HIVAIDS Nclex Questions

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HIV AID

68 terms thie When preparing the newly diagnosed client with HIV and significant other for discharge, which explanation by the nurse accurately describes proper condom use?

• ''Condoms should be used when lesions on the penis

are present.''

• ''Always position the condom with a space at the tip of

an erect penis.''

• ''Make sure it fits loosely to allow for penile erection.''
• ''Use adequate lubrication such as petroleum jelly.''

B)

• ''Always position the condom with a space at the tip of an erect penis.''

Rationale: This allows for the collection of semen at the tip of the condom.

Which interventions does the home health nurse teach to family members to reduce confusion in the client diagnosed with AIDS dementia? (Select all that apply.)

• Report any behavior changes.
• Use the Glasgow Coma Scale on a daily basis.
• Change the decorations in the home according to the

season.

• Put the bed close to the window.
• Write out all instructions and have the client read them

over before performing a task.

• Ask the client when he or she wants to shower or

bathe.

• Mark off the days of the calendar, leaving open the

current date.

• For continuity, the primary caregiver should be the

only person reorienting the client.

(C, D, F, G)

• Change the decorations in the home according to the season.

Rationale: Seasonal decorations in the home helps with maintaining orientation.

• Put the bed close to the window.

Rationale: This allows the client to visualize seasonal and weather changes and

assists in orientation.

• Ask the client when he or she wants to shower or bathe.

Rationale: Involving the client in planning the daily schedule helps with

orientation.

• Mark off the days of the calendar, leaving open the current date.

Rationale: Using calendars and crossing off past dates helps with orientation.

The home health nurse is making an initial home visit to the client currently living with family members after being hospitalized with pneumonia and newly diagnosed with AIDS. Which statement by the nurse best acknowledges the client's fear of discovery by his family?

• ''Do you think that I could post a sign on your

bedroom door for everyone about the need to wash their hands?''

• ''Is there somewhere private in the home we can go

and talk?''

• ''I hope that all of your family members know about

your disease and how you need to be protected, since you have been so sick.''

• ''It is your duty to protect your family members from

getting AIDS.'' (B)

• ''Is there somewhere private in the home we can go and talk?''

Rationale: A nonthreatening approach initially to find out whether the client has informed family members or desires privacy is very important.The nurse is caring for a patient newly diagnosed with HIV. The patient asks what would determine the actual development of AIDS. The nurse's response is based on the knowledge that what is a diagnostic criterion for AIDS?

• Presence of HIV antibodie
• CD4+ T cell count below 200/µL
• Presence of oral hairy leukoplakia
• White blood cell count below 5000/µl
• CD4+ T cell count below 200/µL

Diagnostic criteria for AIDS include a CD4+ T cell count below 200/µL and/or the development of specified opportunistic infections, cancers, wasting syndrome, or dementia. The other options may be found in patients with HIV disease but do not define the advancement of HIV infection to AIDS.When teaching a patient infected with HIV regarding transmission of the virus to others, which statement made by the patient would indicate a need for further teaching?

• "I will need to isolate any tissues I use so as not to

infect my family."

• "I will notify all of my sexual partners so they can get

tested for HIV."

• "Unprotected sexual contact is the most common

mode of transmission."

• "I do not need to worry about spreading this virus to

others by sweating at the gym."

• "I will need to isolate any tissues I use so as not to infect my family."

HIV is not spread casually. The virus cannot be transmitted through hugging, dry kissing, shaking hands, sharing eating utensils, using toilet seats, or attending school with an HIV-infected person. It is not transmitted through tears, saliva, urine, emesis, sputum, feces, or sweat.The nurse is providing care for a patient who has been living with HIV for several years. Which assessment finding most clearly indicates an acute exacerbation of the disease?

• A new onset of polycythemia
• Presence of mononucleosis-like symptoms
• A sharp decrease in the patient's CD4+ count
• A sudden increase in the patient's WBC count
• A sharp decrease in the patient's CD4+ count

A decrease in CD4+ count signals an exacerbation of the severity of HIV.Polycythemia is not characteristic of the course of HIV. A patient's WBC count is very unlikely to suddenly increase, with decreases being typical. Mononucleosis- like symptoms such as malaise, headache, and fatigue are typical of early HIV infection and seroconversion.

The nurse was accidently stuck with a needle used on an HIV-positive patient. After reporting this, what care should this nurse first receive?

• Personal protective equipment
• Combination antiretroviral therapy
• Counseling to report blood exposures
• A negative evaluation by the manager
• Combination antiretroviral therapy

Postexposure prophylaxis with combination antiretroviral therapy can significantly decrease the risk of infection. Personal protective equipment should be available although it may not have stopped this needle stick. The needle stick has been reported. The negative evaluation may or may not be needed but would not occur first.Which statements accurately describe HIV infection (select all that apply)?

