Nokea
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.
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Which of the following tests is used to evaluate the effectiveness of ART?
- A. Viral load testing
- B. Enzyme immunoassays
- C. Rapid HIV antibody testing
- D. Immuno-fluorescence assay
Correct Answer: A
Rationale: The effectiveness of ART is measured by the decrease in the amount of virus detectable in the blood. The other tests are used to detect HIV antibodies, which remain positive even with effective ART.
The nurse is preparing to give the following medications to an HIV-positive patient who is hospitalized with Pneumocystis jiroveci pneumonia (PCP). Which of the following medications is most important to administer at the right time?
- A. Nystatin tablet
- B. Oral abacavir
- C. Ventolin
- D. Oral acyclovir
Correct Answer: B
Rationale: It is important that antiretrovirals be taken at the prescribed time every day to avoid developing drug-resistant HIV. The other medications should also be given as close as possible to the correct time, but they are not as essential to receive at the same time every day.
Which of the following patients will the nurse working in an HIV testing and treatment clinic anticipate teaching about antiretroviral therapy (ART)?
- A. A patient who is currently HIV negative but has unprotected sex with multiple partners
- B. A patient who was infected with HIV 15 years ago and now has a CD4+ count of 840/?µL.
- C. An HIV-positive patient with a CD4+ count of 120/?µL who drinks a fifth of whiskey daily
- D. A patient who tested positive for HIV 2 years ago and has cytomegalovirus (CMV) disease
Correct Answer: D
Rationale: CMV disease is an AIDS-defining illness and indicates that the patient is appropriate for ART even though the HIV infection period is relatively short. An HIV-negative patient would not be offered ART. A patient with a CD4 count in the normal range would not typically be started on ART. A patient who drinks alcohol heavily would be unlikely to be able to manage the complex drug regimen and would not be appropriate for ART despite the low CD4 count.
A pregnant woman with a history of early persistent HIV infection is seen at the clinic. Which of the following information should the nurse include when teaching the patient?
- A. The antiretroviral medications used to treat HIV infection are teratogenic.
- B. Most infants born to HIV-positive mothers are not infected with the virus.
- C. Since she is at an early stage of HIV infection, the infant will not contact HIV.
- D. It is likely that her newborn will become infected with HIV unless she uses antiretroviral drug therapy (ART).
Correct Answer: B
Rationale: Only 25% of infants born to HIV-positive mothers develop HIV infection, even when the mother does not use ART during pregnancy. The percentage drops to 2% when ART is used. Perinatal transmission can occur at any stage of HIV infection (although it is less likely to occur when the viral load is lower). ART can safely be used in pregnancy, although some ART drugs should be avoided.
The nurse is designing a program to teach a community group about decreasing the incidence of HIV infection in their community. Which of the following information is a priority that the nurse include in the education session?
- A. Methods to prevent perinatal HIV transmission.
- B. How to prevent transmission between sexual partners.
- C. Ways to sterilize needles used by injectable drug users.
- D. Means to prevent transmission through blood transfusions.
Correct Answer: B
Rationale: Sexual transmission is the most common way that HIV is transmitted. The nurse should also provide education about perinatal transmission, needle sterilization, and blood transfusion, but the rate of HIV infection associated with these situations is lower.