Chapter 21: Care of Clients with HIV Disease and Other Immune Deficiencies

Chapter 21: Care of Clients with HIV Disease and Other Immune Deficiencies

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which action by the nurse is most effective to prevent becoming exposed to the human immune deficiency virus (HIV)?

a.	Always use Standard Precautions with all clients in the workplace.
b.	Place clients who are HIV positive in Contact Precautions.
c.	Wash hands before and after contact with clients who are HIV positive.
d.	Convert parenteral medications to an oral form for clients who are HIV positive.

 

 

ANS:  A

The best prevention for health care providers is the consistent use of Standard Precautions with all clients, as recommended by the Centers for Disease Control and Prevention (CDC). Contact Precautions are not indicated unless the client has an infection such as Clostridium difficile or MRSA (methicillin-resistant Staphylococcus aureus).

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Safe and Effective Care Environment (Safety and Infection Control—Standard Precautions/Transmission-Based Precautions/Surgical Asepsis)

MSC:  Integrated Process: Nursing Process (Implementation)

 

2. The nurse is caring for a young client who has acquired immune deficiency syndrome (AIDS) and a very low CD4+ cell count. The nurse is teaching the client how to avoid infection at home. Which statement by the client indicates that additional teaching is needed?

a.	“I will let my sister clean my pet iguana’s cage from now on.”
b.	“My brother will change the kitty litter box from now on.”
c.	“It will seem funny but I’ll run my toothbrush through the dishwasher.”
d.	“I will not drink juice that has been sitting out for longer than an hour.”

 

 

ANS:  A

Immune compromised clients should avoid having reptiles or turtles as pets and should avoid changing cat litter to help prevent opportunistic infections. Drinking juice that has been at room temperature for longer than 1 hour can lead to opportunistic infection and should be avoided. Clients should clean their toothbrushes daily by running them in the dishwasher or rinsing them in liquid laundry bleach.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Health Promotion and Maintenance (Self-Care)

MSC:  Integrated Process: Teaching/Learning

 

3. The nurse is working with a client at a public health clinic. The client says to the nurse, “The doctor said that my CD4+ count is 450. Is that good?” What is the nurse’s best response?

a.	“Your count is high so you can cut back on your medication.”
b.	“Your count is normal because your medications are working well.”
c.	“Your count is a bit low and you are susceptible to infection.”
d.	“Your count is very low and you actually now have AIDS.”

 

 

ANS:  C

A CD4+ T-cell count of 450 cells/mm³ of blood is low, and the client is at increased risk for developing an infection. Normal CD4+ counts range from 800 to 1000 cells/mm³. To be diagnosed with AIDS, a client must have a CD4+ T-cell count of <200 cells/mm³ (or a CD4+ T-cell percentage of <4%) and/or an opportunistic infection.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 360

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Laboratory Values) MSC:           Integrated Process: Teaching/Learning

 

4. The nurse is caring for a young woman at the primary health care clinic. Which assessment finding leads the nurse to question the client about risk factors for HIV?

a.	Six vaginal yeast infections in the last 12 months
b.	Unable to become pregnant for the last 2 years
c.	Severe cramping and irregular periods
d.	Very heavy periods and breakthrough bleeding

 

 

ANS:  A

Persistent or recurrent vaginal candidiasis may be the first symptom of HIV in women. Decreased immune function allows overgrowth of this fungus. Infertility, heavy periods, and cramping are not generally indicative of HIV.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 361

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Assessment)