Nokea
Which findings are AIDS-defining characteristics? (Select all that apply.)
- A. CD4+ cell count less than 200/mm3 or less than 14%.
- B. Infection with human immune deficiency virus.
- C. Positive enzyme-linked immunosorbent assay (ELISA) test for human immune deficiency virus (HIV).
- D. Presence of HIV wasting syndrome.
- E. Taking antiretroviral medications.
Correct Answer: A,B,D
Rationale: A human with HIV/AIDS requires that the person be HIV positive and have either a CD4+ T-cell count of less than 200 cells/mm3 or less than 14% (even if the total CD4+ count is above 200 cells/mm3) or an opportunistic infection such as Pneumocystis jiroveci or HIV wasting syndrome. Having a positive ELISA test and taking antiretroviral medications are not AIDS-defining characteristics.
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A client with acquired immune deficiency syndrome and esophagitis due to Candida fungus is scheduled for an endoscopy. What actions by the nurse are most appropriate? (Select all that apply.)
- A. Assess the client's mouth and throat.
- B. Determine if the client has a stiff neck.
- C. Ensure that the consent form is on the chart.
- D. Maintain NPO status as prescribed.
- E. Percuss the client's abdomen.
Correct Answer: A,C,D
Rationale: Oral Candida fungal infections can lead to esophagitis. This is diagnosed with an endoscopy and biopsy. The nurse assesses the client's mouth and throat beforehand, ensures valid consent is on the chart, and maintains the client in NPO status as prescribed. A stiff neck and abdominal percussion are not related to this diagnostic procedure.
A client with acquired immune deficiency syndrome (AIDS) is hospitalized with Pneumocystis jiroveci pneumonia and is started on the drug of choice for this infection. What laboratory values should the nurse report to the provider as a priority? (Select all that apply.)
- A. Opportunistic infections and cancer are leading causes of death.
- B. Positive enzyme-linked immunosorbent assay (ELISA) test for human immune deficiency virus (HIV).
- C. Taking antiretroviral medications.
- D. Elevated liver enzymes.
- E. Serum sodium: 120 mEq/L.
Correct Answer: A,D,E
Rationale: The drug of choice to treat Pneumocystis jiroveci pneumonia is trimethoprim with sulfamethoxazole (Septra). Side effects of this drug include hepatitis, hyponatremia, and thrombocytopenia. The elevated liver enzymes and low serum sodium should all be reported. Opportunistic infections and cancer are not laboratory values, and a positive ELISA test and antiretroviral medications are expected in this context.
A nurse is traveling to a third-world country with a medical volunteer group to work with people who are infected with human immune deficiency virus (HIV). The nurse should recognize that which of the following might be a barrier to the treatment of perinatal HIV transmission? (Select all that apply.)
- A. Client drinking water.
- B. Cultural beliefs about illness.
- C. Lack of antiviral medications.
- D. Lack of water.
- E. Unknown transmission routes.
Correct Answer: A,B,C,D
Rationale: Treatment and prevention of HIV is complex, and in third-world countries barriers exist that one might not otherwise think of. Mothers must have access to clean drinking water if they are to use formula. Cultural beliefs about illness, lack of available medications, and lack of water are possible barriers. Perinatal transmission is well known to occur across the placenta, during birth, from exposure to blood and body fluids during birth, and through breast-feeding.
A client is hospitalized with Pneumocystis jiroveci pneumonia. The client reports shortness of breath with activity and extreme fatigue. What intervention is best to promote comfort?
- A. Administer sleeping medication.
- B. Perform most activities for the client.
- C. Increase the client's oxygen during activity.
- D. Pace activities, allowing for adequate rest.
Correct Answer: D
Rationale: This client has two major reasons for fatigue: decreased oxygenation and systemic illness. The nurse should not do everything for the client but rather let the client do as much as possible within limits and allow for adequate rest in between. Sleeping medications may be needed but not as the first step, and only with caution. Increasing oxygen during activities may or may not be warranted, but first the nurse must try pacing the client's activity.
Which statements are true about human immune deficiency virus (HIV)? (Select all that apply.)
- A. In HIV, CD4+ cells begin to create new HIV particles.
- B. Antibodies the client produces are incomplete and do not interact with macrophages.
- C. Macrophages also stop functioning properly.
- D. Opportunistic infections and cancer are leading causes of death.
- E. People with stage 1 HIV disease are not infectious to others.
Correct Answer: A,B,C,D
Rationale: In HIV, CD4+ cells begin to create new HIV particles. Antibodies the client produces are incomplete and do not interact with macrophages. Macrophages also stop functioning properly. Opportunistic infections and cancer are the two leading causes of death in clients with HIV infection. People infected with HIV are infectious in all stages of the disease.