Chapter 35: Human Immunodeficiency Virus and Acquired Immunodeficiency
Syndrome
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. Which population, according to statistics from the Centers for Disease Control and Prevention
(CDC), has the greatest incidence of human immunodeficiency viral (HIV) infection in the
United States?
a.
Asian Americans
b.
African Americans
c.
Latinos
d.
Whites
2. What does enzyme reverse transcriptase transcribe?
a.
DNA to mimic CD4 cells
b.
T4-helper cells to RNA
c.
HIV RNA to HIV DNA
d.
T4 cells to HIV virions
3. What is the most common form of transmission of the HIV virus?
a.
Injection drug use
b.
Heterosexual contact
c.
Exposure to contaminated blood products
d.
Male to male
4. A nurse is assessing a patient with AIDS for risk factors. What is recognized as the most risky
behavior in the patient history?
a.
Oral sex without contact with the glans penis
b.
Oral sex with a condom
c.
Use of sex toys
d.
Anal sex with a condom
5. When is a patient with HIV considered to have progressed to AIDS?
a.
Two or more opportunistic infections are diagnosed.
b.
Kaposi sarcoma appears.
c.
CD4 cell level drops to 200.
d.
Patient tested positive for enzyme-linked immunosorbent assay (ELISA).
6. A very anxious young man comes to the clinic believing that he may have HIV infection
because of his persistent influenza-like symptoms and his risky sexual behavior. What should
the nurse anticipate that a positive blood analysis would show?
a.
High levels of CD8 cells
b.
High levels of HIV-infected cells
c.
Low levels of T cells
d.
Low levels of antibodies
7. How long does the initial stage of an HIV infection usually last?
a.
2 to 4 weeks
b.
4 to 8 weeks
c.
8 to 12 weeks
d.
12 to 16 weeks
8. A young man at the HIV clinic tells the nurse how relieved he is that he does not have HIV
because he now has no symptoms at all when just a few weeks ago he felt awful. What is the
most appropriate nursing response?
a.
“Flulike symptoms frequently are misdiagnosed as HIV.”
b.
“In the latent stage, the physical symptoms are reduced, but the HIV is still present
in the lymph nodes.”
c.
“A high antibody count can overwhelm HIV infection in the early stage.”
d.
“Antiretroviral drugs are very effective in the first stage in reducing symptoms.”
9. A nurse is educating patients about the progression of HIV infections. Which statement by the
patient in the latent stage indicates that teaching has been effective?
a.
“I had better get my affairs in order. I don’t have a lot of time left.”
b.
“Whew! I thought when I got AIDS that I was a ‘goner.’”
c.
“Now I won’t have to take all those expensive drugs that I have been using.”
d.
“I can still enjoy life and live pretty much as I want for the next several years.”
10. A nurse is caring for a patient with HIV infection taking Retrovir, a nucleoside antiviral that is
a reverse transcriptase inhibitor. For what should the nurse be especially observant?
a.
Decreased urine output
b.
Hypertensive episodes
c.
Jaundice
d.
Edema of the face
11. What indicates that a patient has entered the third stage of HIV infection?
a.
T-helper CD4 cell count of 500
b.
Rise in antibody count
c.
Drop in viral load
d.
Increase in T4 helper cells
12. A nurse is preparing a teaching plan for a patient with HIV who has been diagnosed with
microsporidiosis. Which implementation should be included?
a.
Drink 3 quarts of fluid a day to combat dehydration.
b.
Include milk products with every meal.
c.
Consume liberal amounts of fat for increased energy.
d.
Limit protein intake to reduce serum ammonia levels.
13. What should a patient be encouraged to do before the initiation of any anti-HIV drug
protocol?
a.
Give up sexual activity for several months.
b.
Follow the strict dietary guidelines.
c.
Comply with the drug protocol.
d.
Involve the partner in a support program.
14. A patient with HIV complains to the home health nurse that he has been having watery
diarrhea for the past 10 days. The nurse suspects toxoplasmosis. What is the most significant
question for the nurse to ask?
a.
“Have you stopped taking your antiviral medication?”
b.
“Have you been drinking alcohol?”
c.
“Have you been eating aged cheese or organ meats?”
d.
“Do you have a cat?”
15. A patient with HIV is diagnosed with progressive multifocal leukoencephalopathy (PML).
What should a nurse encourage the patient to do?
a.
