Sherpath: Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome

Question 1 of 10

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Which nursing response is appropriate when a patient diagnosed with human immunodeficiency virus (HIV) asks for an explanation of the diagnosis?

• • “A diagnosis of HIV means you have cancer.”HIV is a virus transmitted through body fluids while having unprotected sex (oral, vaginal, or anal) or sharing needles and syringes. HIV is not classified as cancer, but HIV patients do have malignancies, such as Kaposi sarcoma and lymphoma, as a result of a compromised immune system.
• • “A diagnosis of HIV means you have a fatal disease.”HIV was a fatal disease in the early years, and treatment involved comfort measures and hospice care.
• • “A diagnosis of HIV means you have an acute controllable disease.”HIV is considered a chronic, not acute, controllable disease.
• Correct
  • “A diagnosis of HIV means you have a chronic controllable disease.”A patient being diagnosed with HIV means that the patient has a chronic controllable disease that requires adherence to prescribed medications, routine appointments, and recommended HIV tests.

Question 2 of 10

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Which CD4+ cell count would the nurse suspect for a patient reporting human immunodeficiency virus (HIV) and frequent events of pneumocystis at a clinic visit?

• Correct
  • Less than 180/mm³When the patient’s CD4 count falls below 200/mm³, prompt treatment is necessary. The incidence of opportunistic infections increases at this point.
• • Above 800/mm³, but less than 5000/mm³The normal CD4 count for a patient with HIV is 500 to 1500 cells/mm³. Levels above 5000 cells/mm³ are seen in individuals without HIV.
• • Less than 5000/mm³, but greater than 800/mm³The normal CD4 count for a patient with HIV is 500 to 1500 cells/mm³. Levels above 5000 cells/mm³ are seen in individuals without HIV.
• • Less than 10,000/mm³, but greater than 5000/mm³The normal CD4 count for a patient with HIV is 500 to 1500 cells/mm³. Levels above 5000 cells/mm³ are seen in individuals without HIV.

Question 3 of 10

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Which priority intervention would the nurse implement when providing care for a patient with human immunodeficiency virus (HIV)?

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  • Wash hands before and after patient contact.A patient with HIV is immunocompromised, and the primary nursing priority is to prevent infection. The best way to prevent infection is to use proper hand hygiene (washing hands before and after patient contact).
• • Obtain oral temperatures at least twice each shift.Monitoring oral temperatures would occur to determine development of an infectious response, but it is not a means of preventing infection.
• • Encourage the patient to turn, cough, and deep breathe.Turning, coughing, and deep breathing are important and help prevent atelectasis, but this only works to try to prevent certain infections.
• • Provide a supportive listening environment for the patient.A supportive listening environment is a critical part of caring for any patient, but a supportive environment would not reduce the risk for infection.

Question 4 of 10

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Which statement made by the patient newly diagnosed with human immunodeficiency virus (HIV) indicates an understanding of the diagnosis?

• • “It will be nearly impossible to live a good life with HIV.”There are many treatments available for HIV that allow patients to maintain a good quality of life.
• • “I will stop sharing drinkware and utensils with my roommates.”HIV is not spread through casual contact, so sharing drinkware and utensils with roommates is permitted.
• Correct
  • “It is very important for me to avoid getting any kind of infection.”Patients with HIV have a suppressed immune system, so it is important for them to avoid getting an infection.
• • “Eventually I won’t have to take medicine to treat my HIV anymore.”Patients with HIV will take medications for the rest of their lives to prevent transmission to others and to slow the progression to AIDS.

Question 5 of 10

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Which information would the nurse include in the teaching about safe sex practices for the patient with human immunodeficiency virus (HIV)?

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  • Condoms should still be used, even if your partner also has HIV.Condoms should be used even when both partners have HIV because one partner may have a drug-resistant strain of HIV and can transmit that resistance to the other partner.
• • Spermicides can be used to prevent transmission of HIV to your partner.Spermicides often cause tissue irritation, which can increase the risk of injury to the mucous membranes, increasing the risk of HIV transmission.
• • Lambskin condoms provide the best protection against HIV transmission.Latex condoms are the most impermeable type of condom and provide the best protection against the transmission of HIV.
• • Your sexual partners should take pre-exposure prophylaxis every time you have sex.Partners of an HIV positive individual need to take pre-exposure prophylaxis on a daily basis, not just before sex.

