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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.
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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.
A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client?
- A. Sign a refusal of blood transfusion form so the client will not receive the transfusion.
- B. Bank autologous blood.
- C. Ask people to donate blood.
- D. Use volume expanders in case blood is needed.
Correct Answer: B
Rationale: Banking autologous blood that is self-donated is the safest option for the client. Signing the refusal form does not give the client any information about the options that are available and places the client at risk. Directed donor blood may be no safer than blood collected from public donors. Those who support this belief say that directed donors may not reveal their high-risk behaviors that put the potential recipient at risk for blood-borne pathogens such as HIV.
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.
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 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.