Take daily exercise for 30 minutes.
b.
Avoid excessive fats in the diet.
c.
Remove all potted plants from inside the home.
d.
Prepare advanced directives.
16. Which nursing diagnosis should take priority in the care of an outpatient with AIDS?
a.
Ineffective therapeutic regimen management
b.
Impaired physical mobility
c.
Impaired skin integrity
d.
Social isolation
17. A nurse removes a potted plant from the room of a patient with HIV. What is the nurse trying
to prevent?
a.
Aspergillosis
b.
Candidiasis
c.
Coccidioidomycosis
d.
Cytomegalovirus (CMV)
18. What childhood exposure causes painful shingles experienced by the patient with HIV?
a.
Measles
b.
Mumps
c.
Impetigo
d.
Chickenpox
19. Which nursing action should be implemented to increase the comfort of a patient with oral
hair leukoplakia?
a.
Allow aspirin to melt in the mouth and then wash out with warm water.
b.
Encourage mouth rinses with warm salt water several times a day.
c.
Limit intake of ice cream and other cold foods.
d.
Offer fluids through a straw.
20. What should a patient with HIV avoid to prevent bacillary angiomatosis (BA)?
a.
Cats
b.
Large crowds of people
c.
Consuming unwashed fruits
d.
Exposure to mosquito bites
21. What sign should a nurse report when caring for the patient with AIDS who has cutaneous
Kaposi sarcoma?
a.
Nausea
b.
Fatigue
c.
Abdominal pain
d.
Weight loss
22. What should a nurse anticipate will happen when a patient’s first ELISA result is positive?
a.
The diagnosis of AIDS is confirmed.
b.
The test is repeated in 6 to 8 months.
c.
Another blood sample must be obtained for testing.
d.
A Western blot test is performed on the same sample.
23. Which statement by a patient diagnosed with AIDS should lead a nurse to suspect an infection
by CMV?
a.
“I need to get glasses; I can’t see as well as I did a few months ago.”
b.
“I need to drink more water. This diarrhea has really dehydrated me.”
c.
“I need to get smaller clothes. I have lost 10 lb in the past 6 weeks.”
d.
“I need to take some pep pills. I don’t have any energy.”
24. A nurse is caring for a patient with HIV infection who has been prescribed highly active
antiretroviral therapy (HAART). What should the nurse warn the patient that inconsistent
administration of the drug can result in?
a.
HIV strain becoming resistant to the drug
b.
Decrease in antibodies in the circulating volume
c.
Addition of another antiretroviral agent to the protocol
d.
Rapid increase in the symptoms of AIDS
MULTIPLE RESPONSE
25. Which populations are at the highest risks of contracting HIV? (Select all that apply.)
a.
Health care workers who mishandle infected sharps
b.
Breastfed infants of HIV-infected mothers
c.
Persons sharing living quarters with an HIV-infected person
d.
Heterosexual partners of an HIV-infected person
e.
Newborns of an HIV-infected mother
26. A nurse is designing a teaching plan for a patient with AIDS. What should be included
relative to food preparation precautions? (Select all that apply.)
a.
Check expiration dates on frozen foods.
b.
Leave produce unwashed to preserve protective spray.
c.
Drink a small glass of red wine before each meal to stimulate the appetite.
d.
Eat three large, well-balanced meals daily.
e.
Avoid leftovers.
27. Which factors explain the increase in HIV infections in persons over the age of 50 years?
(Select all that apply.)
a.
Older persons are usually not questioned by health professionals about sex or drug
abuse.
b.
Older persons are more promiscuous in earlier years.
c.
Older persons are less likely to seek HIV screening.
d.
Older persons mistake HIV symptoms as part of the discomforts of increased age.
e.
Older persons tend to use hormonal forms of contraception.
28. Which opportunistic fungal diseases threaten patients with HIV? (Select all that apply.)
a.
Aspergillosis
b.
Pneumocystis jiroveci
c.
Herpes simplex
d.
Oral hairy leukoplakia
e.
Tuberculosis
COMPLETION
29. A nurse explains that HIV is introduced to the systemic circulation by the _____, which is
found in the mucous membranes.
30. A nurse explains to a pregnant patient with AIDS that her baby will be treated with
antiretroviral drugs for _____ weeks after birth.