Chapter 56 (Test 3)

Question 1

When assigned to a newly admitted patient with AIDS, the nurse says, “I’m pregnant. It is not safe for me or my baby if I am assigned to his case.” Which response is the most appropriate response by the charge nurse?
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.”
b. “You should ask for a transfer to another unit because contact with this patient
would put you and your baby at risk for AIDS.”
c. “Wear a mask, gown, and gloves every time you go into his room and use
disposable trays, plates, and utensils to serve his meals.”
d. “We should recommend that this patient be transferred to an isolation unit.”

Answer 1

ANS: A

Question 2

The anxious male patient is fearful that he has been exposed to a person with an HIV infection. He states he does not want to go to a laboratory for the ELISA tests because he does not want to be identified. Which response would be the nurse’s most helpfulresponse?
a. “There really is not an option, you will need to get the Western blot test first.”
b. “There is an FDA-approved home test called OraQuick.”
c. “The rapid test Reveal can identify all the HIV strains.”
d. “You can be tested anonymously for ELISA. If you are seronegative, your
concerns are over.”

Answer 2

ANS: B

Question 3

The patient, age 21, has been treated for chlamydia and has a history of recurrent herpes. Which factors will the nurse counsel this patient about?
a. Sexual history, risk reduction measures, and testing for HIV
b. Getting an appointment at a family planning clinic
c. Testing for HIV and what the test results mean d. Abstinence and a monogamous relationship

Answer 3

ANS: A

Question 4

A patient has just been diagnosed as HIV-positive. He asks the nurse, “Does this mean I have AIDS?” Which response would be most informative?
a. “Most people get AIDS within 3 to 12 weeks after they are infected with HIV.”
b. “Don’t worry. You may never get AIDS if you eat properly, exercise, and get
plenty of rest.”
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.”
d. “You can expect to develop signs and symptoms of AIDS within 6 months.”

Answer 4

ANS: C

Question 5

Which factor is a CDC criterion for the progression of HIV infection to AIDS?
a. Increase in viral load
b. Decreased ratio of CD8 to CD4
c. Increase in white blood cells
d. Increased reactivity to skin tests

Answer 5

ANS: A

Question 6

Which factor should the nurse look for when reviewing a patient’s chart to determine whether she has progressed from HIV disease to AIDS?
a. CD4+ count below 500, chronic fatigue, night sweats
b. HIV-positive test result, CD4+ count below 200, history of opportunistic disease
c. Weight loss, persistent generalized lymphadenopathy, chronic diarrhea
d. Fever, chills, CD4+ count below 200

Answer 6

ANS: B

Question 7

A male patient is advised to receive HIV antibody testing because of his multiple sexual partners and injectable drug use. Which information will the nurse provide for the patient to ensure understanding?
a. HIV antibody testing determines the number of viruses detected
b. HIV antibody tests can detect antibodies in the blood or oral fluid.
c. HIV antibody testing determines the likelihood a person will develop an
opportunistic disease
d. If the HIV tests are seronegative, the patient can be assured that he is not infected.

Answer 7

ANS: B

Question 8

A 28-year-old married attorney with one child is in the first trimester of her second pregnancy. The patient states that she is at no risk for HIV, so she would not need to be counseled about testing for HIV. Which is the most appropriate response?
a. “You are a professional woman in a monogamous relationship. You are obviously
not at risk.”
b. “Women are not at great risk. The greatest risk is with men who have sex with
men.”
c. “ “The decline in cases of pediatric AIDS is likely due to universal counseling and
testing of pregnant women”
d. “We need to review your chart to determine if your first child was infected.”

Answer 8

ANS: C

Question 9

A young male patient who has sex with males is being treated for his third sexually transmitted disease. He does not see why he should use condoms, because “they don’t work.” Which is the most appropriate response?
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.”
b. “You are correct. Condoms don’t always work, so your best protection is to limit
your number of partners.”
c. “Condoms do not provide 100% protection, so you should always discuss with
your sexual partners their HIV status or ask if they have any STD.”
d. “Condoms do not provide 100% protection, but when used with a spermicide you
can be assured of complete protection against HIV and other STDs.”

