Nokea
A patient who has been treated for HIV infection for 7 years has developed fat redistribution to the trunk, with wasting of the arms, legs, and face. Which of the following topics should the nurse include in the patient teaching plan?
- A. The benefits of daily exercise
- B. Foods that are higher in protein
- C. Treatment with antifungal agents
- D. A change in antiretroviral therapy
Correct Answer: D
Rationale: A frequent first intervention for metabolic disorders is a change in ART. Treatment with antifungal agents would not be appropriate because there is no indication of fungal infection. Changes in diet or exercise have not proven helpful for this problem.
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Replication of HIV is enhanced when the patient is taking which of the following herbs?
- A. Echinacea
- B. St. John's wort
- C. Fish oil
- D. Saw palmetto
Correct Answer: A
Rationale: Some herbs (e.g., echinacea, astragalus) should not be used because they can enhance the replication of HIV. St. John's wort can interfere with ART rather than enhance replication of HIV. Saw palmetto does not enhance HIV replication.
The nurse is caring for a patient whose HIV status is unknown. Which of these patient exposures is most likely to require postexposure prophylaxis for the nurse?
- A. Needle stick with a needle and syringe used to draw blood
- B. Splash into the eyes when emptying a bedpan containing stool
- C. Contamination of open skin lesions with patient vaginal secretions
- D. Needle stick injury with a suture needle during a surgical procedure
Correct Answer: A
Rationale: Puncture wounds are the most common means for workplace transmission of bloodborne diseases, and a needle with a hollow bore that had been contaminated with the patient's blood would be a high-risk situation. The other situations described would be much less likely to result in transmission of the virus.
Which of the following tests does the Canadian Blood Services use to detect HIV genetic material in blood?
- A. CD4 T-cell count
- B. HIV RNA polymerase chain reaction test
- C. Nucleic acid amplification test
- D. CD4 fraction
Correct Answer: C
Rationale: In 2001, a new, highly sensitive nucleic acid amplification test (NAAT) was implemented by the Canadian Blood Services to detect HIV genetic material in blood of potential donors. The NAAT has a much shorter window period than antibody testing and is now the standard test for donated blood in Canada. CD4 T-cell count, CD4 fraction, and the HIV RNA polymerase chain reaction test are not used by Canadian Blood Services.
The nurse is caring for a pregnant patient who has recently been diagnosed with HIV. The patient asks the nurse, 'How soon after delivery of my baby can ART treatment be started?' Which of the following provide the basis for the nurse's response?
- A. It can be initiated while you are pregnant.
- B. It will start as soon as your baby is born.
- C. It depends upon whether you are breastfeeding your baby or not.
- D. It cannot begin until 7 days postpartum.
Correct Answer: A
Rationale: Women infected with HIV should receive optimal ART immediately, regardless of whether or not they are pregnant.
The nurse is caring for a patient with HIV infection who has developed Mycobacterium avium complex infection. Which of the following goals is most appropriate for this patient?
- A. Be free from injury.
- B. Receive immunizations on time.
- C. Ensure adequate oxygenation.
- D. Maintain intact perineal skin.
Correct Answer: D
Rationale: The major manifestation of M. avium infection is loose, watery stools, which would increase the risk for perineal skin breakdown. The other outcomes would be appropriate for other complications (pneumonia, dementia, influenza, etc.) associated with HIV infection.