
B) Splash into the eyes when emptying a bedpan containing stool
C) Contamination of open skin lesions with patient vaginal secretions
D) Needle stick injury with a suture needle during a surgical procedure

Answer 3

Needle stick with a needle and syringe used to draw blood

Question 4

A pregnant woman with a history of early chronic HIV infection is seen at the clinic. 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) Since she is at an early stage of HIV infection, the infant will not contract HIV.
D) It is likely that her newborn will become infected with HIV unless she uses antiretroviral drug therapy (ART).

Question 5

A patient who is diagnosed with AIDS tells the nurse, "I have lots of thoughts about dying. Do you think I am just being morbid?" Which response by the nurse is best?

A) "Thinking about dying will not improve the course of AIDS."
B) "It is important to focus on the good things about your life now."
C) "Do you think that taking an antidepressant might be helpful to you?"
D) "Can you tell me more about the kind of thoughts that you are having?"

Question 6

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

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

Question 7

Which nursing action will be most useful in assisting a 21-year-old college student to adhere to a newly prescribed antiretroviral therapy (ART) regimen?

A) Give the patient detailed information about possible medication side effects.
B) Remind the patient of the importance of taking the medications as scheduled.
C) Encourage the patient to join a support group for students who are HIV positive.
D) Check the patient's class schedule to help decide when the ART should be taken.

Question 8

Ten years after seroconversion, an 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) Monitor for symptoms of AIDS.
B) Teach about the effects of antiretroviral agents.
C) Encourage adequate nutrition, exercise, and sleep.
D) Discuss likelihood of increased opportunistic infections.

Question 9

Which action can the nurse delegate to nursing assistive personnel (NAP) who help with the care of a patient admitted with tuberculosis and placed on airborne precautions?

A) Teach the patient about how to use tissues to dispose of respiratory secretions.
B) Stock the patient's room with all the necessary personal protective equipment.
C) Interview the patient to obtain the names of family members and close contacts.
D) Tell the patient's family members the reason for the use of airborne precautions.

Question 10

A 20-year-old female patient who is HIV-positive has a new prescription for efavirenz ( Sustiva ). Which information about the patient is most important to communicate to the prescribing physician before administering the efavirenz?

A) The patient's cd4+ T cell count is 800 cells/?L.
B) The patient already has etravirine ( Intelence ) prescribed.
C) The patient states that the antiretroviral therapy ( ART ) frequently cause nausea.
D) The patient is sexually active and does not use any contraception.

Question 11

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.

Question 12

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) receive immunizations.
C) have adequate oxygenation.
D) maintain intact perineal skin.

Question 13

The nurse is reviewing the chart for a patient who is scheduled for an annual physical exam. Which information will be most important in determining whether the patient needs HIV testing?

A) Patient age
B) Patient lifestyle
C) Patient symptoms
D) Patient sexual orientation

Question 14

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 15

Which information about an HIV-positive patient who is taking antiretroviral medications is most important for the nurse to address when planning care?

A) The patient's blood glucose level is 168 mg/dl.
B) The patient complains of feeling "constantly tired."
C) The patient is unable to state the side effects of the medications.
D) The patient states "sometimes I miss a dose of zidovudine (AZT)."

Question 16

After having a positive rapid-antibody test for HIV, a 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) teach the patient about the medications available for treatment.
B) inform the patient how to protect sexual and needle-sharing partners.
C) remind the patient about the need to return for retesting to verify the results.
D) ask the patient to notify individuals who have had risky contact with the patient.

Question 17

Antiretroviral therapy (ART) is being considered for an HIV-infected patient who has a CD4+ cell count of 400/µl. Which factor is most important to consider when determining whether ART will be started for this patient?

A) Patient social support system
B) HIV genotype and phenotype
C) Potential medication side effects
D) Patient ability to comply with ART schedule

Question 18

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

A) A patient who is currently HIV negative but has unprotected sex with multiple partners
B) A patient who was infected with HIV 15 years ago and now has a CD4+ count of 840/µl
C) An HIV-positive patient with a CD4+ count of 120/µl who drinks a fifth of whiskey daily
D) A patient who tested positive for HIV 2 years ago and has cytomegalovirus (CMV) retinitis

Question 19

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

A) the EIA 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 acquired immunodeficiency syndrome ( AIDS ).
D) the Western blot test will be done to determine whether AIDS has developed.

Question 20

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

Question 21

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

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

Question 22

When caring for a patient who has just been diagnosed with early chronic HIV infection, which prophylactic measures will the nurse anticipate being included in the plan of care (select all that apply)?

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