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A client who had sexual contact with a partner who is HIV+ recently develops flulike symptoms such as a low grade fever, headache, and muscle pain. What does the nurse suspect this client is experiencing?
- A. Pneumocystis pneumonia
- B. Influenza
- C. AIDS
- D. Acute retroviral syndrome
Correct Answer: D
Rationale: At the time of primary HIV infection, one third to more than one half of those infected develop acute retroviral syndrome, also called acute HIV syndrome, which often is mistaken for flu or some other common illness. Some manifestations 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. It is too soon after exposure for the client to develop Pneumocystis pneumonia or AIDS.
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A client has been diagnosed with HIV and has been placed on antiretroviral therapy. What does the nurse inform the client will be required for determining the progression of the disease as well as guiding drug therapy?
- A. The client will be required to stop the medication for 2 weeks and then have laboratory studies drawn to determine if the antiretroviral therapy has cured the disease.
- B. Viral load and T4-cell counts will be performed every 2 to 3 months.
- C. More antiretroviral medication will be added every 2 to 3 months.
- D. The Western blot test will be monitored every 6 months to see if the virus is still present.
Correct Answer: B
Rationale: Viral load testing is used to guide drug therapy and follow the progression of the disease. Viral load tests and T4-cell counts may be performed every 2 to 3 months once it is determined that a person is HIV positive. The medication should be adhered to and not discontinued. There is no cure for the disease at this time. Antiretroviral therapy is not generally changed or added to without reason or lack of response. The Western blot is used for confirmation of the presence of the HIV virus.
A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay (ELISA) with positive results twice. The next step for the nurse to explain to the client for confirmation of the diagnosis is to perform what?
- A. p24 antigen test for confirmation of diagnosis.
- B. Western blot test for confirmation of diagnosis.
- C. polymerase chain reaction test for confirmation of diagnosis.
- D. T4-cell count for confirmation of diagnosis.
Correct Answer: B
Rationale: The enzyme-linked immunosorbent assay (ELISA) test, an initial HIV screening test, is positive when there are sufficient HIV antibodies; it also is positive when there are antibodies from other infectious diseases. The test is repeated if results are positive. If results of a second ELISA test are positive, the Western blot is performed. The p24 antigen test and the polymerase chain reaction test determine the viral load, and the T4-cell count is not used for diagnostic confirmation of the presence of HIV in the blood.
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 healthcare worker has been exposed to the blood of an HIV-positive client and is awaiting the results of an HIV test. In the meantime, what precautions must the healthcare worker take to prevent the spread of infection?
- A. Limit interactions with people who are not HIV infected.
- B. Limit interactions with people who are already HIV infected.
- C. Follow the same sexual precautions as someone who has been diagnosed with AIDS.
- D. Quit the healthcare job and get admitted to a hospital or a cancer treatment center.
Correct Answer: C
Rationale: The healthcare worker will be tested for HIV at regular intervals and treated with antiretrovirals depending on the results of the tests or the potential for infection. While awaiting the results, the healthcare worker should follow the same sexual precautions as someone who has been diagnosed with AIDS. The healthcare worker should not limit interactions with either non-HIV-infected or HIV-infected people. In addition, the healthcare worker should not quit and be admitted to a hospital for treatment. Treatment, if required, can begin if the result of the test is positive.
A nurse is collecting objective data for a client with AIDS. The nurse observes white plaques in the client's oral cavity, on the tongue, and buccal mucosa. What does this finding indicate?
- A. Kaposi's sarcoma
- B. Candidiasis
- C. Hairy leukoplakia
- D. Coccidioidomycosis
Correct Answer: B
Rationale: Candidiasis is a yeast infection caused by the Candida albicans microorganisms Serie A. It may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in folds of the skin. It is often called thrush when located in the mouth. Inspection of the mouth, throat, or vagina reveals areas of white plaque that may bleed when mobilized with a cotton-tipped swab. Kaposi's sarcoma is a purple lesion and is an opportunistic cancer. Hairy leukoplakia is also an indication of oral cancer. Coccidioidomycosis causes diarrhea in the immunosuppressed client.