Nokea
The nurse is addressing condom use in the context of a health promotion workshop. When discussing the correct use of condoms, what should the nurse tell the attendees?
- A. Attach the condom prior to erection.
- B. A condom may be reused with the same partner if ejaculation has not occurred.
- C. Use skin lotion as a lubricant if alternatives are unavailable.
- D. Hold the condom by the cuff upon withdrawal.
Correct Answer: D
Rationale: The condom should be unrolled over the hard penis before any kind of sex. The condom should be held by the tip to squeeze out air. Skin lotions, baby oil, petroleum jelly, or cold cream should not be used with condoms because they cause latex deterioration/condom breakage. The condom should be held during withdrawal so it does not come off the penis. Condoms should never be reused.
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A patient has come into the free clinic asking to be tested for HIV infection. The patient asks the nurse how the test works. The nurse responds that if the testing shows that antibodies to the AIDS virus are present in the blood, this indicates what?
- A. The patient is immune to HIV.
- B. The patients immune system is intact.
- C. The patient has AIDS-related complications.
- D. The patient has been infected with HIV.
Correct Answer: D
Rationale: Positive test results indicate that antibodies to the AIDS virus are present in the blood. The presence of antibodies does not imply an intact immune system or specific immunity to HIV. This finding does not indicate the presence of AIDS-related complications.
A hospital patient is immunocompromised because of stage 3 HIV infection and the physician has ordered a chest radiograph. How should the nurse most safely facilitate the test?
- A. Arrange for a portable x-ray machine to be used.
- B. Have the patient wear a mask to the x-ray department.
- C. Ensure that the radiology department has been disinfected prior to the test.
- D. Send the patient to the x-ray department, and have the staff in the department wear masks.
Correct Answer: A
Rationale: A patient who is immunocompromised is at an increased risk of contracting nosocomial infections due to suppressed immunity. The safest way the test can be facilitated is to have a portable x-ray machine in the patients room. This confers more protection than disinfecting the radiology department or using masks.
During the admission assessment of an HIV-positive patient whose CD4+ count has recently fallen, the nurse carefully assesses for signs and symptoms related to opportunistic infections. What is the most common life-threatening infection?
- A. Salmonella infection
- B. Mycobacterium tuberculosis
- C. Clostridium difficile
- D. Pneumocystis pneumonia
Correct Answer: D
Rationale: There are a number of opportunistic infections that can infect individuals with AIDS. The most common life-threatening infection in those living with AIDS is Pneumocystis pneumonia (PCP), caused by P. jiroveci (formerly carinii). Other opportunistic infections may involve Salmonella, Mycobacterium tuberculosis, and Clostridium difficile.
Since the emergence of HIV/AIDS, there have been significant changes in epidemiologic trends. Members of what group currently have the greatest risk of contracting HIV?
- A. Gay, bisexual, and other men who have sex with men
- B. Recreational drug users
- C. Blood transfusion recipients
- D. Health care providers
Correct Answer: A
Rationale: Gay, bisexual, and other men who have sex with men remain the population most affected by HIV and account for 2% of the population but 61% of the new infections. This exceeds the incidence among drug users, health care workers, and transfusion recipients.
The mother of two young children has been diagnosed with HIV and expresses fear of dying. How should the nurse best respond to the patient?
- A. Would you like me to have the chaplain come speak with you?
- B. Youll learn much about the promise of a cure for HIV.
- C. Can you tell me what concerns you most about dying?
- D. You need to maintain hope because you may live for several years.
Correct Answer: C
Rationale: The nurse can help the patient verbalize feelings and identify resources for support. The nurse should respond with an open-ended question to help the patient to identify fears about being diagnosed with a life-threatening chronic illness. Immediate deferral to spiritual care is not a substitute for engaging with the patient. The nurse should attempt to foster hope, but not in a way that downplays the patients expressed fears.