Answer 9

ANS: A

Question 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. Currently, he has a low-grade fever, severe diarrhea, and a productive cough. He is admitted with Pneumocystis jiroveci. Which precaution will the nurse take when caring for the patient?
a. Use a gown, mask, and gloves when assisting the patient with his bath.
b. Wear a gown when assisting the patient to use the bedpan.
c. Use a gown, mask, and gloves to administer oral medications.
d. Use a mask when taking the patient’s temperature.

Answer 10

ANS: A

Question 11

The nurse will instruct the patient who is diagnosed with AIDS to report which signs of Kaposi’s sarcoma?
a. reddish-purple skin lesions.
b. open, bleeding skin lesions.
c. blood-tinged sputum.
d. watery diarrhea.

Answer 11

ANS: A

Question 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. Which factor is true of the patient during this time?
a. He is not dangerous to anyone.
b. He experiences minor symptoms only.
c. He experiences decreased immunity.
d. He is contagious.

Answer 12

ANS: D

Question 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 which abnormality?
a. Opportunistic infection
b. A positive ELISA or Western blot test
c. Weight loss, fever, and generalized lymphedema
d. CD4+ lymphocyte count less than 200 mm3

Answer 13

ANS: D

Question 14

For which reason will interventions such as promotion of nutrition, exercise, and stress reduction be undertaken by the nurse for patients who have HIV infection?
a. They will promote a feeling of well-being in the patient.
b. They will improve immune function.
c. They will prevent transmission of the virus to others.
d. They will increase the patient’s strength and ability to care for himself or herself.

Answer 14

ANS: B

Question 15

A patient is concerned about telling others about an HIV infection diagnosis. Which information will the nurse stress when discussing this concern?
a. Care providers and sexual partners should be told about the diagnosis.
b. There is no reason to hide the disease.
c. Secrecy is a poor idea because it will lower self-esteem.
d. The diagnosis will be obvious to most people with whom the patient will come
into contact.

Answer 15

ANS: A

Question 16

The patient who has HIV 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 which phases?
a. viremia, clinical latency, opportunistic diseases, and death.
b. asymptomatic phase, clinical latency, ARC, and AIDS.
c. acute retroviral syndrome, early infection, early symptomatic disease, and AIDS.
d. transitional viral syndrome, inactive disease, early symptomatic infection, and
opportunistic diseases.

Answer 16

ANS: C

Question 17

While teaching community groups about AIDS, which information will the nurse indicate as the most common method of transmission of the HIV?
a. Sexual contact with an HIV-infected partner
b. Perinatal transmission
c. Exposure to contaminated blood
d. Nonsexual exposure to saliva and tears

Answer 17

ANS: A

Question 18

Which substance do the activated monocytes and macrophages produce in the presence of an inflammatory process?
a. Red blood cells
b. White blood cells
c. Neopterin
d. Natural killer (NK) cells

Answer 18

ANS: C

Question 19

For most people who are HIV-positive, marker antibodies are usually present 10 to 12 weeks after exposure. Which term describes the development of these antibodies?
a. Immunocompetence
b. Seroconversion
c. Opportunistic infection
d. Immunodeficiency

Answer 19

ANS: B

Question 20

Which information will the nurse emphasize when counseling an anxious HIV-positive mother about the care of her HIV-positive infant?
a. The baby will develop AIDS and refer her to a local AIDS support group. The
baby will remain HIV-positive for the rest of its life.
b. Although infants of HIV-infected mothers may test positive for HIV antibodies,
not all infants are infected with the virus.
c. She has not yet developed AIDS, and that it is possible the baby will not develop
AIDS for many years.
d. If the infant is started on zidovudine (AZT) within the first month after delivery, AIDS can be prevented.

Answer 20

ANS: B

Question 21

For which reason are snacks high in potassium, such as bananas and apricot nectar, recommended for a patient with an HIV infection who has diarrhea?
a. Electrolytes are lost through diaphoresis.
b. Sodium is lost through frequent diarrhea.
c. To replace the potassium lost in diarrhea
d. Potassium helps fight infection.

