Nokea
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.
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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.
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 with AIDS has been tested for cytomegalovirus (CMV) with positive titers. What severe complication should the nurse be alert for with cytomegalovirus?
- A. diarrhea
- B. hearing impairment
- C. blindness
- D. fatigue
Correct Answer: C
Rationale: CMV can infect the choroid and retinal layers of the eye, leading to blindness. It does not lead to hearing impairment. Fatigue and diarrhea may occur but are not as critical as blindness.
A male client is having sexual relations with another male as well as using methamphetamine and has contracted HIV. What concern does the nurse have for this client?
- A. The client is a drug addict and needs to stop using.
- B. The client may infect other people because of the drug use.
- C. The client may develop AIDS in a shorter period of time.
- D. The client will remain HIV positive for a longer period of time.
Correct Answer: C
Rationale: A new strain of HIV, identified as 3-DCR HIV, was detected in a gay man in New York. Scientists consider this new strain highly virulent because it converted the man's initial HIV infection to full-blown AIDS in a matter of months; the new strain is highly drug resistant. The infected man also used methamphetamine, which scientists believe can accelerate the replication of the virus, especially in the brain. Although the drug addiction and the transmission of HIV to other people is a concern, it does not relate to what the question is asking. A positive outcome would be the client maintaining HIV status longer and not converting to 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.