Deck 55: Pharmacotherapy of Hiv-Aids

Question 1

The nurse is providing discharge teaching to a client recently been diagnosed with HIV.The nurse knows the client has understood the instructions when he states that a goal of HIV pharmacotherapy is to:
Select all that apply.

A)prevent HIV-related morbidity.
B)prolong survival.
C)restore and preserve immunologic function.
D)increase viral load.
E)eliminate the potential for transmission from mother to child in pregnant clients who have HIV infection.

Answer 1

prolong survival.
restore and preserve immunologic function.

Question 2

An HIV client has been on an antiviral protease inhibitor for 2 months and recently complains of being hungry and thirsty and urinating more frequently.Knowing the adverse effects of protease inhibitors,the nurse should assess for:

A)pancreatitis.
B)kidney failure.
C)hepatomegaly.
D)hyperglycemia.

Answer 2

hyperglycemia.

Question 3

The nurse teaches a client that the transmission of HIV infection occurs by:

A)exposure to respiratory secretions.
B)exposure to fecal material.
C)exposure to blood or semen.
D)exposure to contaminated food.

Answer 3

exposure to blood or semen.

Question 4

The nurse is teaching a client about the goals of drug therapy for HIV-AIDS.Which statement by the client indicates the need for further teaching?

A)A goal of pharmacotherapy is an increased life span."
B)A goal of pharmacotherapy is curing the disease."
C)Increased quality of life is a goal of pharmacotherapy."
D)Reduced HIV RNA in the blood is a goal of pharmacotherapy."

Question 5

The nurse is teaching a client about the standard drug therapy for HIV-AIDS.Which antiviral medications does the nurse include in the teaching plan?

A)Zidovudine (Retrovir,AZT)
B)Interferon-alfa
C)Rimantadine (Flumadine)
D)Acyclovir (Zovirax)

Question 6

When discussing antiviral drug resistance with a client initiating pharmacotherapy,the nurse explains that most of the reasons for drug resistance in certain medicines are related to:

A)the viral load.
B)the lymphocyte count.
C)the suppressor T cells.
D)the mutations that can occur in the virus.

Question 7

When the client is started on antiretroviral drugs for HIV,what important information should the nurse teach the client?

A)This drug is readily available all over the world for treatment.
B)This type of drug will be used prior to vaccines.
C)This drug will cure the disease over a period of time.
D)This drug will not cure the disease,but could extend life expectancy.

Question 8

The nurse states that the goal of HAART is:

A)reduction of the plasma level of HIV to the lowest level possible.
B)elimination of the virus from the lymph system.
C)reduction of side effects seen with other HIV-AIDS drugs.
D)elimination of the virus from the bloodstream.

Question 9

The nurse caring for a client who has been prescribed the antiretroviral medication emtricitabine explains that the advantages of this medication include:
Select all that apply.

A)once-daily dosing.
B)once-weekly dosing.
C)fewer adverse effects.
D)can be taken with concurrent HBV infection.
E)safe for pregnant women with HIV.

Question 10

The client asks the nurse how HIV is transmitted.The nurse explains that HIV is transmitted through:
Select all that apply.

A)needlesticks.
B)sexual activity.
C)breast-feeding.
D)casual contact.
E)birth.

Question 11

All six major classes of drugs used to manage HIV infection have the ability to:

A)Prevent the virus from entering the host cell.
B)Destroy the cell walls of the virus.
C)Inhibit enzymes that are necessary for viral replication.
D)Promote cell division only in uninfected cells.

Question 12

During the second stage of pathogenesis of HIV,the virus converts its genetic material from:

A)RNA to DNA.
B)DNA to RNA.
C)DNA to CD4 receptors.
D)RNA to CD4 receptors.

Question 13

When HIV progresses to AIDS,there is a gradual destruction of the immune system,measured by:

A)decline in CD4 receptors.
B)decline in CD4 lymphocytes.
C)decline in platelet count.
D)decline in red blood cells.

Question 14

The nurse is asked by a client which drug regimens have been shown to be the most successful for the initial therapy of HIV infection.The nurse responds:
Select all that apply.

A)An NNRTI-based regimen."
B)PI-based regimens."
C)An integrase inhibitor-based regimen."
D)NRTIs/NtRTIs-based regimens."
E)Entry inhibitor-based regimens."

