HIVAIDS Nclex Questions

HIV/AIDS Nclex Questions Leave the first rating Students also studied Terms in this set (63) Science MedicineNursing Save Virtual coach testing Ati orientation ...

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David_Johnson6541 Preview Critical Care medication test 20 terms MulancjPreview Critical care medications ATI 25 terms sgonza94Preview ATI Crit 20 terms Asa The nurse is instructing an unlicensed health care worker on the care of the client with HIV who also has active genital herpes. Which statement by the health care worker indicates effective teaching of standard precautions?''Washing my hands and putting on a gown and gloves is what I must do before

starting care.'' Rationale: Standard precautions include whatever personal

protective equipment (PPE) is necessary for the prevention of transmission of HIV and genital herpes.Which statement made to the nurse by a health care worker assigned to care for the client with HIV indicates a breach of confidentiality and requires further education by the nurse?''The other health care worker and I were out in the hallway discussing how we were concerned about getting HIV from our client, so no one could hear us in the client's room.'' When preparing the newly diagnosed client with HIV and significant other for discharge, which explanation by the nurse accurately describes proper condom use?''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.

The nurse presents a seminar on HIV testing to a group of seniors and their caregivers in an assisted living facility.Which responses fit the Centers for Disease Control and Prevention's (CDC's) recommendations for HIV testing?

• ''I am 78 years old and I was treated and cured of syphilis many years ago.''

Rationale: People who have had sexually transmitted diseases should be tested

for HIV.

• ''Seven years ago, I was released from a penitentiary.''

Rationale: HIV testing is recommended for people who are or have been in jails or prisons.

• 'At 68, I am going to get married for the fourth time.''

Rationale: People who are planning to get married should be tested for HIV.

Which interventions does the home health nurse teach to family members to reduce confusion in the client diagnosed with AIDS dementia?

1. Change decorations in home according to season. Rationale: Seasonal

decorations in home helps maintain orientation. 2. Put bed close to window. This allows client to visualize seasonal and weather changes and assists in orientation.

• Ask client when he or she wants to shower or bathe. 4. Mark off days of

calendar, leaving open current date. 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?

''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?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.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. "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.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 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.A pregnant woman who was tested and diagnosed with HIV infection is very upset. What should the nurse teach this patient about her baby's risk of being born with HIV infection?"Treatment with antiretroviral therapy will decrease the baby's chance of HIV infection." On average, 25% of infants born to women with untreated HIV will be born with HIV. The risk of transmission is reduced to less than 2% if the infected pregnant woman is treated with antiretroviral therapy. Duration and frequency of contact with the HIV organism is one variable that influences whether transmission of HIV occurs.A 25-year-old male patient has been diagnosed with HIV.The patient does not want to take more than one antiretroviral drug. What reasons can the nurse tell the patient about for taking more than one drug?Viral replication will be inhibited. The major advantage of using several classes of antiretroviral drugs is that viral replication can be inhibited in several ways, making it more difficult for the virus to recover and decreasing the likelihood of drug resistance that is a major problem with monotherapy. Combination therapy also delays disease progression and decreases HIV symptoms and opportunistic diseases. HIV cannot be cured. CD4+ T cell counts increase with therapy. There are dangerous interactions with many antiretroviral drugs and other commonly used drugs.The woman is afraid she may get HIV from her bisexual husband. What should the nurse include when teaching her about preexposure prophylaxis (select all that apply)?Using male or female condoms, having monthly HIV testing for the patient and her husband, and the woman taking emtricitabine and tenofovir regularly has shown to decrease the infection of heterosexual women having sex with a partner who participates in high-risk behavior.

