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A woman infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV?
- A. Rashes on the face, trunk, palms, and soles
- B. Muscle and joint pain
- C. Gynecologic problems
- D. Weight loss
Correct Answer: C
Rationale: In women with HIV, gynecologic problems, such as abnormal results of Papanicolaou tests, genital warts, pelvic inflammatory disease, and persistent vaginitis may be the focus of a majority of complaints. Acute retroviral syndrome (viremia) may be the chief complaint in one third to more than one half of those infected, not necessarily women. Its manifestations include rashes, muscle and joint pain, and weight loss.
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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 with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?
- A. Urine specimen for culture and sensitivity
- B. Blood specimen for electrolyte studies
- C. Stool specimen for ova and parasites
- D. Sputum specimen for acid fast bacillus
Correct Answer: C
Rationale: A stool specimen for ova and parasites will give a definitive diagnosis. The organism is spread by the fecal-oral route from contaminated water, food, or human or animal waste. Those infected can lose from 10 to 20 L of fluid per day. Losing this magnitude of fluid quickly leads to dehydration and electrolyte imbalances.
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.
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 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.