NCLEX HIV & AIDS Drugs Review

A comprehensive practice set covering HIV pathophysiology, ART medication classes, side effects, nursing interventions, and NCLEX-specific alerts.

According to the NCLEX Master Guide, when should a patient with HIV start Antiretroviral Therapy (ART)?

All patients with HIV should start ART regardless of their $CD4$ count.

What is the standard combination therapy regimen for ART?

Two NRTIs plus one drug from another class, preferably an INSTI, NNRTI, or Protease Inhibitor.

What does the $CD4$ count represent in a patient with HIV?

Immune status or immune strength; a decrease indicates worsening immunity.

What does the viral load represent in terms of disease activity?

The amount of virus in the blood; a decrease indicates treatment success, with the goal being 'undetectable.'

Which fluids are responsible for the transmission of HIV?

Blood, semen, vaginal fluids, and breast milk.

In the HIV stages, how is Stage 2 characterized?

Chronic and asymptomatic, though the patient remains infectious.

What are the primary side effects associated with NRTIs (Nucleoside Reverse Transcriptase Inhibitors)?

GI upset, lactic acidosis, and hepatotoxicity.

Which NNRTI should be taken at bedtime on an empty stomach to manage CNS side effects like vivid dreams?

Efavirenz

What metabolic side effects are common with Protease Inhibitors (PIs)?

Hyperglycemia, lipodystrophy (fat redistribution), and increased cholesterol.

Which HIV medication is unique because it is administered via subcutaneous (SQ) injection?

Enfuvirtide

What is the required adherence rate for ART to prevent drug resistance?

$95\text{--}100\text{\%}$ adherence.

What are the timing and duration requirements for Post-Exposure Prophylaxis (PEP)?

Must start within $72$ hours of exposure and continue for $4$ weeks.

What is Immune Reconstitution Inflammatory Syndrome (IRIS)?

A condition where the immune system overreacts and inflammation occurs after starting ART, often making the patient feel worse initially.

Which opportunistic infection, characterized by a dry cough and dyspnea, is treated with TMP-SMX?

PCP pneumonia (caused by fungus).

What is the key drug used during pregnancy to prevent maternal-fetal HIV transmission?

Zidovudine

Which specific lab must be screened before administering Abacavir due to the risk of hypersensitivity reactions?

HLA-B*5701

What specific toxicity is associated with Tenofovir?

Renal toxicity and bone fractures.

Which Protease Inhibitor requires the patient to hydrate with at least $1.5\text{\,}L/\text{day}$ to prevent nephrolithiasis?

Indinavir

What is the 'Black-box warning' associated with Tipranavir?

Hepatotoxicity and intracranial bleeding.

Which opportunistic infection is associated with purple lesions on the skin?

Kaposi sarcoma

What is the 'NCLEX meaning' when a patient's viral load is under $200$ copies?

The virus is considered suppressed; if undetectable, it is not transmissible.

Which drug class is often 'boosted' with Ritonavir or Cobicistat?

Protease Inhibitors (PIs)

What should a nurse monitor for a patient taking Zidovudine due to the risk of bone marrow suppression?

CBC (Complete Blood Count) for signs of anemia or neutropenia.

Which opportunistic infection is a protozoan infection often presenting with neurological symptoms?

Toxoplasmosis

Why are mineral supplements (Mg, Fe, Ca) a concern with INSTIs like Raltegravir?

They can interact; supplements must be separated from the medication dose.