Chapter 55: Care of the Patient with HIV/AIDS My Nursing Test Banks

Chapter 55: Care of the Patient with HIV/AIDS

Cooper and Gosnell: Foundations and Adult Health Nursing, 7th Edition

MULTIPLE CHOICE

1.When assigned to a newly admitted patient with AIDS, the nurse says, Im pregnant. It is not safe for me or my baby if I am assigned to his case. Which 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.

ANS: A

HIV is transmitted from human to human through infected blood, semen, cervicovaginal secretions, and breast milk. The use of Standard Precautions by all staff members for all patients all the time simplifies this issue.

PTS: 1 DIF: Cognitive Level: Application REF: Pages 1996, Box 55-6

OBJ:6TOP:Transmission of AIDS

KEY:Nursing Process Step: Implementation

MSC:NCLEX: Safe, Effective Care Environment

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. What would be the nurses most helpful response?

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.

ANS: B

The OraQuick is a home OTC test approved by the FDA. One seronegative on the ELISA is not evidence because seroconversion may not have taken place. The Western blot test follows if the ELISA is positive.

PTS: 1 DIF: Cognitive Level: Application REF: Page 2008

OBJ: 6 TOP: HIV testing KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

3.The patient, age 21, has been treated for chlamydia and has a history of recurrent herpes. What should 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

ANS: A

Chlamydia is considered a sexually transmitted disease (STD). As such it requires further testing and a sexual history to advise the sexual partners.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 2008

OBJ:6TOP:Risk for infection

KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance

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. Dont 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.

ANS: C

Typical progress of HIV includes a period of relative clinical latency, occurring immediately after the primary infection, which can last for several years. Long-term nonprogressors remain symptom-free for 8 to10 years.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1988

OBJ:4TOProgression of disease

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

5.Which of the following 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

ANS: A

AIDS is the end stage of an HIV infection. The CDC has developed criteria for the diagnosis of AIDS, which are: increase in viral load even with pharmacologic interventions, increase in the ratio of CD8 to CD4, decline in the WBCs, and a decreased reactivity to skin tests.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1989

OBJ:7TOP:AIDS diagnostic criteria

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

6.What should the nurse look for when reviewing a patients 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

ANS: B

Patients who have progressed from HIV disease to AIDS will have the condition in which the CD4+ cell count drops to less than 200 cells/mm3 and have a history of opportunistic diseases.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Pages 1986, Table 55-1

OBJ:9TOProgression of disease

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

7.A male patient is advised to receive HIV antibody testing because of his multiple sexual partners and injectable drug use. What should the nurse inform the patient to ensure understanding?

a. The blood is tested with the highly sensitive test called the Western blot.
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.
c. A series of HIV tests is performed to confirm if the patient has AIDS.
d. If the HIV tests are seronegative, the patient can be assured that he is not infected.

ANS: B

The individuals blood is tested with ELISA or enzyme immunoassay (ELA), antibody tests that detect the presence of HIV antibodies. If the ELA is positive for HIV, then the same blood is tested a second time. If the second ELA is positive, a more specific confirming test such as the Western blot is done. Blood that is reactive or positive in all three steps is reported to be HIV-positive. A seronegative is not an assurance that the individual is free of infection since seroconversion may not have yet occurred.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1990, Box 55-2

OBJ:9TOPiagnostic procedures

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

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. Shes a professional woman in a monogamous relationship. She obviously is not at risk.
b. Women are not at great risk. The greatest risk is with gay men.
c. The fastest-growing segment of the population with AIDS is women and children. We need to assess her risks.
d. We need to review her chart to determine if her first child was infected.

ANS: C

Increases in AIDS cases in women and heterosexuals and a slowing of cases in the men who have sex with men (MSM) category are a direct reflection of early educational efforts directed at the MSM population, who were believed to be the only population at risk. Women need to be assessed for different manifestations of HIV infection. It is the current recommendation for voluntary HIV testing for all pregnant women.

PTS: 1 DIF: Cognitive Level: Application REF: Page 2008

OBJ:6TOP:Risk for infection

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

9.A young gay patient being treated for his third sexually transmitted disease does not see why he should use condoms, because they dont 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 dont 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.

