Transmitted Disease

Question 1

A client diagnosed with AIDS is seen in the emergency room with complaints of mouth pain, difficulty swallowing, and a white discharge in the back of the throat. The nurse expects the physician to order which of the following?

1. Metronidazole (Flagyl) 7.5 mg/kg q6h.
2. Ketoconazole (Nizoral) 200 mg daily.
3. Trimethoprim-sulfamethoxazole (Bactrim) 800 mg PO q12h.
4. Rifampin (Rifadin) PO 10 mg/kg daily.

Answer 1

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Strategy: The topic of the question is unstated.

(1) anti-infective, used in treatment of intestinal amebiasis, trichomoniasis, inflammatory bowel disease
(2) correct—drug of choice for treatment of candidiasis
(3) treatment for PCP; symptoms of dyspnea, tachypnea, persistent dry cough, fever, fatigue
(4) treatment for tuberculosis; symptoms of fever, chills, night sweats, weight loss, anorexia

Question 2

The RN makes nursing assignments for the burn unit. Which of the following indicates the MOST appropriate assignment for a client with a positive cytomegalovirus (CMV) titer?

1. A nurse with an upper respiratory infection.
2. A young nurse who is 8 weeks pregnant.
3. A male nurse who is CMV-negative.
4. An older nurse with 30 years of experience.

Answer 2

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Strategy: Determine the nurse with the least risk.

(1) those with a cytomegalovirus-positive titer are often immunosuppressed clients who should be protected from other pathogens
(2) CMV is fetotoxic; should inform client of risks
(3) this nurse is at increased risk for developing the disease
(4) correct—most appropriate option due to decreased risk

Question 3

A young adult asks the nurse in the AIDS clinic what to do for the multiple small, painless purplish-brown spots on the right leg and ankle. The nurse should instruct the client to take which of the following actions?

1. Clean the spots carefully with soap and warm water twice a week, and cover them with a sterile dressing.
2. Clean the lesions twice a day with a diluted solution of povidone-iodine (Betadine), and leave them open to the air.
3. Shower daily using a mild soap from a pump dispenser, and pat the skin dry.
4. Soak in a warm tub three times a day, and rub the spots with a washcloth.

Answer 3

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Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired?

(1) if lesions are open and draining, they must be cleaned and dressed daily to prevent secondary infection
(2) treatment for herpes simplex virus abscess, not Kaposi’s sarcoma
(3) correct—important to keep the skin clean and prevent secondary skin infection
(4) increases risk of secondary skin infection

Question 4

The client comes to the clinic for hepatitis B vaccine and asks if more than one injection is necessary. Which of the following responses by the nurse is BEST?

1. "A booster shot is required yearly."
2. "Additional injections are given at one and six months."
3. "Repeat doses are given at two and four months."
4. "Revaccination is not required.

Answer 4

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Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired?

(1) yearly doses are given for flu shots, not for hepatitis B vaccine
(2) correct—hepatitis B vaccine is repeated at 1 and 6 months
(3) schedule for infant immunizations for IPV and DPT
(4) inaccurate