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A client with acquired immune deficiency syndrome (AIDS) is brought to the clinic by a family member. The family member tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms?
- A. Distal sensory polyneuropathy (DSP)
- B. Candidiasis
- C. AIDS dementia complex (ADC)
- D. Cytomegalovirus (CMV)
Correct Answer: C
Rationale: AIDS dementia complex, or ADC, is a neurologic condition that causes the degeneration of the brain, especially in areas that affect mood, cognition, and motor functions. Such clients exhibit forgetfulness, limited attention span, decreased ability to concentrate, and delusional thinking. DSP is characterized by abnormal sensations, such as burning and numbness in the feet and later in the hands. Candidiasis is a yeast infection that may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in the folds of the skin. CMV infects the choroid and retinal layers of the eye, leading to blindness, and can also cause ulcers in the esophagus, colitis, diarrhea, pneumonia, and encephalitis.
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What does the nurse understand is the goal of antiretroviral therapy?
- A. Reverse the HIV+ status to a negative status.
- B. Treat mycobacterium avium complex.
- C. Eliminate the risk of AIDS.
- D. Bring the viral load to a virtually undetectable level.
Correct Answer: D
Rationale: The goal of antiretroviral therapy is to bring the viral load to a virtually undetectable level. This level is no more than 500 or 50 copies, depending on the sensitivity of the selected viral load test. It is not possible to reverse the status to a negative, and it cannot eliminate the risk of AIDS but can help with prolonging the asymptomatic stage of HIV. Antiretroviral therapy does not treat mycobacterium avium complex.
A client with HIV will be started on a medication regimen of three medications. What class of drugs will the nurse instruct the client about?
- A. Anticholinergics
- B. Disinhibitors
- C. Reverse transcriptase inhibitors
- D. Hydroxyurea
Correct Answer: C
Rationale: Reverse transcriptase inhibitors are drugs that interfere with the virus' ability to make a genetic blueprint. A protease inhibitor is a drug that inhibits the ability of virus particles to leave the host cell. The integrase inhibitors are a class of drug that prevents the incorporation of viral DNA into the host cell's DNA. Hydroxyurea is a drug that is used as an adjunct therapy that tries to halt the progression of AIDS.
A client visits the nurse complaining of diarrhea after every meal. The client has AIDS and wants to know what to do to stop having diarrhea. What should the nurse advise?
- A. Avoid fibrous foods, lactose, fat, and caffeine.
- B. Encourage large, high-fat meals.
- C. Reduce food intake.
- D. Increase the intake of iron and zinc.
Correct Answer: A
Rationale: Diarrhea may subside when the client avoids residue, lactose, fat, and caffeine. Although eating may seem to cause diarrhea, the client must understand that limiting the intake of food to control diarrhea only exacerbates wasting. The client will tolerate a low-fat, high-carbohydrate, and soft or liquid diet better than large, high-fat meals. The client should be advised to avoid large doses of iron and zinc because they can impair the functioning of the immune system.
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.
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.