ANS: A

Risk-reducing sexual activities decrease the risk of contact with HIV through the use of barriers. The most commonly used barrier is the male condom. Although not 100% effective, when used correctly and consistently, male condoms are very effective in the prevention of HIV transmission.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 2010

OBJ:5TOP:Transmission of disease

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

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. What should the nurse do 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 patients temperature

ANS: A

The use of Standard Precautions and body substance isolation has been shown not only to reduce the risk of blood-borne pathogens, but also to reduce the risk of transmission of other disease between the patient and the health care worker.

PTS: 1 DIF: Cognitive Level: Application REF: Page 2011

OBJ:16TOP:Transmission of disease

KEY:Nursing Process Step: Implementation

MSC:NCLEX: Safe, Effective Care Environment

11.The nurse should instruct the patient who is diagnosed with AIDS to report signs of Kaposi sarcoma, which include:

a. Reddish-purple skin lesions
b. Open, bleeding skin lesions
c. Blood-tinged sputum
d. Watery diarrhea

ANS: A

Kaposi sarcoma is a rare cancer of the skin and mucous membranes characterized by blue, red, or purple raised lesions seen mainly in Mediterranean men. Kaposi sarcoma: firm, flat, raised or nodular, hyperpigmented, multicentric lesions on the skin and mucous membranes.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1977

OBJ:8TOP:Kaposi sarcoma

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

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. What 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.

ANS: D

A prolonged period in which HIV is not readily detectable in the blood follows within a few weeks or months of the initial infection. This titer, or viral load, falls dramatically as the immune system responds and controls the HIV infection, and it may last 10 to 12 years. During this period, there are few clinical symptoms of HIV infection, although an individual is still capable of transmitting HIV to others.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1988

OBJ:15TOProgression of disease

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

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 of the following?

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

ANS: D

The 1993 expanded case definition of AIDS includes all HIV-infected people who have CD4+, T-lymphocyte counts of less than 200 cells/mm3; this includes all people who have one or more of these three clinical conditions: pulmonary tuberculosis, recurrent pneumonia, or invasive cervical cancer, and it retains the 23 clinical conditions listed in the 1987 AIDS case definition.

PTS: 1 DIF: Cognitive Level: Analysis REF: Pages 1986, Table 55-1

OBJ:2TOPefinition of AIDS disease

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

14.Why should 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 patients strength and ability to care for himself or herself.

ANS: B

HIV disease progression may be delayed by promoting a healthy immune system. Useful interventions for HIV-infected patients include the following: nutritional changes that maintain lean body mass, regular exercise, and stress reduction.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 2001

OBJ:15TOP:Immune function improvement

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

15.A male patient is concerned about telling others he has HIV infection. What should the nurse stress when discussing his concerns?

a. Care providers and sexual partners should be told about his diagnosis.
b. There is no reason to hide his disease.
c. Secrecy is a poor idea because it will lower his self-esteem.
d. His diagnosis will be obvious to most people with whom he will come into contact.

ANS: A

Nurses have a responsibility to assess each patients risk for HIV infection and counsel those at risk about HIV testing and the behaviors that put them at risk, and about how to reduce or eliminate those risks. The diagnosis needs to be carefully protected and shared only with caregivers who need to know for the purpose of assessment and treatment.

PTS: 1 DIF: Cognitive Level: Application REF: Page 2000

OBJ: 13 TOP: Coping KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

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:

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.

ANS: C

The progression from HIV to AIDS includes initial exposure, primary HIV infection, asymptomatic HIV infection, early HIV disease, and AIDS.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1980, Figure 55-3

OBJ:4TOProgression of disease

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

17.While teaching community groups about AIDS, what should the nurse indicate as the most common method of transmission of the HIV virus?

a. Sexual contact with an HIV-infected partner
b. Perinatal transmission
c. Exposure to contaminated blood
d. Nonsexual exposure to saliva and tears

ANS: A

Modes of transmission have remained constant throughout the course of the HIV pandemic. It is also important for health care providers to remember that transmission of HIV occurs through sexual practices, not sexual preferences. Worldwide, sexual intercourse is by far the most common mode of HIV transmission.

PTS: 1 DIF: Cognitive Level: Application REF: Page 2000, Box 55-11

OBJ:7TOP:Transmission of disease

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

18.What do the activated monocytes and macrophages produce in the presence of an inflammatory process?

a. Reduction of red cells
b. Increase in WBCs
c. Neopterin
d. Increase in T-helper cells increase natural killer (NK) cells

ANS: C

Neopterin is produced in the presence of an inflammatory reaction and is increased in HIV disease.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1990, Box 55-2

OBJ: 5 TOP: Neopterin KEY: Nursing Process Step: Intervention

MSC: NCLEX: Physiological Integrity

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

a. Immunocompetence
b. Seroconversion
c. Opportunistic infection
d. Immunodeficiency

ANS: B

Seroconversion is the development of antibodies from HIV, which takes place approximately 5 days to 3 months after exposure, generally within 1 to 3 weeks. Although the conversion has taken place, the patient is not yet immunodeficient.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1987

OBJ:10TOProgression of disease

KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance

20.What should 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.

