A client with AIDS is exhibiting shortness of breath, cough, and fever. The nurse most likely would suspect infection with which of the following?
answer
Pneumocystis jiroveci
question
A male patient has come into the free clinic asking to be tested for HIV infection. The patient asks the nurse how the test works. The nurse responds that if the testing shows antibodies to the AIDS virus are present in the blood, this indicates what?
answer
The patient has been infected with HIV.
question
A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?
answer
Stool specimen for ova and parasites
question
A client taking abacavir has developed fever and rash. What is the priority nursing action?
answer
Report to the health care provider: Fever and a rash could be indicative of a hypersensitivity reaction. Hypersensitivity reactions are also known as anaphylactic reactions and often involve skin rashes, fever, and bronchopulmonary issues such as bronchial constriction. The health care provider should be notified immediately and the medication stopped. Interventions need to be taken to assure that the client's airway is not compromised.
question
The nurse receives a phone call at the clinic from the family of a patient with AIDS. They state that the patient started "acting funny" after complaining of headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member?
answer
"The patient may have cryptococcal meningitis and will need to be evaluated by the physician."
question
A nurse is working in a support group for clients with acquired immunodeficiency syndrome (AIDS). Which point is most important for the nurse to stress?
answer
Following safer-sex practices
question
A client with AIDS is brought to the clinic by their family. The family tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms?
answer
HIV encephalopathy
(aids dementia)
question
A client who is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication will the client take for the treatment of this infection?
answer
trimethoprim-sulfamethoxazole
question
A patient in the clinic states, "My boyfriend told me he went to the clinic and was treated for gonorrhea." While testing for the sexually transmitted infection (STI), what else should be done for this patient?
answer
Inform the patient that it would be beneficial to test for HIV.
question
Which is usually the most important consideration in the decision to initiate antiretroviral therapy?
answer
CD4+ counts
question
A nurse is implementing appropriate infection control precautions for a client who is positive for human immunodeficiency virus (HIV). The nurse demonstrates a need for a review of transmission routes by identifying which body fluid as a means of transmission?
answer
Urine
question
A client with AIDS develops pneumocystis pneumonia. The nurse would most likely expect to include administration of which agent in the client's plan of care?
answer
TMP-SMZ
question
The nurse is performing an admission assessment on a patient with AIDS. When assessing the patient's gastrointestinal (GI) system what is most likely to be the priority nursing diagnosis?
answer
Diarrhea
question
While caring for a patient with pneumocystis pneumonia, the nurse assesses flat, purplish lesions on the back and trunk. What does the nurse suspect these lesions indicate?
answer
Kaposi's sarcoma
question
Which blood test confirms the presence of antibodies to HIV?
answer
Enzyme-linked immunoabsorbent assay (ELISA)
question
Which of the following indicates that a client with HIV has developed AIDS?
answer
Herpes simplex ulcer persisting for 2 months: A diagnosis of AIDS cannot be made until the person with HIV meets case criteria established by the Centers for Disease Control and Prevention. The immune system becomes compromised. The CD4 T-cell count drops below 200 cells and develops one of the opportunistic diseases, such as Pneumocystis carinii pneumonia, candidiasis, cytomegalovirus, or herpes simplex.
question
A healthcare worker has been exposed to the blood of an HIV-positive client and is awaiting the results of an HIV test. In the meantime, what precautions must the healthcare worker take to prevent the spread of infection?
answer
Follow the same sexual precautions as someone who has been diagnosed with AIDS.
question
A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client?
answer
Bank autologous blood: Banking autologous blood that is self-donated is the safest option for the client.
question
The nurse completes a history and physical assessment on a patient with AIDS who was admitted to the hospital with respiratory complications. The nurse knows to assess for the most common infection in persons with AIDS (80% occurrence). This is:
answer
Pneumocystic pneumonia (PCP) is one of the first and most common opportunistic infections associated with AIDS. It may be present despite the absence of crackles. If untreated, PCP progresses to cause significant pulmonary impairment and respiratory failure.
question
When assisting the client to interpret a negative HIV test result, the nurse informs the client that the results mean that
answer
the body has not produced antibodies to the AIDS virus: A negative test result should be interpreted as demonstrating that if infected, the body has not produced antibodies (which takes from 3 weeks to 6 months or longer)
question
A client visits the nurse complaining of diarrhea every time they eat. The client has AIDS and wants to know what they can do to stop having diarrhea. What should the nurse advise?
answer
Avoid residue, lactose, fat, and caffeine.
question
A client has been diagnosed with HIV and has been placed on antiretroviral therapy. What does the nurse inform the client will be required for determining the progression of the disease as well as guiding drug therapy?
answer
Viral load and T4-cell counts will be performed every 2 to 3 months: Viral load tests and T4-cell counts may be performed every 2 to 3 months once it is determined that a person is HIV positive
question
A client is beginning highly active antiretroviral therapy (HAART). The client demonstrates an understanding of the need for follow up when he schedules a return visit for viral load testing at which time?
answer
6 wks: Viral load tests are measured immediately before initiating antiretroviral therapy and then again in 2 to 8 weeks. In most clients, adherence to a regimen of potent antiretroviral agents should result in a large decrease in the viral load by 2 to 8 weeks. Therefore, a return visit at 6 weeks would be in this time frame.
question
The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is:
answer
Chronic diarrhea.
question
HIV is harbored within which type of cell?
answer
Lymphocyte
question
A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay (ELISA) with positive results twice. The next step for the nurse to explain to the client for confirmation of the diagnosis is to perform a:
answer
Western blot test for confirmation of diagnosis.
question
A client who is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication will the client take for the treatment of this infection?
answer
trimethoprim-sulfamethoxazole
(Bactrim, Septra)
question
A nurse is preparing an in-service presentation about human immunodeficiency virus (HIV) for a group of new graduate nurses. As part of the presentation, the nurse is planning to describe the events that occur once HIV enters the host cell. Which of the following would the nurse describe as the first step?
answer
Attachment
question
A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wartlike lesions on my vagina. This is happening quite often." What should the nurse consult with the physician regarding?
answer
testing the client for the presence of HIV
question
The nurse teaches the client that reducing the viral load will have what effect?
answer
Longer survival
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