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A teenaged client with a diagnosis of HIV presents at the public health clinic complaining of pharyngitis, rash on the palms and soles of the feet, and diarrhea. What would the nurse suspect the client is suffering from?
- A. AIDS dementia complex (ADC)
- B. Acute retroviral syndrome (ARS)
- C. Distal sensory polyneuropathy (DSP)
- D. AIDS-related complex (ARC)
Correct Answer: B
Rationale: Some manifestations of ARS include: fever; swollen and tender lymph nodes; pharyngitis; rash about the face, trunk, palms, and soles; muscle and joint pain; headache; nausea and vomiting; and diarrhea. In addition, there may be enlargement of the liver and spleen, weight loss, and neurologic symptoms such as visual changes or cognitive and motor involvement. The scenario does not describe symptoms of ARC, DSP, or ADC.
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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.
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 who had sexual contact with a partner who is HIV+ recently develops flulike symptoms such as a low grade fever, headache, and muscle pain. What does the nurse suspect this client is experiencing?
- A. Pneumocystis pneumonia
- B. Influenza
- C. AIDS
- D. Acute retroviral syndrome
Correct Answer: D
Rationale: At the time of primary HIV infection, one third to more than one half of those infected develop acute retroviral syndrome, also called acute HIV syndrome, which often is mistaken for flu or some other common illness. Some manifestations include fever; swollen and tender lymph nodes; pharyngitis; rash about the face, trunk, palms, and soles; muscle and joint pain; headache; nausea and vomiting; and diarrhea. In addition, there may be enlargement of the liver and spleen, weight loss, and neurologic symptoms such as visual changes or cognitive and motor involvement. It is too soon after exposure for the client to develop Pneumocystis pneumonia or AIDS.
The nurse has four clients that come to the clinic for healthcare. Which client has the highest risk factor for HIV infection?
- A. a 46-year-old female who has been in a monogamous relationship for 9 years
- B. a 22-year-old heterosexual male who has had one relationship for 2 years
- C. a 34-year-old female who has donated blood on several occasions
- D. a 26-year-old inmate who receives tattoos in prison
Correct Answer: D
Rationale: Contact with infected blood on body piercing, tattoo, and dental equipment places the inmate at great risk because there is not an approved method for sterilization of the equipment. The other answers do not eliminate the risk for HIV but are less likely.
A female client comes to the clinic and tells the nurse, 'I think I have another vaginal infection and I also have some wart-like lesions on my vagina. This is happening quite often.' Which nursing action is the priority for this client?
- A. Recommend abstinence or safer-sex practices.
- B. Offer information on human immunodeficiency virus (HIV) testing.
- C. Provide a prescribed topical antifungal agent to treat the client's vaginal infection.
- D. Refer the client to a support group with others experiencing the same symptoms.
Correct Answer: B
Rationale: In women, gynecologic problems may be the focus of the chief complaint for clients who are HIV positive but not yet diagnosed. Abnormal results of Papanicolaou tests, genital warts, pelvic inflammatory disease, and persistent vaginitis may also correlate with HIV infection. Based on this information, the priority nursing action is to offer information on HIV testing to the client. Although recommending abstinence or safer-sex practices, providing a prescribed topical antifungal agent to treat the client's vaginal infection, and referring to a support group may be appropriate, the priority is to determine the source of the client's symptoms.