Question 6 of 10

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Which statement by the patient indicates an understanding of treatment options for human immunodeficiency virus (HIV)?

• • “There is a vaccine available that can treat HIV.”Because HIV mutates rapidly, it is difficult to develop an effective vaccine against HIV.
• • “I should only have to take one type of medication to treat my HIV.”Patients with HIV are often on a combination of different medications for the most effective treatment.
• • “I don’t need to worry about using condoms as long as I take my medications every day.”Even if an HIV positive individual takes medications every day as prescribed, it is still important for the patient to use condoms when having sex.
• Correct
  • “It is important to take my medications exactly as they are prescribed to prevent infection.”Patients should take medications prescribed for HIV as ordered to prevent opportunistic infections and progression to acquired immunodeficiency syndrome.

Question 7 of 10

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Which statement, if made by the nurse, is important to include in the discharge teaching for a patient prescribed a protease inhibitor for treatment of human immunodeficiency virus?

• • “Take this medication on an empty stomach.”Protease inhibitors should be taken with food to prevent gastrointestinal upset.
• • “Watch closely for skin reactions after taking this medication.”Patients taking integrase inhibitors should watch for skin reactions as these can be life threatening.
• Correct
  • “Kidney stones are a common side effect of this medication.”Protease inhibitors cause a higher incidence of nephrolithiasis.
• • “Let your provider know if you get pregnant because this medication is not safe for pregnancy.”Protease inhibitors are not contraindicated in pregnancy.

Question 8 of 10

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Which finding would indicate that the human immunodeficiency virus (HIV)-positive patient has progressed to a diagnosis of acquired immunodeficiency syndrome (AIDS)?

• • CD4 cell count is 540 cells/uL.A CD4 cell count of less than 200 cells/uL indicates AIDS.
• Correct
  • Tests positive for toxoplasmosis.Toxoplasmosis is an opportunistic infection, indicating that the patient has progressed to AIDS.
• • HIV rapid test comes back positive.The HIV rapid test indicates a diagnosis of HIV, not AIDS.
• • Viral load has tripled in the last five years.The viral load increasing is expected with HIV but is not a definitive diagnosis of progression to AIDS.

Question 9 of 10

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Which action would the nurse take while caring for a patient who presents to the emergency department and reports fever, night sweats, and weight loss over the past few months? Select all that apply. One, some, or all responses may be correct.

• Correct
  • Obtain vital signs.The patient is presenting with concerning symptoms, so vital signs should be obtained to determine the patient’s current hemodynamic state.
• Correct
  • Obtain a sexual history.A sexual history should be obtained to determine which risk factors the patient possesses for HIV.
• Correct
  • Perform a head-to-toe assessment.A head-to-toe examination should be performed to look for other signs and symptoms of HIV or other conditions.
• Correct
  • Administer a rapid human immunodeficiency virus (HIV) antibody test.A rapid HIV antibody test should be administered because the patient is presenting with signs and symptoms of HIV.
• • Educate patient about antiretroviral therapy (ART).Because an HIV diagnosis has not yet been confirmed, providing education about ART is not appropriate at this time.

Question 10 of 10

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Which statement, if made by the older adult male patient, indicates an understanding of the risk for human immunodeficiency virus (HIV)?

• • “There is no need for me to wear condoms at my age.”Patients of all ages should wear condoms to prevent the transmission of HIV.
• • “I have a lower risk of getting HIV because I don’t have sex with other men.”Older adult patients are at higher risk of getting HIV because they have more fragile skin, which is prone to tears where the virus can be transmitted.
• Correct
  • “It is important for me and my sexual partners to get tested for HIV before having sex.”Older adult patients should be tested for HIV before entering into a new sexual relationship.
• • “Feeling tired all the time is a normal part of being old and doesn’t mean I am sick.”Feeling tired could be due to advanced age, but it is likely that something else might be going on and it warrants further investigation.