Chapter - 080 Clietns With AIDS

Black & Hawks: Medical-Surgical Nursing: Clinical Management for Positive
Outcomes, 7th Edition
Chapter 80: Management of Clients with Acquired Immunodeficiency Syndrome
MULTIPLE CHOICE
1. A human immunodeficiency virus (HIV)–positive client is beginning therapy with

antiretroviral medications. The nurse will include in the teaching plan relative to the
medication that the client should
a. take the dose at any time after eating.
b. not skip a dose. If a dose is missed, double the next dose.
c. wait until the next visit before reporting significant side effects.
d. tell the prescriber if the decision is made to terminate treatment.
ANS: d
Instruct all clients taking retrovirals as follows. Take the drug at specified intervals. Do not skip a
dose. Do not increase or decrease the number of pills you take. If side effects occur, tell your
physician or nurse. If you do not want to take the drugs, tell your primary care provider. If you
take the drugs only periodically, it would be better not to take them at all.
DIF: Cognitive Level: Application REF: Text Reference: 2388, 2389;

TOP: Nursing Process Step: Intervention
MSC: NCLEX: Physiological Integrity
2. The nurse participating in the evaluation of a client with a known HIV infection explains that
the laboratory study that will be of most significance during this process is
a. CD4+ cell count.
b. the total white blood cell count.
c. the enzyme-linked immunosorbent assay (ELISA) test.
d. the Western blot test.
ANS: a
The most recent classification system for HIV disease in adults and adolescents is based on two
monitoring parameters used to follow a client: (1) laboratory data (CD4+ cell count) and (2)
clinical presentation (the person's clinical manifestations of diseases).
DIF: Cognitive Level: Knowledge REF: Text Reference: 2380

3. A nurse with a small grant to increase knowledge of the transmission of HIV infection is
trying to determine the best expenditure of the funds. The nurse should recognize that the
group in which this problem of HIV infection is growing most rapidly is
a. adults older than the age of 50.
b. black teenagers.
c. gay white men.
Chapter 80: Management of Clients with Acquired Immunodeficiency Syndrome 2
d. blacks and Hispanics.

ANS: a
An overlooked population of rapidly growing HIV-positive people are those older than the age of
50.
DIF: Cognitive Level: Analysis REF: Text Reference: 2377

TOP: Nursing Process Step: N/A
4. The nurse is counseling a woman who is HIV positive and has just given birth to a baby girl.
The nurse should advise the client to
a. avoid breast-feeding her infant.
b. seek professional counseling to deal with the guilt associated with the almost
certain passing of the disease to her child.
c. report all of her sexual partners to the infectious disease department in order to
break the chain of transmission of the disease.
d. anticipate the needs of her child immediately and make arrangements for
placement in a setting where her child's life will be comfortable.
ANS: a
Perinatal HIV exposure can occur during pregnancy, during vaginal delivery, and postpartum
through breast-feeding.
DIF: Cognitive Level: Application REF: Text Reference: 2378

5. The nurse counseling a client who is afraid that HIV exposure has occurred would explain
that the period of time it takes before HIV antibodies can be detected by laboratory tests is
generally
a. 1 to 3 days.
b. 7 to 10 days.
c. 1 to 3 weeks.
d. 4 to 12 weeks.
ANS: d
There is a "window" for seroconversion (the time it takes for a newly infected person to develop
antibodies that can be detected in a laboratory specimen). On average, antibodies can be detected
in 4 to 12 weeks.
DIF: Cognitive Level: Comprehension REF: Text Reference: 2382

6. The nurse teaching a client who is HIV positive should alert the client that the virus can be
transmitted
a. as soon as manifestations of illness appear.
Elsevier items and derived items © 2005 by Elsevier Inc.

b. only to another susceptible host.

c. to anyone having contact with blood or semen.
d. once the diagnosis has been made.
ANS: c
Modes of transmission have remained constant throughout the course of the HIV pandemic. The
virus is spread through certain sexual practices, through exposure to blood, and through perinatal
transmission.

MSC: NCLEX: Health Promotion and Maintenance
7. The nurse caring for a client with acquired immunodeficiency syndrome (AIDS) whose CD4+
cell count is 100 is aware that the most effective way to prevent Pneumocystis carinii
pneumonia in this client is to
a. administer prescribed oral trimethoprim-sulfamethoxazole.
b. encourage a high fluid intake.
c. place the client in protective isolation.
d. restrict the client's visitors.
ANS: a
Maintenance lifetime suppressive therapy for P. carinii is required with trimethoprim-
sulfamethoxazole, pentamidine aerosol, atovaquone, dapsone, or clindamycin-primaquine.

