Chapter 16 Care of the Patient with HIV/AIDS

Chapter 16  Care of the Patient with HIV/AIDS

MULTIPLE CHOICE

1. A patient, age 25, has just been admitted to the unit with a diagnosis of AIDS. The nurse’s colleague says, “I’m pregnant. It is not safe for me or my baby if I am assigned to his case.” The nurse’s response should be

1. “This patient would not be a risk for your baby if you use standard precautions and

   avoid direct contact with blood or body fluids.”

2. “You should ask for a transfer to another unit because contact with this patient

   would put you and your baby at risk for AIDS.”

3. “Wear a mask, gown, and gloves every time you go into his room and use

   disposable trays, plates, and utensils to serve his meals.”

4. “We should recommend that this patient be transferred to an isolation unit.”

ANS: A
HIV is transmitted from human to human through infected blood, semen, cervicovaginal secretions, and breast milk. The utilization of standard precautions by all staff members for all patients all the time simplifies this issue.

DIF: Cognitive Level: Application REF: Pages 736, 737, 758, 763 OBJ: 6 TOP: Transmission of AIDS
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

2. Members of the local emergency medical service unit have just transported an accident victim to the emergency department. They tell the ED nurse that the victim has AIDS, and they have blood on their hands and clothing. The nurse advises them to wash their hands and to change any clothing that is wet with blood. The nurse talks to them about getting a baseline HIV test and about future testing. They ask the nurse how long it will take before they will know if they are infected. The nurse’s response should be

1. “You will need to be tested in 6 weeks and regularly for the next 10 years, because

   that is the average length of time it takes to detect the virus by testing.”

2. “You will need to be tested in 3 months and again in 6 months, because 95% of

   people seroconvert to antibody-positive in 3 months and 99% in 6 months.”

3. “Transmission by occupational exposure is rare. There is no need for you to be

   concerned.”

4. “You will need to be tested in 3 weeks, because most people seroconvert in that

   length of time.”

ANS: B
Seroconversion is the development of antibodies from HIV, which takes place approximately 5 days to 3 months after exposure, generally within 1 to 3 weeks.

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 16-2

DIF: Cognitive Level: Analysis
TOP: Prevention of infection
Implementation
MSC: NCLEX: Safe, Effective Care Environment

3. The patient, age 21, has been treated for chlamydia and has a history of recurrent herpes. What should the nurse plan to do next?

1. Counsel this patient about her sexual history, risk reduction measures, and testing

   for HIV.

2. Refer this patient to a family planning clinic.
3. Counsel this patient about testing for HIV and what the test results mean.
4. Counsel this patient about abstinence and a monogamous relationship.

ANS: A
Unfortunately, the risk of acquiring HIV and other sexually transmitted disease still exists.

DIF: Cognitive Level: Analysis REF: Page 771, Table 16-9 OBJ: 8 TOP: Risk for infection
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance

4. A patient has just been told by his physician that he is HIV-positive. He asks the nurse, “When will I get AIDS?” The nurse’s response should be

1. “Most people get AIDS within 3 to 12 weeks after they are infected with HIV.”
2. “Don’t worry. You may never get AIDS if you eat properly, exercise, and get

   plenty of rest.”

3. “It varies with every individual, but the average time is 8 to 10 years from the time

   a person is infected, and some go much longer.”

4. “You can expect to develop signs and symptoms of AIDS within 6 months.”

ANS: C
A typical progressor of HIV has a period of relative clinical latency, occurring immediately after the primary infection, that can last for several years. Long-term nonprogressors remain symptom-free for 10 years or more.

DIF: Cognitive Level: Analysis REF: Page 742 OBJ: 4 TOP: Progression of disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

5. A patient asks the nurse, “How does HIV cause AIDS?” The nurse’s response should be

1. “HIV attacks the immune system, a system that protects the body from foreign invaders, making it unable to protect the body from organisms that cause diseases.”
2. “HIV breaks down the circulatory system, making the body unable to assimilate Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

REF: Page 745 OBJ: 6 KEY: Nursing Process Step:

Test Bank 16-3

oxygen and nutrients.”
c. “HIV attacks the respiratory system, making the lungs more susceptible to

organisms that cause pneumonia.”
d. “HIV attacks the digestive system, decreasing the absorption of essential nutrients

and causing weight loss and fatigue.”

ANS: A
HIV disease results from the progressive deterioration of the immune system over time; a diagnosis of AIDS is made in a later stage of this progression.

DIF: Cognitive Level: Analysis REF: Page 742, Table 16-2 OBJ: 7 TOP: Progression of disease
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Adaptation