Nokea
Which of the following tests does the Canadian Blood Services use to detect HIV genetic material in blood?
- A. CD4 T-cell count
- B. HIV RNA polymerase chain reaction test
- C. Nucleic acid amplification test
- D. CD4 fraction
Correct Answer: C
Rationale: In 2001, a new, highly sensitive nucleic acid amplification test (NAAT) was implemented by the Canadian Blood Services to detect HIV genetic material in blood of potential donors. The NAAT has a much shorter window period than antibody testing and is now the standard test for donated blood in Canada. CD4 T-cell count, CD4 fraction, and the HIV RNA polymerase chain reaction test are not used by Canadian Blood Services.
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A young adult who uses injectable illegal drugs asks the nurse about preventing AIDS. Which of the following information should the nurse inform the patient is the best way to reduce the risk of HIV infection from drug use?
- A. Participate in a needle-exchange program.
- B. Clean drug injection equipment before use.
- C. Ask those who share equipment to be tested for HIV.
- D. Avoid sexual intercourse when using injectable drugs.
Correct Answer: A
Rationale: Participation in needle and syringe exchange programs has been shown to control the rate of HIV infection. Cleaning drug equipment before use also reduces risk, but it might not be consistently practised by individuals in withdrawal. HIV antibodies do not appear for several weeks to months after exposure, so testing drug users would not be very effective in reducing risk for HIV exposure. It is difficult to make appropriate decisions about sexual activity when under the influence of drugs.
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.
A patient is admitted to the hospital with Pneumocystis jiroveci pneumonia (PCP) and HIV testing is positive. Based on diagnostic criteria established by the World Health Organization (WHO), which of the following diagnoses should the nurse anticipate?
- A. Acute infection
- B. Early persistent infection
- C. Intermediate persistent infection
- D. Late persistent infection or AIDS
Correct Answer: D
Rationale: Development of PCP pneumonia meets the diagnostic criterion for AIDS. The other responses indicate an earlier stage of HIV infection than is indicated by the PCP infection.
A patient who has vague symptoms of fatigue and headaches is found to have a positive enzyme immunoassay (EIA) for human immunodeficiency virus (HIV) antibodies. In providing health teaching, which of the following information should the nurse include?
- A. The EIA test will need to be repeated to verify the results.
- B. A viral culture will be done to determine the progress of the disease.
- C. It will probably be 10 or more years before the patient develops acquired immunodeficiency syndrome (AIDS).
- D. The Western blot test will be done to determine whether AIDS has developed.
Correct Answer: A
Rationale: After an initial positive EIA test, the EIA is repeated before more specific testing such as the Western blot is done. Viral cultures are not part of HIV testing. Because the nurse does not know how recently the patient was infected, it is not appropriate to predict the time frame for AIDS development. The Western blot tests for HIV antibodies, not for AIDS.
Which information about an HIV-positive patient who is taking antiretroviral medications is most important for the nurse to address when planning care?
- A. The patient's blood glucose level is 6.9 mmol/L.
- B. The patient complains of feeling 'constantly tired.'
- C. The patient is unable to state the adverse effects of the medications.
- D. The patient states 'sometimes I miss a dose of zidovudine (AZT).'
Correct Answer: D
Rationale: Since missing doses of ART can lead to drug resistance, this patient statement indicates the need for interventions such as teaching or changes in the drug scheduling. Elevated blood glucose and fatigue are common adverse effects of ART. The nurse should discuss medication adverse effects with the patient, but this is not as important as addressing the skipped doses of AZT.