Deck 17: Infection and Human Immunodeficiency Virus Infection

Question 1

A patient who tested positive for HIV 3 years ago is admitted to the hospital with Pneumocystis pneumonia.Based on diagnostic criteria established by the World Health Organization,what is the patient diagnosed as having?

A) AIDS
B) HIV infection
C) Early chronic infection
D) Intermediate chronic infection

Answer 1

AIDS

Question 2

What early manifestations of HIV infection should the nurse assess for in both the nursing history and the physical examination?

A) Ataxia and confusion
B) Rectal lesions and bleeding
C) Lesions of the mouth and tongue
D) Weight loss and wasting syndrome

Answer 2

Lesions of the mouth and tongue

Question 3

At the health promotion level of care for HIV infection,what should the nurse assess for?

A) Symptoms the patient may be experiencing
B) Drug side effects or interactions that may be present
C) The patient's need for assistance from the community
D) Behaviours that place the patient at risk for HIV infection

Answer 3

Behaviours that place the patient at risk for HIV infection

Question 4

A patient has recently tested positive for HIV and asks the nurse about drug therapy for HIV infection.What should the nurse tell the patient about drug therapy?

A) Drug therapy for HIV is indicated only when CD4⁺ T-cell counts are abnormal.
B) Drug therapy is delayed as long as possible to prevent development of viral resistance to the drugs.
C) When to start drug therapy is controversial,and treatment decisions are individualized for each patient.
D) AZT is administered initially to all patients who test positive for HIV to slow viral growth.

Question 5

Which of the following patients should be instructed to report to a health care provider immediately?

A) A patient with blurry or black areas in the vision field
B) A patient with burning,itching,or discharge from the eyes
C) A patient with headache accompanied by fever and nasal congestion
D) A patient with painful urination with blood in the urine and urethral discharge

Question 6

A patient with HIV infection has developed Mycobacterium avium complex.What is an appropriate outcome for the nurse to expect for the patient?

A) The patient will be free from injury.
B) The patient will maintain intact perineal skin.
C) The patient will maintain adequate oxygenation.
D) The patient will contact agencies that provide services for the visually impaired.

Question 7

A recently divorced woman seeks health care for vague symptoms of fatigue and headache.During her examination,she agrees to human immunodeficiency virus (HIV)testing and is found to have a positive enzyme immunoassay (EIA)for HIV antibodies.In discussing the test results with the patient,what should the nurse inform the patient about?

A) The EIA test will have to be repeated to verify the results.
B) A viral culture will be done to determine the progress of her disease.
C) It will probably be 10 or more years before she develops acquired immune deficiency syndrome (AIDS).
D) The EIA test is frequently false-positive,and a more specific Western blot test will determine whether she has AIDS.

Question 8

When teaching a patient with HIV infection about ART,what should the nurse explain that these drugs do?

A) They work in various ways to decrease viral replication in the blood.
B) They alter the cellular surface of cells with CD4 receptors,preventing viral attachment.
C) They destroy the viral envelope,enabling monocyte and macrophage phagocytosis of the viral ribonucleic acid.
D) They stimulate the activity of B lymphocytes to produce antibodies that react with the virus in the blood.

Question 9

Drug therapy is being considered for an HIV-infected patient who has asymptomatic HIV infection with a CD4⁺ T-cell count of 400 per microlitre.Which nursing assessment is most important in determining whether therapy will be used?

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

Question 10

During post-test counselling for a patient who has tested positive for HIV,the patient is very anxious and does not appear to hear what the nurse is saying.To promote the patient's adjustment to HIV infection,what is it important that the nurse do?

A) Inform the patient how to protect sexual and needle-sharing partners.
B) Teach the patient about the medications that are available for treatment.
C) Identify the need to test others who have had risky contact with the patient.
D) Discuss retesting to verify the results,which will ensure continuing contact with the health care system.

Question 11

In health care workers,which following activity poses the highest risk for acquiring HIV from an HIV-infected patient?

A) A needle stick with a suture needle
B) Contamination of open skin lesions with vaginal secretions
C) A needle stick with a needle and syringe used to draw blood
D) A needle stick with a needle and syringe used to administer an intramuscular injection

Question 12

A 24-year-old woman who uses injectable,illegal drugs asks the nurse about preventing AIDS.The nurse should inform the patient that which of the following activities can eliminate the risk of HIV infection from drug use?

A) Participating in a needle exchange program
B) Cleaning drug injection equipment before use
C) Asking those she shares equipment with to be tested for HIV
D) Not having sexual intercourse when under the influence of the drugs

Question 13

A young mother with a history of intravenous drug use and HIV infection delivered a baby who has tested positive for HIV.The mother will not care for the baby because she believes the baby will die soon.When counselling the mother about the care of her infant,what is an appropriate approach for the nurse to take?

A) Confirm with the mother that the baby will develop AIDS and refer her to a local AIDS support group.
B) Remind the mother that she has not yet developed AIDS and that it is possible the baby will not develop AIDS for many years.
C) Inform the mother that if the infant is started on zidovudine (AZT)within the first month after delivery,AIDS can be prevented.
D) Inform the mother that although infants of HIV-infected mothers always test positive for HIV antibodies,most infants are not infected with the virus.

Question 14

Which of the following involves malignant vascular lesions on the torso?

A) Leukoplakia
B) Toxoplasma gondii
C) Kaposi's sarcoma
D) Coccidioides immitis

Question 15

To evaluate the effect of HIV infection in a patient,the nurse assesses the patient with the knowledge that in addition to lymphocytes,the virus also commonly infects which of the following?

A) Osteocytes
B) Astrocytes
C) Hepatocytes
D) Erythrocytes

Question 16

Four years after seroconversion,an HIV-infected patient has a CD4⁺ T-cell count of 800 per microlitre and a low viral load.What does the nurse recognize at this time?

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

Question 17

The nurse should promote interventions such as nutrition,exercise,and stress reduction in patients who have HIV infection primarily because these interventions will do which of the following?

A) Improve immune function.
B) Prevent transmission of the virus to others.
C) Promote a feeling of well-being in the patient.
D) Increase the patient's strength and ability to care for himself or herself.

Question 18

What is the median interval between untreated HIV infection and a diagnosis of AIDS?

A) 2 years
B) 5 years
C) 10 years
D) 20 years

Question 19

Which following condition is most commonly caused by Escherichia coli?

A) Diphtheria
B) Food poisoning
C) Urinary tract infection
D) Gastroenteritis

Question 20

While teaching community groups about AIDS,which of the following should the nurse tell people is currently the most common method of transmission of the HIV virus?

A) Nonsexual exposure to saliva and tears
B) Sharing equipment to inject illegal drugs
C) Transfusions with HIV-contaminated blood
D) Sexual contact with an HIV-infected partner

Question 21

The nurse should counsel a newly infected HIV patient to anticipate that symptoms of acute retroviral syndrome will appear at which time?

A) Within 48 hours of diagnosis
B) During the initial 7 days after diagnosis
C) 1 to 3 weeks after diagnosis
D) Within the first 6 months after diagnosis

Question 22

During which period of chronic HIV infection would the patient experience lymphadenopathy and nervous system manifestations?

A) Early
B) Intermediate
C) Late
D) Terminal