Ch 56: Care of the Patient with HIV/AIDS

1. A patient, age 25, has just been admitted to the unit with a diagnosis of AIDS. The nurse's colleague says, "I'm pregnant. It is not safe for me or my baby if I am assigned to his case." The nurse's response should be

a. "This patient would not be a risk for your baby if you use standard precautions and avoid direct contact with blood or body fluids."

2. Members of the local emergency medical service unit have just transported an accident victim to the emergency department. They tell the ED nurse that the victim has AIDS, and they have blood on their hands and clothing. The nurse advises them to wash their hands and to change any clothing that is wet with blood. The nurse talks to them about getting a baseline HIV test and about future testing. They ask the nurse how long it will take before they will know if they are infected. The nurse's response should be

b. "You will need to be tested in 3 months and again in 6 months, because 95% of people seroconvert to antibody-positive in 3 months and 99% in 6 months."

3. The patient, age 21, has been treated for chlamydia and has a history of recurrent herpes. What should the nurse plan to do next?

a. Counsel this patient about her sexual history, risk reduction measures, and testing for HIV.

4. A patient has just been told by his physician that he is HIV-positive. He asks the nurse, "When will I get AIDS?" The nurse's response should be

c. "It varies with every individual, but the average time is 8 to 10 years from the time a person is infected, and some go much longer."

5. A patient asks the nurse, "How does HIV cause AIDS?" The nurse's response should be

a. "HIV attacks the immune system, a system that protects the body from foreign invaders, making it unable to protect the body from organisms that cause diseases."

6. In reviewing a patient's chart to determine whether she has progressed from HIV disease to AIDS, the nurse should look for

b. HIV-positive test result, CD4+ count below 200, history of opportunistic disease.

7. A patient is advised to be tested for HIV because of his multiple sexual partners and injectable drug use. The nurse should ensure that this patient understands the test by informing him that:

b. The blood is tested with an ELISA; if positive, it is tested again with an ELISA, followed by a Western blot if the second ELISA is positive.

8. A 28-year-old married attorney with one child is in the first trimester of her second pregnancy. A colleague states that she is at no risk for HIV, so she would not need to be counseled about testing for HIV. The nurse's most appropriate response would be

c. "The fastest-growing segment of the population with AIDS is women and children. We need to assess her risks."

9. A young gay patient being treated for his third sexually transmitted disease does not see why he should use condoms, because "they don't work." The nurse's most appropriate response would be

a. "Condoms may not provide 100% protection, but when used correctly and consistently with every act of sexual intercourse they reduce your risk of getting infected with HIV or other sexually transmitted diseases."

10. A 21-year-old male who has been an IV heroin user has been experiencing fever, weight loss, and diarrhea and has been diagnosed as having AIDS. At this time, he has a low-grade fever, severe diarrhea, and a productive cough. He is admitted with Pneumocystis jiroveci. When caring for the patient, the nurse should

a. use a gown, mask, and gloves when assisting the patient with his bath.

11. Kaposi's sarcoma is a common problem in patients with AIDS. The nurse should instruct the patient who is diagnosed with AIDS to report which sign of Kaposi's sarcoma?

a. Reddish-purple skin lesions

12. A patient states that he feels terrific, but a blood test shows that he is HIV-positive. It is important for the nurse to discuss with him that HIV may remain dormant for several years. During this time, the patient

d. is contagious.

13. To be diagnosed as having AIDS, the patient must be HIV-positive, have a compromised immune system without known immune system disease or recent organ transplant, and present with

d. CD4+ lymphocyte count below 200 mm3.

14. Interventions such as promotion of nutrition, exercise, and stress reduction should be undertaken by the nurse for patients who have HIV infection, primarily because these interventions will

b. improve immune function.

15. A patient is concerned about telling others he has HIV infection. In discussing his concerns, which response by the nurse is most appropriate?

a. Care providers and sexual partners should be told about his diagnosis.

16. The HIV patient asks the nurse about what to expect in terms of disease progression. The nurse tells this patient that although the disease can vary greatly among individuals, the usual pattern of progression includes

c. acute retroviral syndrome, early infection, early symptomatic disease, and AIDS.

17. While teaching community groups about AIDS, the nurse informs people that the most common method of transmission of the HIV virus currently is

a. sexual contact with an HIV-infected partner.

18. The nurse clarifies that the least likely method for children to contract AIDS is

c. from other children who have AIDS.

19. For most people who are HIV-positive, marker antibodies are usually present 10 to 12 weeks after exposure. The development of these antibodies is called

b. seroconversion.

20. A patient, age 28, has a history of IV drug use and has tested positive for HIV. About 2 weeks ago, she delivered a baby who has tested positive for HIV. This patient will not care for the baby because she believes the baby will die soon. In counseling her about the care of her infant, which approach by the nurse is most appropriate?

b. Inform her that although infants of HIV-infected mothers may test positive for HIV antibodies, not all infants are infected with the virus.

21. Snacks such as bananas and apricot nectar, which are high in potassium, are recommended because

b. diarrhea is a common problem.

22. In addition to handwashing, what important precaution must the nurse take when changing the dressing of an AIDS patient?

c. Wearing gloves

23. HIV patients who are suffering from depression should be frequently assessed for

d. suicidal ideation.

24. What is the best way to prevent transmission of HIV to a fetus or infant?

b. Avoidance of pregnancy

25. A nursing intervention to help infected HIV patients regain lost weight is

b. eat small meals throughout the day.

26. is a type of sexual option classified as "no risk" for a person to become infected with HIV virus.

Abstinence

27. Which are signs and symptoms of HIV infection? (Select all that apply.)

b. Weight loss

c. Sore throat

f. Dyspnea

28. Most children with AIDS contracted their disease (Select all that apply.)

a. during intrauterine life with an HIV-positive mother.

b. during the birth process of an HIV-positive mother.

d. from receiving a transfusion contaminated with the HIV virus.

e. from breast feeding by an HIV-positive mother.

29. Which nutritional intake will assist the patient in regaining lost weight? (Select all that apply.)

c. Offer nutritional supplements (Boost, Sustacal, etc.)

d. Eat several small meals during the day

e. Provide referrals to dietitians and social workers

30. Nutritional management can help control diarrhea. Which foods would be recommended on a diarrhea diet? (Select all that apply.)

a. Bananas and apricot nectar

d. Cooked fruits and vegetables