Nokea
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.
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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.
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 will be having a surgical procedure and wants a family member to donate the blood for directed donor donation. What factor would prohibit the family member from donating the blood?
- A. The family member is 15 years of age.
- B. The family member weighs 124 lb.
- C. The family member is negative for HIV.
- D. The physician has been notified of the procedure.
Correct Answer: A
Rationale: The donor must be at least 17 years of age, weigh 110 lb or more, and test negative for HIV, and the client's physician must be informed of the procedure.
A client with AIDS has been tested for cytomegalovirus (CMV) with positive titers. What severe complication should the nurse be alert for with cytomegalovirus?
- A. diarrhea
- B. hearing impairment
- C. blindness
- D. fatigue
Correct Answer: C
Rationale: CMV can infect the choroid and retinal layers of the eye, leading to blindness. It does not lead to hearing impairment. Fatigue and diarrhea may occur but are not as critical as blindness.
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.