TOP: Nursing Process Step: Assessment
8. An early manifestation that should alert the nurse to further evaluate a client with an HIV
infection for the opportunistic infection of toxoplasmosis is:
a. discoloration of the mucous membranes.
b. cardiac dysrhythmias.
c. headache.
d. lymphadenopathy.
ANS: c
Clinical manifestations of central nervous sytem (CNS) infections include headache, impaired
cognition, hemiparesis, aphasia, ataxia, vision loss, cranial nerve palsies, motor problems, and
seizures.

9. The problem the nurse should plan for when a client with AIDS is infected with the
Cryptosporidium parasite is
a. delirium.

b. painful open lesions.

c. profuse, watery diarrhea.
d. severe respiratory tract infection.
ANS: c
Clinical presentation includes profuse diarrhea, steatorrhea (1L/day), flatulence, abdominal
cramping and pain, anorexia, nausea, vomiting, profound weight loss, fever, fatigue, myalgia,
and electrolyte imbalance.

10. The nurse is assessing a client with AIDS for the presence of Kaposi's sarcoma (KS). The
manifestation the nurse should look for is
a. a thick, white exudate in the mouth.
b. a purple-red lesion on the body.
c. a crusty lesion on the back and groin.
d. a pustular lesion with yellow exudate.
ANS: b
Clinical presentation generally starts with an initial "patch" that is flat, pink, looks like a bruise,
and is symmetrical on both sides of the body. Later it turns into dark violet or black plaques.

11. A client with an HIV infection is receiving zidovudine (Retrovir). The nurse counsels the
client about the major problem with this medical protocol, which is
a. side effects.
b. noncompliance with its complex regimen.
c. cost.
d. long-term administration schedule.
ANS: b
Noncompliance relative to the complexity of the regimen is the major concern about the use of
this drug.
DIF: Cognitive Level: Application

REF: Text Reference: 2386, Integrating Pharmacology Box - Understanding HAART;
12. The nurse explains that currently the drug that is best for treating HIV wasting syndrome is
a. human growth hormone.
b. megestrol acetate.
c. dronabinol.

d. thalidomide.
ANS: a
The drug used most successfully to treat wasting is human growth hormone.

13. The suggestions a nurse could make to a client with AIDS who is experiencing night sweats
is
a. limit fluid intake after supper.
b. drink all liquids in the morning.
c. keep liquids at the bedside to drink.
d. take aspirin if awakened in the night.
ANS: c
Teach the client how to manage chronic recurrent night fever and night sweats by taking the
antipyretic of choice before going to sleep; having a change of bedclothes nearby; keeping a
plastic cover on the pillow; placing a towel over the pillow in case of profuse diaphoresis; and
keeping liquids at the bedside to drink.

14. In order to conserve energy, the nurse would encourage the client with AIDS who has a
nursing diagnosis of Fatigue to
a. bathe before eating breakfast.
b. sit down while showering.
c. use easy to clean forks and knives.
d. rest after every third major activity.
ANS: b
Promote rest and activity by developing a plan of daily activities that alternates short activities
with rest periods. Evaluate the client's needs and point out ways to conserve energy, such as
sitting down while dressing, shaving, or preparing food; sitting on a shower chair while bathing;
or using disposable items for eating so that no cleanup is needed.

15. A client with AIDS has a nursing diagnosis of Imbalanced Nutrition: Less Than Body
Requirements. The nurse should
a. encourage sweet foods and desserts that appeal to the taste.
b. encourage the client to dine alone to focus on food intake.
c. instruct the client to prepare meals, then divide and freeze them.

d. tell the client to eat large meals to result in greater intake.

ANS: c
Interventions include eating small meals frequently throughout the day; preparing meals ahead of
time so they can be divided into individual servings and frozen until ready to use; encouraging
the client to dine with family and friends; and consuming more nutrient-dense foods and
beverages rather than filling up on low-calorie items.
DIF: Cognitive Level: Comprehension REF: Text Reference: 2396

16. When a client with AIDS experiences pain while swallowing, the nurse could suggest
a. eating very cold foods.
b. drinking acidic juices such as orange juice.
c. increasing the intake of well-cooked eggs and noodle dishes.
d. avoiding the use of straws while drinking.
ANS: c
Encourage the client to eat foods at room temperature; choose mild foods and drinks, such as
apple juice rather than orange juice; eat nonabrasive foods that are easy to swallow (well-cooked
eggs, noodle dishes); use a straw while drinking.

