Lewis Chapter 17: Infection and HIV Flashcards
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 which of the following is a diagnostic criterion for AIDS?
A. Presence of HIV antibodies
B. CD4+ T-cell count <200/µL
C. White blood cell count <5 000/µL
D. Presence of oral hairy leukoplakia
B. Diagnostic criteria for AIDS include a CD4+ T-cell count <200/µL and the development of specified opportunistic infections, cancers, wasting syndrome, or dementia. The other options may be found in clients with HIV disease, but do not define the advancement of the disease to AIDS.
The nurse is teaching a patient that has been diagnosed with HIV about transmission of the virus to others. Which of the following statements made by the patient would identify a need for further education?
A. “I will need to isolate any tissues I use so as not to infect my family.”
B. “I will notify all of my sexual partners so they can get tested for HIV.”
C. “Unprotected sexual contact is the most common mode of transmission.”
D. “I do not need to worry about spreading this virus to others by sweating at the gym.”
A. 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. It is not transmitted through tears, saliva, urine, emesis, sputum, feces, or sweat.
A hospital has seen a recent increase in the incidence of health care–associated infections (HAIs). Which of the following measures should be prioritized in the response to this trend?
A. Use of gloves during patient contact.
B. Frequent and thorough handwashing.
C. Prophylactic, broad-spectrum antibiotics.
D. Fitting and appropriate use of N95 masks.
B. Handwashing remains the mainstay of the prevention of health care–associated infections (HAIs). Gloves, masks, and antibiotics may be appropriate in specific circumstances, but none of these replaces the central role of vigilant, thorough hand hygiene.
Which of the following scenarios is an indication for the application of standard precautions when providing patient care?
A. All patients, regardless of diagnosis.
B. Pediatric and older-person patients.
C. Patients who are immune-compromised.
D. Patients with a history of infectious diseases.
A. Standard precautions are designed for all care of all clients in hospitals and health care facilities.
The nurse is providing care for a patient who has been living with HIV for several years. Which of the following assessment findings most clearly indicates a compromised immune system?
A. A new onset of polycythemia
B. Presence of mononucleosis-like symptoms.
C. A CD4 fraction of 12%.
D. A sudden increase in the patient’s WBC count.
C. CD4 fraction is a stable number for most people, with a normal range of 27% to 60%. A CD4 fraction of less than 15% is associated with immune compromise. Polycythemia is not characteristic of the course of HIV. A client’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.
What are nursing responsibilities regarding emerging and re-emerging infections? (Select all that apply.)
a. Educating clients about risks of developing emerging and re-emerging infections
b. Maintaining awareness of unusual disease patterns
c. Participating in immunization programs
d. Using infection control procedures
e. Examining prescribing practices to ensure appropriate antibiotic use
A, B, C, D, E.
Which of the following antibiotic-resistant organisms are resistant to normal hand soap?
a. Vancomycin-resistant enterococci
b. Methicillin-resistant Staphylococcus aureus
c. Penicillin-resistant Streptococcus pneumoniae
d. β-Lactamase–producing Klebsiella pneumoniae
A.
How is human immunodeficiency virus (HIV) transmitted?
a. Most commonly as a result of sexual contact
b. In all infants born to women with HIV infection
c. Only when there is a large viral load in the blood
d. Frequently in health care workers with needle-stick exposures
A.
Which is the common physiological change after HIV infection?
a. The virus replicates mainly in B lymphocytes before spreading to CD4+ T cells in lymph nodes.
b. The immune system is impaired predominantly by infection and destruction of CD4+ T cells.
c. Infection of monocytes may occur, but these cells are destroyed by antibodies produced by oligodendrocytes.
d. A long period develops during which the virus is not found in the blood and there is little viral replication.
B.
Which of the following statements is false?
a. “Infection with HIV results in a chronic disease with acute exacerbations and progression if left untreated.”
b. “Untreated HIV infection can remain in the early chronic stage for a decade or more.”
c. “Late-stage infection is often called acquired immune deficiency syndrome (AIDS).”
d. “Opportunistic diseases occur more often when the CD4+ T-cell count is high and the viral load is low.”
D.