Question 15

The nurse teaches clients with acquired immune deficiency syndrome (AIDS)about the importance of taking their medications as prescribed.What does the nurse recognize as the primary factors for medication nonadherence in the AIDS population?
Select all that apply.

A)The difficulty with availability of medications to treat AIDS
B)A lack of understanding for the reason to take medications
C)The necessity of having to take multiple medications throughout the day
D)The unpleasant side effects associated with the medications
E)Provider unwillingness to follow established protocols.

Question 16

An HIV-positive client questions the nurse about a vaccine for HIV.Which response by the nurse is most accurate?

A)Scientists are far from developing a vaccine to prevent HIV."
B)The HIV vaccines developed can prevent fatal consequences of the virus."
C)Scientists currently have many HIV vaccines in clinical trials."
D)Scientists are close to discovering a vaccine for HIV."

Question 17

A client is started on efavirenz,a NNRTI.Which medication should the nurse before giving it with efavirenz?

A)Diazepam
B)Penicillin
C)Ibuprofen
D)Diphenhydramine

Question 18

Which teaching point by the nurse is correct in regards to antiviral therapy?

A)Antiviral drug therapy can be challenging because of how slowly viruses become resistant to the drugs.
B)They have a broad spectrum of activity.
C)It is difficult to administer adequate doses of medication to kill the virus without injuring normal cells.
D)They must be given one at a time because of the possibility of severe side effects.

Question 19

The client asks the nurse why there aren't better drugs for HIV infection when so much money is spent on research.What is the best response by the nurse?

A)"Developing new drugs is difficult because we still do not understand the virus."
B)"Developing new drugs is difficult because we still do not have enough money."
C)"Developing new drugs is difficult because the virus mutates so readily."
D)"Developing new drugs is difficult because people think AIDS is a 'gay' disease."

Question 20

The client with AIDS asks the nurse why so many medications are prescribed.What is the best response by the nurse?

A)"To decrease the possibility of the virus developing resistance to the medications."
B)"Because the earlier we start multiple medications,the better for you."
C)"To provide you with the most effective treatment for your illness."
D)"Research has shown single medications to be ineffective."

Question 21

Which regimen is part of protocol to reduce perinatal transmission of HIV?

A)Intravenous zidovudine administered to the mother during the postpartum period
B)Continuous infusion of zidovudine during labor.
C)Intravenous zidovudine administered to the newborn for the first 3 days of life
D)Oral zidovudine administered to the newborn for 12 weeks following delivery

Question 22

The nurse is providing discharge education to a client who has been prescribed lopinavir with ritonavir (Kaletra)for the treatment of HIV.Which information should the nurse include in the teaching plan for this client?
Select all that apply.

A)Take on an empty stomach.
B)Take the medication with herbal supplements to enhance absorption.
C)Discontinue your statin drug.
D)Practice safe sex while taking this drug.
E)Discontinue medication if bothersome side effects occur.

Question 23

When providing client and family education for the nucleoside reverse transcriptase inhibitor (NRTI)drugs for HIV-AIDS,the nurse would include instructions to:

A)Take the medicine with apple juice to decrease the bad taste.
B)Take the medicine with orange juice to increase absorption.
C)Take the medicine on an empty stomach.
D)Take the medicine on a full stomach.

Question 24

Opportunistic infections have become less common,and mortality is diminished,because HAART:

A)decreases RNA replication.
B)increases the amount of red blood cells in the body.
C)increases the number of CD4 lymphocytes.
D)decreases the transmission of opportunistic infections from one person to another.

Question 25

Which assessment finding would concern the nurse if found in the client receiving darunavir (Prezista)?

A)Nausea and vomiting
B)Constipation
C)Abdominal pain,headache,and rash
D)Complete numbness and tingling around the mouth

Question 26

The nurse does health teaching with a client who has HIV who has been started on antiviral medications.The nurse recognizes teaching has been effective when the client makes which statement?

A)"I will need to be on a high-calorie diet to enhance the effect of the medication."
B)"I will still need to take precautions to avoid spreading the virus to others."
C)"I will not be able to continue working at my high-stress job anymore."
D)"I will need to limit my travel to avoid people with other infections."

