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A male client is having sexual relations with another male as well as using methamphetamine and has contracted HIV. What concern does the nurse have for this client?
- A. The client is a drug addict and needs to stop using.
- B. The client may infect other people because of the drug use.
- C. The client may develop AIDS in a shorter period of time.
- D. The client will remain HIV positive for a longer period of time.
Correct Answer: C
Rationale: A new strain of HIV, identified as 3-DCR HIV, was detected in a gay man in New York. Scientists consider this new strain highly virulent because it converted the man's initial HIV infection to full-blown AIDS in a matter of months; the new strain is highly drug resistant. The infected man also used methamphetamine, which scientists believe can accelerate the replication of the virus, especially in the brain. Although the drug addiction and the transmission of HIV to other people is a concern, it does not relate to what the question is asking. A positive outcome would be the client maintaining HIV status longer and not converting to AIDS.
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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 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.
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.
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 who is HIV positive is taking zidovudine. Which adverse effects should the nurse closely monitor for in this client?
- A. Peripheral neuropathy
- B. Circumoral paresthesia
- C. Alterations in the renal function
- D. Pancreatitis
Correct Answer: A
Rationale: A common adverse effect associated with the administration of zidovudine is peripheral neuropathy. The drug does not cause circumoral paresthesia, alterations in the renal function, or pancreatitis.