• Untreated HIV infection has a predictable pattern of

progression.

• Late chronic HIV infection is called acquired

immunodeficiency syndrome (AIDS).

• Untreated HIV infection can remain in the early chronic

stage for a decade or more.

• Untreated HIV infection usually remains in the early

chronic stage for 1 year or less.

• Opportunistic diseases occur more often when the

CD4+ T cell count is high and the viral load is low

Correct answers: a, b, c

Rationale: The typical course of untreated HIV infection follows a predictable

pattern. However, treatment can significantly alter this pattern, and disease progression is highly individualized. Late chronic infection is another term for acquired immunodeficiency syndrome (AIDS). The median interval between untreated HIV infection and a diagnosis of AIDS is about 11 years.Screening for HIV infection generally involves

• laboratory analysis of blood to detect HIV antigen.
• electrophoretic analysis for HIV antigen in plasma.
• laboratory analysis of blood to detect HIV antibodies.
• analysis of lymph tissues for the presence of HIV RNA.

Correct answer: c

Rationale: The most useful screening tests for HIV detect HIV-specific antibodies Antiretroviral drugs are used to

• cure acute HIV infection.
• decrease viral RNA levels.
• treat opportunistic diseases.
• decrease pain and symptoms in terminal disease.

Correct answer: b

Rationale: The goals of drug therapy in HIV infection are to (1) decrease the viral load, (2) maintain or raise CD4+ T cell counts, and (3) delay onset of HIV infection- related symptoms and opportunistic diseases.Opportunistic diseases in HIV infection

• are usually benign.
• are generally slow to develop and progress.
• occur in the presence of immunosuppression.
• are curable with appropriate drug interventions.

Correct answer: c

Rationale: Management of HIV infection is complicated by the many opportunistic

diseases that can develop as the immune system deteriorates (see Table 15-10).

Which statement about metabolic side effects of ART is true (select all that apply)?

• These are annoying symptoms that are ultimately

harmless.

• ART-related body changes include central fat

accumulation and peripheral wasting.

• Lipid abnormalities include increases in triglycerides

and decreases in high-density cholesterol.

• Insulin resistance and hyperlipidemia can be treated

with drugs to control glucose and cholesterol.

• Compared to uninfected people, insulin resistance and

hyperlipidemia are more difficult to treat in HIV-infected patients

Correct answers: b, c, d

Rationale: Some HIV-infected patients, especially those who have been infected

and have received ART for a long time, develop a set of metabolic disorders that include changes in body shape (e.g., fat deposits in the abdomen, upper back, and breasts along with fat loss in the arms, legs, and face) as a result of lipodystrophy, hyperlipidemia (i.e., elevated triglyceride levels and decreases in high-density lipoprotein levels), insulin resistance and hyperglycemia, bone disease (e.g., osteoporosis, osteopenia, avascular necrosis), lactic acidosis, and cardiovascular disease.A 52-year-old female patient was exposed to human immunodeficiency virus (HIV) 2 weeks ago through sharing needles with other substance users. What symptoms will the nurse teach the patient to report that would indicate the patient has developed an acute HIV infection?

• Cough, diarrhea, headaches, blurred vision, muscle

fatigue

• Night sweats, fatigue, fever, and persistent generalized

lymphadenopathy

• Oropharyngeal candidiasis or thrush, vaginal candidal

infection, or oral or genital herpes

• Flu-like symptoms such as fever, sore throat, swollen

lymph glands, nausea, or diarrhea

• Flu-like symptoms such as fever, sore throat, swollen lymph glands, nausea, or

diarrhea Clinical manifestations of an acute infection with HIV include flu-like symptoms between 2 to 4 weeks after exposure. Early chronic HIV infection clinical manifestations are either asymptomatic or include fatigue, headache, low-grade fever, night sweats, and persistent generalized lympadenopathy. Intermediate chronic HIV infection clinical manifestations include candidal infections, shingles, oral or genital herpes, bacterial infections, Kaposi sarcoma, or oral hairy leukoplakia. Late chronic HIV infection or acquired immunodeficiency syndrome (AIDS) includes opportunistic diseases (infections and cancer).The nurse is monitoring the effectiveness of antiretroviral therapy (ART) for a 56-year-old man with acquired immunodeficiency syndrome (AIDS). What laboratory study result indicates the medications have been effective?

• Increased viral load
• Decreased neutrophil count
• Increased CD4+ T cell count
• Decreased white blood cell count
• Increased CD4+ T cell count

Antiretroviral therapy is effective if there are decreased viral loads and increased CD4+ T cell counts.