Question 27

Which statement by the nurse is true in regard to the development of a vaccine to prevent HIV?

A)HIV has a low number of genetic variants.
B)HIV has such a slow replication rate.
C)HIV has an extremely rapid replication rate.
D)There is a low mutation rate.

Question 28

Why is PEP initiated only if exposure was severe,and the source of fluid is known or strongly suspected to contain HIV?

A)The cost and anxiety associated with taking the drugs are high.
B)There is not enough research supporting this treatment.
C)The cost of the drugs is high,and there are many ethical issues surrounding their use.
D)The cost of the drugs is high,and there are many adverse effects.

Question 29

The nurse accidentally sticks herself with a needle after starting an intravenous line on a client with AIDS.The nurse tells the supervisor about the accident.What is the best initial response by the supervisor to decrease anxiety in the nurse?

A)"Workers compensation will cover the cost of your illness and medications."
B)"Fortunately,the chances of you contracting human immunodeficiency virus after the stick are very small."
C)"If you are started on medications soon,it will decrease the severity of the disease."
D)"Did you use the hospital protocols for starting IV lines on a client with AIDS?"

Question 30

The client receives delavirdine (Rescriptor)as treatment for AIDS.The nurse assesses the client for which serious side effect?

A)cardiac arrest
B)bone marrow suppression
C)rash
D)seizures

Question 31

A priority system of assessment in a client recently started on efavirenz (Sustiva)includes:

A)pulmonary.
B)CNS.
C)GI.
D)cardiac.

Question 32

A client has been prescribed tenofovir.What information should include in the client's education?

A)Double the next dose if a dose is missed.
B)Take the medicine on an empty stomach.
C)The risk of transmitting the disease through blood contamination is decreased.
D)The drug increases bone mineral density.

Question 33

A client with HIV has been started on AZT as part of the pharmacotherapeutic regimen.What is appropriate for the nurse to teach the client who is on this medication?
Select all that apply.

A)The appropriate use of condoms with sexual activity
B)The importance of taking St.John's wort in conjunction with AZT
C)The need to notify the health care provider if pregnancy occurs
D)That breast-feeding is safe when taking this medication
E)Not to discontinue the medication without notifying the health care provider

Question 34

A client was recently given a prescription for enfuvirtide (Fuzeon).What educational information should be in the teaching plan?

A)Inject the drug into the same abdominal site area daily.
B)Take this drug with vitamin D to help absorption.
C)Some serious drug interactions could occur.
D)Inject the drug subcutaneously twice daily.

Question 35

Although research for a vaccine to prevent HIV infection has been unsuccessful,the nurse states that benefits of HIV vaccine research include:
Select all that apply.

A)The development of new drugs.
B)Advances on how to treat and control the disease.
C)Ways to prevent transmission.
D)Ethical treatment regimens.
E)Vaccine cocktails.

Question 36

A client who is pregnant is taking ritonavir.When asking about the safety of this medication in pregnancy,the nurse informs the client that this drug is in pregnancy category:

A)X.
B)B.
C)C.
D)A.

Question 37

Postexposure prophylaxis (PEP)for occupational HIV exposure should be started within what time period after exposure to be most successful?

A)2 weeks
B)24-36 hours
C)36-48 hours
D)1 week

Question 38

Which drug used to treat HIV-AIDS is a nonnucleoside reverse transcriptase inhibitor (NNRTI)?

A)Lamivudine (Epivir,3TC)
B)Zidovudine (Retrovir,AZT)
C)Indinavir (Crixivan)
D)Efavirenz (Sustiva)

Question 39

The preferred drug to be used in combination with zidovudine for perinatal transmission prevention is:

A)ritonavir.
B)lamivudine.
C)tenofovir.
D)didanosine.

Question 40

The nurse is caring for a client with AIDS who has just learned she is pregnant.She tearfully asks the nurse if her baby will die of AIDS.What is the best course of action for this client?

A)The client will take tipranavir (Aptivus)as prescribed.
B)The client will take raltegravir (Isentress)as prescribed.
C)The client will take indinavir (Crixivan)as prescribed.
D)The client will take zidovudine (Retrovir)as prescribed.