Nokea
A client tells the nurse, 'You know I have AIDS. I still cannot afford to tell my employer because they will probably cancel my health insurance, then what would I do?' What is the best response by the nurse?
- A. An employer cannot cancel your currently active health insurance on the basis of AIDS.'
- B. I just wouldn't tell them. It is none of their business.'
- C. You have to tell them, it is not your right to allow them exposure to you. What if you give it to someone?'
- D. I understand your dilemma, but I think you should tell them. I would want to know.'
Correct Answer: A
Rationale: Despite HIV-specific confidentially laws, clients infected with AIDS fear that disclosure of their condition will affect employment, health insurance coverage, and even housing. An employer cannot cancel a client's currently active health insurance policy on the basis of AIDS. However, employers are more apt to dismiss a worker with a known HIV-positive status from employment to reduce future insurance premiums and death payments. The other answers are nontherapeutic and not based in fact.
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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.
The nurse is gathering data from laboratory studies for a client who has HIV. The client's T4-cell count is 200/mm3, and the client has been diagnosed with Pneumocystis pneumonia. What does this indicate to the nurse?
- A. The client has converted from HIV infection to AIDS.
- B. The client has advanced HIV infection.
- C. The client's T4-cell count has decreased due to the Pneumocystis pneumonia.
- D. The client has another infection present that is causing a decrease in the T4-cell count.
Correct Answer: A
Rationale: AIDS is the end stage of HIV infection. Certain events establish the conversion of HIV infection to AIDS: a markedly decreased T4 cell count from a normal level of 800 to 1200/mm3 and the development of certain cancers and opportunistic infections. The client does not have advanced HIV; they meet the criteria for the development of AIDS. The T4-cell count is not decreasing due to an infection.
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 requires a blood transfusion for anemia and tells the nurse, 'I don't want a transfusion because I don't want to get AIDS.' Which is the best response from the nurse to the client?
- A. It's always a possibility.'
- B. You don't want to die, do you?'
- C. The blood is screened, and your risk is one in two million.'
- D. If you don't have the transfusion, you are taking a greater risk.'
Correct Answer: C
Rationale: Before 1984, blood and blood products were a major source of HIV transmission. Since then, an HIV screening test known as nucleic acid testing (NAT) is performed on all blood and plasma donations. Although screening donated blood for HIV antibodies reduces the risk of transfusion-related infection with HIV, it is not flawless. The Verywell Health's website states that the risk for HIV infection in the United States from a blood transfusion is approximately one in two million units of blood. Informing the client that transmission is always a possibility does not provide any information that will be relevant to the decision. The other responses are nontherapeutic and, therefore, should not be used as a response to the client's statement.
A teenaged client with a diagnosis of HIV presents at the public health clinic complaining of pharyngitis, rash on the palms and soles of the feet, and diarrhea. What would the nurse suspect the client is suffering from?
- A. AIDS dementia complex (ADC)
- B. Acute retroviral syndrome (ARS)
- C. Distal sensory polyneuropathy (DSP)
- D. AIDS-related complex (ARC)
Correct Answer: B
Rationale: Some manifestations of ARS include: fever; swollen and tender lymph nodes; pharyngitis; rash about the face, trunk, palms, and soles; muscle and joint pain; headache; nausea and vomiting; and diarrhea. In addition, there may be enlargement of the liver and spleen, weight loss, and neurologic symptoms such as visual changes or cognitive and motor involvement. The scenario does not describe symptoms of ARC, DSP, or ADC.