Nokea
A client is considering beginning sexual relations and wants to know the best way to be protected from a sexually transmitted infection and HIV. What is the best response by the nurse?
- A. Using a latex condom and spermicidal jelly is one of the most effective ways to decrease the risk of transmission of an STI and HIV.'
- B. Using a diaphragm with spermicidal jelly will kill the bacteria and viruses that transmit STIs and HIV.'
- C. Using a lamb skin condom will be the most effective way to decrease transmission of STIs and HIV.'
- D. Douching immediately after intercourse will be the most effective way to kill bacteria and viruses.'
Correct Answer: A
Rationale: Using a latex condom with spermicide is one of the most effective ways to reduce the risk of HIV infection. Condoms are available for both men and women. A diaphragm would not be the most effective way because there is no protection for the penis or vagina. A lamb skin condom is not effective to prevent the transmission of HIV. Douching after intercourse is not an effective method to avoid transmission and does not offer protection from secretions that are already present.
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A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection?
- A. Trimethoprim-sulfamethoxazole
- B. Nystatin
- C. Amphotericin B
- D. Fluconazole
Correct Answer: A
Rationale: To prevent and treat Pneumocystis pneumonia, trimethoprim-sulfamethoxazole (Bactrim, Septra) is prescribed. The other medications are antifungals and used to treat candidiasis.
A client is informed of needing to start on antiretroviral therapy, and the client is concerned about the possibility of not being able to afford the therapy. What can the nurse inform the client is the largest source of public funding for HIV/AIDS care?
- A. Medicaid
- B. Medicare
- C. Blue Cross/Blue Shield
- D. AIDS Drug Assistance Program
Correct Answer: A
Rationale: Medicaid, a state-based medical assistance program for low-income clients, is the largest source of public funding for HIV/AIDS care. Medicare is for clients who are over age 65 years or disabled. Blue Cross/Blue Shield is a private insurance with a cap on coverage. AIDS Drug Assistance Program is the third largest source of funding for HIV in the United States for individuals who do not have health insurance that pays for drug therapy.
The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluid(s) does the nurse inform them will transmit the virus? Select all that apply.
- A. Semen
- B. Urine
- C. Breast milk
- D. Blood
- E. Vaginal secretions
Correct Answer: A,C,D,E
Rationale: There are only four known body fluids through which HIV is transmitted: blood, semen, vaginal secretions, and breast milk. HIV may be present in saliva, tears, and conjunctival secretions, but transmission of HIV through these fluids has not been implicated. HIV is not found in urine, stool, vomit, or sweat.
A client with cytomegalovirus (CMV) infection reports difficulty seeing. The physician determines that the client is developing CMV retinitis. What medication does the nurse anticipate the client will receive for this?
- A. zidovudine
- B. fluconazole
- C. azithromycin
- D. foscarnet
Correct Answer: D
Rationale: The drug foscarnet is used to treat CMV retinitis. Alterations in renal function, nausea, anemia, headaches, seizures, and diarrhea are the most common adverse effects. Zidovudine is used in antiretroviral therapy to prevent the conversion of HIV to AIDS. Azithromycin is an antibiotic and not used to treat CMV retinitis.
A client on antiretroviral drug therapy informs the nurse about sometimes forgetting to take the medication for a few days. What should the nurse inform the client can occur when the medications are not taken as prescribed?
- A. The funding for the medications will cease if the client is not taking the meds correctly.
- B. The client is risking the development of drug resistance and drug failure.
- C. The client will have to take the drugs intravenously to ensure compliance.
- D. The client will have to take higher doses of the antiviral medications.
Correct Answer: B
Rationale: Clients who neglect to take antiretroviral drugs as prescribed risk development of drug resistance. When drug levels are not adequately maintained, viral replication and mutations increase. Funding will not cease for noncompliance. The medications are not all available in IV form. Taking a higher dose of the medication if missed does not resolve drug resistance.