When is AIDS diagnosed in an HIV-infected person?
a. When an AIDS-defining illness develops
b. When the amount of HIV in the blood increases
c. When the CD4:CD8 ratio is reversed to less than 2:1
d. When the person has oral hairy leukoplakia, an infection caused by Epstein-Barr virus
A.
What does screening for HIV infection generally involve?
a. Laboratory analysis of blood to detect HIV antigen and antibody
b. Electrophoretic analysis of HIV antigen in plasma
c. Laboratory analysis of blood to detect increased T cells
d. Analysis of lymph tissues for the presence of HIV RNA
C.
What is the indication for use of antiretroviral medications?
a. Cure acute HIV infection
b. Treat opportunistic diseases
c. Decrease viral RNA levels
d. Supplement radiation therapy and surgery
C.
Which statement about metabolic adverse effects of ART is true? (Select all that apply.)
a. “These are annoying symptoms that are ultimately harmless.”
b. “ART-related body changes include central fat accumulation and peripheral wasting.”
c. “Lipid abnormalities include increases in triglycerides and decreases in high-density cholesterol.”
d. “Insulin resistance and hyperlipidemia can be treated with medications to control glucose and cholesterol.”
e. “Insulin resistance and hyperlipidemia are more difficult to treat in HIV-infected clients than in uninfected people.”
B, C, D.
Which of the following descriptions of opportunistic diseases in HIV infection is correct?
a. Usually occur one at a time
b. Generally slow to develop and progress
c. Occur in the presence of immunosuppression
d. Curable with appropriate pharmacological intervention
C.
Of the following, which is the most appropriate nursing intervention to help an HIV-infected client adhere to the treatment regimen?
a. Give the client a DVD and a brochure to view and read at home.
b. Volunteer to “set up” a medication pillbox for a week at a time.
c. Inform the client that the adverse effects of the medications are bad but that they go away after a while.
d. Assess the client’s lifestyle and find adherence cues that fit into the client’s lifestyle.
D.
Which strategy can the nurse teach the client to eliminate the risk of transmission of HIV?
a. Using sterile equipment to inject drugs
b. Cleaning equipment used to inject drugs
c. Taking zidovudine (azidothymidine [AZT], ZDV, Retrovir) during pregnancy
d. Using latex barriers to cover genitals during sexual contact
A.
Which variable impacts the development of a nursing diagnosis for a patient with human immunodeficiency virus (HIV)?
A. The stage of the infection
B. The occupation of the patient
C. Whether the patient can identify partners
D. Access to care
A. The stage of the infection
Nursing diagnoses related to human immunodeficiency virus (HIV) infection are dictated by several variables, including the stage of the infection.
Which statement about human immunodeficiency virus (HIV) is accurate?
A. Once a person is positive, treatment cannot eliminate the virus from the body.
B. The viral load will only become more elevated as the disease progresses and cannot be controlled.
C. Preventing all other diseases is key to improved outcomes.
D. The goal of medical therapy is to eliminate viral load.
A. Once a person is positive, treatment cannot eliminate the virus from the body.
Once a person is infected, current treatment cannot eliminate human immunodeficiency virus (HIV) from the body.
Which strategy is the most effective for human immunodeficiency virus (HIV) disease?
A. Primary prevention techniques
B. Reduce medication side effects
C. Holistic care
D. Increase awareness of frequent testing
A. Primary prevention techniques
As with most chronic and infectious diseases, primary prevention and health promotion are the most effective health care strategies.
Which of the following are most effective in controlling the human immunodeficiency virus (HIV) epidemic?
A. Prevention
B. Research
C. Education
D. Repeat testing
A. Prevention
Prevention is crucial for control of the epidemic. Another goal of health promotion is to detect disease early so that if primary prevention has failed, early intervention can be implemented.
The nurse is teaching a patient with human immunodeficiency virus (HIV) ways to decrease the risk of infecting other people. Which statement made by the patient indicates effective teaching?
A. “I should refrain from sharing needles with anyone else.”
B. “It is important that I stay away from crowds.”
C. “I should wash my hands frequently throughout the day.”
D. “I should not receive any vaccinations.”
A. “I should refrain from sharing needles with anyone else.”
Risk for human immunodeficiency virus (HIV) among people who use drugs can be eliminated if people do not share injecting equipment. The nurse will instruct the patient with HIV to refrain from sharing needles with others because this exposes people to the virus.