ANS: B

The decline in pediatric AIDS incidence is associated with the increased compliance with universal counseling and testing of pregnant women and the use of zidovudine by HIV-infected pregnant women and their newborn infants. Infants born to HIV-infected mothers will have positive HIV antibody results as long as 15 to 18 months after birth. This is caused by maternal antibodies that cross the placenta during gestation and remain in the infants circulatory system.

PTS: 1 DIF: Cognitive Level: Analysis REF: Pages 1983-1984

OBJ:5TOP:Transmission of disease

KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity

21.Why are snacks high in potassium, such as bananas and apricot nectar, recommended?

a. Electrolytes are lost through diaphoresis.
b. Sodium is lost through frequent diarrhea.
c. Potassium will support weight gain.
d. Potassium helps fight infection.

ANS: C

HIV disease progression may be delayed by promoting a healthy immune system. Nutritional changes that maintain lean body mass, increase weight, and ensure appropriate levels of vitamins and micronutrients are helpful. Eat potassium-rich foods, such as bananas and apricot nectar.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 2000, Box 55-6

OBJ: 15 TOP: Nutrition KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

22.The depressed patient with AIDS says, I dont understand why I am going to be getting doses of testosterone. What good will that do me now? What should 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

ANS: C

Testosterone can increase body mass and lean weight.

PTS: 1 DIF: Cognitive Level: Application REF: Page 2005

OBJ:16TOP:Transmission of disease

KEY:Nursing Process Step: Implementation

MSC:NCLEX: Safe, Effective Care Environment

23.After what period of time would 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

ANS: B

Patients with HIV infection have a great deal of anxiety and guilt, which may interfere with the daily functions of maintaining relationships and making decisions. When this apathy is assessed for a period of 2 weeks, the nurse should refer the patient for a mental health consult.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 2000

OBJ: 13 TOP: Coping KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity

24.The HIV-infected patient who has just seroconverted says he just cannot take all those confusing, expensive antiretroviral (ART) medications. He says he still feels fine, anyway. What should 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

ANS: B

Compliance and adherence to the ART protocol is essential to its success. Cessation of the medication may stimulate the emergence of a resistant strain of HIV virus. ART can be restarted, but the optimum time to start is soon after seroconversion.

PTS: 1 DIF: Cognitive Level: Application REF: Page 2001

OBJ:5TOP:Adherence to ART

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

25.What medication times should the nurse use in writing out a schedule for taking antiretroviral medication three times a day?

a. 8 AM 2 PM 8 PM
b. 8AM 4PM 12 AM
c. 8AM 5PM 1 AM
d. Be given with meals

ANS: C

Antivirals should be given around the clock to keep the therapeutic level of the ART at a constant level.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1993

OBJ:15TOP:Antiretroviral therapy (ART)

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

MULTIPLE RESPONSE

26.Which of the following are early signs and symptoms of an HIV infection? (Select all that apply.)

a. Dry mouth
b. Weight loss
c. Sore throat
d. Vaginal dryness
e. Nausea
f. Dyspnea

ANS: B, C, F

Signs and symptoms of HIV infection include weight loss, sore throat, and dyspnea.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1980, Box 55-1

OBJ:8TOP:HIV infection

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

27.Which of the following are methods 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 virus
e. From breastfeeding by an HIV-positive mother

ANS: A, B, D, E

In the United States, transfusion of infected blood and blood products and transplantation of infected tissues account for 1% of the total adult and adolescent AIDS cases and 2% of the total pediatric AIDS cases. HIV infection can be transmitted from a mother to her infant during pregnancy, at the time of delivery, or after birth, through breastfeeding. In the United States, it is estimated that approximately 30% of infected mothers will transmit HIV to their infants, with approximately 50% to 70% of the transmissions occurring late in utero or intrapartum. In the United States, among children who are less than 13 years old and have AIDS, 93% were infected at birth.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1983