The nurse was accidently stuck with a needle used on an HIV-positive patient. After reporting this, what care should this nurse first receive?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.The HIV-infected patient is taught health promotion activities including good nutrition; avoiding alcohol, tobacco, drug use, and exposure to infectious agents; keeping up to date with vaccines; getting adequate rest; and stress management. What is the rationale behind these interventions that the nurse knows?Delaying disease progression. These health promotion activities along with mental health counseling, support groups, and a therapeutic relationship with health care providers will promote a healthy immune system, which may delay disease progression. These measures will not cure HIV infection, prevent disease transmission, or increase self-care activities The patient is admitted to the ED with fever, swollen lymph glands, sore throat, headache, malaise, joint pain, and diarrhea. What nursing measures will help identify the need for further assessment of the cause of this patient's manifestations (select all that apply)?Assessment of sexual behavior. Assessment of drug and syringe use. With these symptoms, assessing this patient's sexual behavior and possible exposure to shared drug equipment will identify if further assessment for the HIV virus should be made or the manifestations are from some other illness (e.g., lung sounds and living conditions may indicate further testing for TB).Transmission of HIV from an infected individual to another most commonly occurs as a result of unprotected anal or vaginal sexual intercourse.Rationale: Unprotected sexual contact (semen, vaginal secretions, or blood) with a partner During HIV infection

• the virus replicates mainly in B-cells before spreading

to CD4+ T cells.

• infection of monocytes may occur, but antibodies

quickly destroy these cells.

• a long period of dormancy develops during which HIV

cannot be found in the blood and there is little viral replication the immune system is impaired predominantly by the eventual widespread destruction of CD4+ T cells.

Rationale: Immune dysfunction in HIV disease is caused predominantly by

damage to and destruction of CD4+ T cells meaning T helper cells or CD4+ T lymphocytes.Which statements accurately describe HIV infection (select all that apply)?

• Untreated HIV infection has a predictable pattern of progression. b. Late

chronic HIV infection is called acquired immunodeficiency syndrome (AIDS). c.Untreated HIV infection can remain in the early chronic stage for a decade or

more. 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.A diagnosis of AIDS is made when an HIV-infected patient has

a CD4+ T cell count below 200/µL. Rationale: AIDS is diagnosed when an

individual with HIV infection meets one of several criteria; one criterion is a CD4+ T cell count below 200 cells/L. Other criteria are listed in Table 15-9.Screening for HIV infection generally involveslaboratory analysis of blood to detect HIV antibodies.Rationale: The most useful screening tests for HIV detect HIV-specific antibodies

Antiretroviral drugs are used todecrease viral RNA levels.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 infectionoccur in the presence of immunosuppression. 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)?

• ART-related body changes include central fat accumulation and peripheral

wasting. 2. Lipid abnormalities include increases in triglycerides and decreases in high-density cholesterol. 3. Insulin resistance and hyperlipidemia can be treated

with drugs to control glucose and cholesterol. 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.Which strategy can the nurse teach the patient to eliminate the risk of HIV transmission?Using sterile equipment to inject drugs. Rationale: Access to sterile equipment is an important risk-elimination tactic. Some communities have needle and syringe exchange programs (NSEPs) that provide sterile equipment to users in exchange for used equipment. Cleaning equipment before use is a risk-reducing activity. It decreases the risk when equipment is shared, but it takes time, and a person in drug withdrawal may have difficulty cleaning equipment.What is the most appropriate nursing intervention to help an HIV-infected patient adhere to a treatment regimen?Assess the patient's routines and find adherence cues that fit into the patient's life

circumstances. Rationale: The best approach to improve adherence to a treatment

regimen is to learn about the patient's life and assist with problem solving within the confines of that life.The nurse is providing postoperative care for a 30-year- old female patient after an appendectomy. The patient has tested positive for human immunodeficiency virus (HIV). What type of precautions should the nurse observe to prevent the transmission of this disease?Standard precautions are indicated for prevention of transmission of HIV to the health care worker. HIV is not transmitted by casual contact or respiratory droplets. HIV may be transmitted through sexual intercourse with an infected partner, exposure to HIV-infected blood or blood products, and perinatal transmission during pregnancy, at delivery, or though breastfeeding.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?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).