Deck 17: Infection and Human Immunodeficiency Virus Infection

Question 1

After having a positive rapid-antibody test for HIV, a client is anxious and does not appear to hear what the nurse is saying. Which of the following actions should the nurse implement?

A)Teach the client about the medications available for treatment.
B)Inform the client how to protect sexual and needle-sharing partners.
C)Remind the client about the need to return for retesting to verify the results.
D)Ask the client to notify individuals who have had risky contact with the client.

Answer 1

Remind the client about the need to return for retesting to verify the results.

Question 2

Ten years after seroconversion, an HIV-infected client has a CD4+ cell count of 800 cells per microlitre and an undetectable viral load. Which of the following actions 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.

Answer 2

Encourage adequate nutrition, exercise, and sleep.

Question 3

Which of the following nursing actions will be most useful in assisting a young adult college student to adhere to a newly prescribed antiretroviral therapy (ART) regimen?

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

Answer 3

Check the client's class schedule to help decide when the ART should be taken.

Question 4

The nurse is caring for a client with HIV who has a CD4+ cell count of 400/µL. Which of the following factors is most important to consider when determining whether antiretroviral therapy (ART) will be initiated for this client?

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

Question 5

The nurse is caring for a pregnant client who has recently been diagnosed with HIV. The client asks the nurse, "How soon after delivery of my baby can ART treatment be started?" Which of the following provide the basis for the nurse's response?

A)It can be initiated while you are pregnant.
B)It will start as soon as your baby is born.
C)It depends upon whether you are breastfeeding your baby or not.
D)It cannot begin until 7 days postpartum.

Question 6

Aclient is admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP) and HIV testing is positive. Based on diagnostic criteria established by the World Health Organization (WHO), which of the following diagnoses should the nurse anticipate?

A)Acute infection
B)Early chronic infection
C)Intermediate chronic infection
D)Late chronic infection or AIDS

Question 7

Replication of HIV is enhanced when the client is taking which of the following herbs?

A)Echinacea
B)St. John's wort
C)Fish oil
D)Saw palmetto

Question 8

The nurse is caring for a client with HIV infection who has developed Mycobacterium avium complex infection. Which of the following goals is most appropriate for this client?

A)Be free from injury.
B)Receive immunizations on time.
C)Ensure adequate oxygenation.
D)Maintain intact perineal skin.

Question 9

Aclient 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 client, which of the following information should thenurseinclude?

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 client develops acquired immunodeficiency syndrome (AIDS).
D)The Western blot test will be done to determine whether AIDS has developed.

Question 10

A client 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. Which of the following topics should the nurse include in the client teaching plan?

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 11

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

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

Question 12

Which of the following tests is used to evaluate the effectiveness of ART?

A)Viral load testing
B)Enzyme immunoassay
C)Rapid HIV antibody testing
D)Immuno-fluorescence assay

Question 13

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

A)Nystatin tablet
B)Oral abacavir
C)Aerosolized pentamidine
D)Oral acyclovir

Question 14

When assessing an individual who has diagnosed with early chronic HIV infection and has a normal CD4+ count, which of the following assessments should the nurse conduct?

A)Check neurological orientation.
B)Ask about problems with diarrhea.
C)Palpate the regional lymph nodes.
D)Examine the oral mucosa for lesions.

Question 15

A young adult who uses injectable illegal drugs asks the nurse about preventing AIDS. Which of the following information should the nurse inform the client is the best way to reduce the risk of HIV infection from drug use?

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 16

Which of the following tests does the Canadian Blood Services use to detect HIV genetic material in blood?

A)CD4+ T-cell count
B)HIV RNA polymerase chain reaction test
C)Nucleic acid amplification test
D)CD4 fraction

Question 17

The nurse is caring for a client whose HIV status is unknown. Which of these client exposures is most likely to require postexposure prophylaxis for the nurse?

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 client vaginal secretions
D)Needle stick injury with a suture needle during a surgical procedure

Question 18

Aclient who has diagnosed with AIDS tells the nurse, "I have lots of thoughts about dying. Do you think I am just being morbid?" Which of the following responses by the nurse is most appropriate?

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 19

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

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

Question 20

Apregnant woman with a history of early chronic HIV infection is seen at the clinic. Which of the following information should the nurse include when teaching the client?

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 21

The nurse is caring for a client who has just diagnosed with early chronic HIV infection. Which of the following prophylactic measures should 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

Question 22

The nurse is designing a program to teach a community group about decreasing the incidence of HIV infection in their community. Which of the following information is a priority that the nurse include in the education session?

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.