OBJ:5TOP:Transmission of disease

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

28.The home health nurse designing a teaching plan for a person with HIV disease that would support weight gain would include information pertaining to (Select all that apply.)

a. Limit 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. Resistance weight training

ANS: B, C, D, E, F

Increase protein, calorie, and fat intake. Offer nutritional supplements. Eat several small meals per day instead of three large meals. Provide for referrals. Weigh the patient daily. Weight training maintains muscle tone and improves appetite.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 2011

OBJ: 15 TOP: Weight loss KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

29.Which foods would a nurse recommend for a person with debilitating diarrhea as a result 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

ANS: A, D, F

Avoid dairy products, red meat, margarine, butter, eggs, dried beans, peas, and raw fruits and vegetables. Cooked or canned fruits and vegetables will provide needed vitamins. Eat potassium-rich foods, such as bananas and apricot nectar. Discontinue foods, nutritional supplements, and medications that may make diarrhea worse (Ensure, antacids, stool softeners). Avoid gas-producing foods. Serve warm, not hot, foods. Plan small, frequent meals. Drink plenty of fluids between meals.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 2000, Table 55-6

OBJ: 15 TOP: Weight loss KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

30.How does the HIV-2 virus compare to the HIV-1 virus? (Select all that apply.)

a. It has lower mortality risks in the older adult
b. It is less virulent
c. It is less infectious in the initial stage of infection
d. It predisposes the HIV-infected person to a normal life span
e. It develops high viral loads

ANS: A, B, C, D

Persons who are infected with the HIV-2 are less infectious during the initial stage because the virus is less virulent than HIV-1. These persons tend to live a normal life span and the mortality in the later years is less.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1978

OBJ: 7 TOP: HIV-2 KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance

31.Which of the following are examples 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

ANS: C, E

The AIDS wasting syndrome is due to disturbances in metabolism involving lean body mass. The wasting syndrome is signaled by 10% loss of body weight, 30 days of diarrhea, weakness, and fever. The person who has the wasting syndrome is considered to have AIDS.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 2001

OBJ:4TOP:Wasting syndrome

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

COMPLETION

32.______________ is a type of sexual option classified as no risk for a person to become infected with the HIV virus.

ANS:

Abstinence

Abstinence is refraining from sexual contact in which there is exchange of semen, vaginal secretions, or blood.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 2000, Box 55-10

OBJ:5TOP:HIV infection prevention

KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance

33.An organism that can cross from an animal species to humans is a(n) ____________organism.

ANS:

zoonotic

A zoonotic organism is an organism that can cross from an animal species to humans.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1978

OBJ: 1 TOP: Zoonotic KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

34.The nurse explains that an enzyme ____________ ____________ allows the RNA of the retrovirus to be changed to DNA and incorporated into the hosts genetic material.

ANS:

reverse transcriptase

Reverse transcriptase allows the RNA of the retrovirus to be changed to DNA and incorporated into the hosts genetic material.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1984

OBJ:7TOP:Reverse transcriptase

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

35.The term that describes an immunosuppressed patients inability to react to a skin test is __________________.

ANS:

anergic

Anergic is the term that describes an immunosuppressed patients ability to react to a skin test.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1899

OBJ: 2 TOP: Anergia KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

36.The combination of efforts of the medical team, nutritionist, social workers, and clergy is the necessary ______________ approach to the complex needs of the patients with HIV infection.

ANS:

multidisciplinary

The use of many disciplines in a combined approach to a complex medical problem is multidisciplinary.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1999

OBJ: 11 TOP: Multidisciplinary KEY: Nursing Process Step: N/A

MSC:NCLEX: Safe, Effective Care Environment

OTHER

37.The historical progress of the HIV infection began to be tracked in 1979. Arrange the historical events in sequence of their discovery. (Separate letters by a comma and space as follows: A, B, C, D)

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 Pneumocystis jiroveci (previously PCP)

ANS:

E, D, C, B, A

The history of the incidence of HIV infection was slow in being recognized. The first observation was an increase in incidence of Pneumocystis jiroveci, followed by increasing incidence of Kaposi carcinoma in the homosexual population. The infection began to be seen in injection drug users, hemophiliacs, then into the heterosexual population.

PTS: 1 DIF: Cognitive Level: Application REF: Page 1977

OBJ:1 | 12TOP:History of incidence of HIV infection

KEY: Nursing Process Step: N/A MSC: NCLEX: Health Promotion and Maintenance

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