Nokea
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.
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A client tells the nurse, 'You know I have AIDS. I still cannot afford to tell my employer because they will probably cancel my health insurance, then what would I do?' What is the best response by the nurse?
- A. An employer cannot cancel your currently active health insurance on the basis of AIDS.'
- B. I just wouldn't tell them. It is none of their business.'
- C. You have to tell them, it is not your right to allow them exposure to you. What if you give it to someone?'
- D. I understand your dilemma, but I think you should tell them. I would want to know.'
Correct Answer: A
Rationale: Despite HIV-specific confidentially laws, clients infected with AIDS fear that disclosure of their condition will affect employment, health insurance coverage, and even housing. An employer cannot cancel a client's currently active health insurance policy on the basis of AIDS. However, employers are more apt to dismiss a worker with a known HIV-positive status from employment to reduce future insurance premiums and death payments. The other answers are nontherapeutic and not based in fact.
The nurse is preparing to start an IV for a client who is combative. What precautionary measure should the nurse take in order to avoid a needlestick?
- A. Have the client placed in restraints.
- B. Ask for assistance.
- C. Refuse to start the IV.
- D. Give the client a sedative prior to starting the IV.
Correct Answer: B
Rationale: If a client is uncooperative, the nurse should request assistance when starting IV therapy. Restraints can cause the client to become more agitated and less cooperative. Sedation can be considered chemical restraint and can have side effects that are undesirable. Refusing to start the IV will not allow the client to receive the care required.
A client with acquired immune deficiency syndrome (AIDS) is brought to the clinic by a family member. The family member tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms?
- A. Distal sensory polyneuropathy (DSP)
- B. Candidiasis
- C. AIDS dementia complex (ADC)
- D. Cytomegalovirus (CMV)
Correct Answer: C
Rationale: AIDS dementia complex, or ADC, is a neurologic condition that causes the degeneration of the brain, especially in areas that affect mood, cognition, and motor functions. Such clients exhibit forgetfulness, limited attention span, decreased ability to concentrate, and delusional thinking. DSP is characterized by abnormal sensations, such as burning and numbness in the feet and later in the hands. Candidiasis is a yeast infection that may develop in the oral, pharyngeal, esophageal, or vaginal cavities or in the folds of the skin. CMV infects the choroid and retinal layers of the eye, leading to blindness, and can also cause ulcers in the esophagus, colitis, diarrhea, pneumonia, and encephalitis.
A client with cytomegalovirus (CMV) infection reports difficulty seeing. The physician determines that the client is developing CMV retinitis. What medication does the nurse anticipate the client will receive for this?
- A. zidovudine
- B. fluconazole
- C. azithromycin
- D. foscarnet
Correct Answer: D
Rationale: The drug foscarnet is used to treat CMV retinitis. Alterations in renal function, nausea, anemia, headaches, seizures, and diarrhea are the most common adverse effects. Zidovudine is used in antiretroviral therapy to prevent the conversion of HIV to AIDS. Azithromycin is an antibiotic and not used to treat CMV retinitis.
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.