17. The situation that would be least helpful to manage pain in the AIDS client who is an
injecting drug user is
a. having multiple practitioners prescribing medications.
b. refusing to fill lost prescriptions.
c. carefully rationing narcotic prescriptions.
d. limiting rescue doses of narcotic analgesics on a monthly basis.
ANS: a
Helpful guidelines include having a single practitioner prescribe medications.

TOP: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance
18. When the AIDs client refuses pain medication because he or she is not in pain presently, the
nurse should explain that
a. refraining from using the medication makes its effectiveness last longer.
b. taking the medication on schedule keeps the blood level constant.
c. skipping a dose will decrease diarrhea
d. using the drug will increase the appetite.

ANS: b
Taking pain medication on a schedule keeps the blood level constant and incidentally helps
control diarrhea by the side effect of constipation.

19. The nurse counsels other co-workers that the suggested remedy for HIV exposure is
a. combination antiretrovirals for 4 weeks.
b. single antiretrovirals for 2 weeks.
c. combination antiretrovirals with CD4+ count every month.
d. single antiretrovirals for 2 months.
ANS: a
The current remedy for accidental exposure to HIV is combination antiretrovirals for 4 weeks.

20. The client who has a positive enzyme immunoassay test asks the nurse if that means that he
is HIV positive. The nurse’s most helpful response would be
a. “Yes, you should seek medical care for antiretroviral drugs.”
b. “No, you need to have the Western blot test to confirm that you are positive.”
c. “Yes, but antiretrovirals will probably combat the infection now.”
d. “No, many people have positive enzyme immunoassays.”
ANS: b
If the enzyme immunoassay is positive, the Western blot test is needed to confirm an HIV-
positive status.


Chapter - 080 Clietns With AIDS

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Chapter - 080 Clietns With AIDS

Uploaded by

Copyright:

Available Formats

Black & Hawks: Medical-Surgical Nursing: Clinical Management for Positive

Outcomes, 7th Edition

Chapter 80: Management of Clients with Acquired Immunodeficiency Syndrome

1. A human immunodeficiency virus (HIV)–positive client is beginning therapy with

DIF: Cognitive Level: Application REF: Text Reference: 2388, 2389;

DIF: Cognitive Level: Knowledge REF: Text Reference: 2380

d. blacks and Hispanics.

DIF: Cognitive Level: Analysis REF: Text Reference: 2377

DIF: Cognitive Level: Application REF: Text Reference: 2378

DIF: Cognitive Level: Comprehension REF: Text Reference: 2382

Elsevier items and derived items © 2005 by Elsevier Inc.

b. only to another susceptible host.

DIF: Cognitive Level: Application REF: Text Reference: 2377

DIF: Cognitive Level: Knowledge REF: Text Reference: 2387

DIF: Cognitive Level: Application REF: Text Reference: 2392

Elsevier items and derived items © 2005 by Elsevier Inc.

b. painful open lesions.

DIF: Cognitive Level: Application REF: Text Reference: 2392

DIF: Cognitive Level: Application REF: Text Reference: 2393

DIF: Cognitive Level: Application

Elsevier items and derived items © 2005 by Elsevier Inc.

DIF: Cognitive Level: Knowledge REF: Text Reference: 2394

DIF: Cognitive Level: Application REF: Text Reference: 2395

DIF: Cognitive Level: Application REF: Text Reference: 2395

Elsevier items and derived items © 2005 by Elsevier Inc.

d. tell the client to eat large meals to result in greater intake.

DIF: Cognitive Level: Comprehension REF: Text Reference: 2396

DIF: Cognitive Level: Analysis REF: Text Reference: 2396

DIF: Cognitive Level: Knowledge REF: Text Reference: 2397

Elsevier items and derived items © 2005 by Elsevier Inc.

DIF: Cognitive Level: Application REF: Text Reference: 2397

DIF: Cognitive Level: Analysis REF: Text Reference: 2378

DIF: Cognitive Level: Analysis REF: Text Reference: 2382

Elsevier items and derived items © 2005 by Elsevier Inc.

You might also like