Answer 21

ANS: C

Question 22

The says, “I don’t understand why I am going to be getting doses of testosterone. What good will that do me now?” Which fact will the nurse keep in mind about testosterone when responding?
a. It can lower viral load.
b. It can lighten depression.
c. It can increase lean body mass.
d. It can increase appetite.

Answer 22

ANS: C

Question 23

After which period will the home health nurse make a mental health appointment for a patient with an HIV infection after assessing a diminished ability to attend to daily functioning?
a. 1 week
b. 2 weeks
c. 3 weeks
d. 1 month

Answer 23

ANS: B

Question 24

The patient with an HIV infection who has just seroconverted says he just cannot take all those confusing, expensive antiretroviral (ART) medications. He says he still feels fine, anyway. Which fact will the nurse keep in mind when counseling this patient?
a. Resumption of the ART later in the disease is just as effective.
b. Adherence to the ART protocol is essential to the success of the treatment.
c. Cessation of the ART may prevent the emergence of a resistant strain of HIV.
d. Once ART is initiated, it cannot be restarted in the same patient.

Answer 24

ANS: B

Question 25

Which statement regarding antiretroviral medication is NOT true?
a. Recycling drugs previously taken can sometimes improve viral suppression.
b. Certain combinations of antiretroviral drugs may reverse the resistance to a single
drug.
c. Scientists stress that while medication cocktails can be minimally effective,
administration of a single strong antiretroviral medication is the most effective
regimen.
d. Some therapies exist that can reduce the quantity of circulating virus in the blood,
even rendering the levels of virus in the blood undetectable.

Answer 25

ANS: C

Question 26

The historical progress of the HIV infection began to be tracked in 1979. Which is the first historical event in sequence of its discovery?
a. Infection in heterosexual men and women
b. Infection in hemophiliacs
c. Infection in injection drug users
d. Increased incidence of Kaposi carcinoma in young homosexual men
e. Increased incidence of P. jiroveci (previously PCP)

Answer 26

ANS: E

Question 27

MULT RESP
Which is an early signs or symptom of an HIV infection? (Select all that apply.)
a. Dry mouth
b. Weight loss
c. Sore throat
d. Vaginal dryness
e. Nausea
f. Dyspnea

Answer 27

ANS: B, C, F

Question 28

Which is a method in which children with AIDS could have 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
c. From other children who are HIV-positive
d. From receiving a transfusion contaminated with the HIV
e. From breast-feeding by an HIV-positive mother

Answer 28

ANS: A, B, D, E

Question 29

The home health nurse designing a teaching plan for a person with HIV disease that would support weight gain would include information pertaining to which intervention? (Select all that apply.)
a. limiting fluid intake.
b. eating high-protein/high-calorie diet.
c. drinking nutritional supplements (Boost, Sustacal, etc.).
d. eating several small meals during the day.
e. providing referrals to dietitians.
f. resisting weight training.

Answer 29

ANS: B, C, D, E, F

Question 30

Which food would a nurse recommend for a person with debilitating diarrhea because of HIV infection? (Select all that apply.)
a. Bananas
b. Ensure
c. Fresh broccoli
d. Cooked fruits and vegetables
e. Red meat
f. Apricot nectar

Answer 30

ANS: A, D, F

Question 31

In which way does the HIV-2 virus compare to the HIV-1 virus? (Select all that apply.)
a. It is transmitted the same way as HIV-1
b. It is less virulent.
c. It results in the HIV-infected person to experience immunodeficiency issues more
slowly.
d. It predisposes the HIV-infected person to be a long-term nonprogressor.
e. It develops high viral loads.

Answer 31

ANS: A, B, C, D

Question 32

Which is an example of the AIDS wasting syndrome in a patient with an HIV infection? (Select all that apply.)
a. Episodes of vomiting for 20 days
b. Appearance of Kaposi sarcoma
c. Loss of 10% of body mass
d. Marked hair loss
e. Episodes of diarrhea for 30 days
f. Episodes of hypotension

Answer 32

ANS: C, E