ATI MED SURG EXAM WITH RATIONALE %PASS
human immunodeficiency virus (HIV) - retrovirus that causes immunosuppression making person more susceptible to infections
How can HIV be transmitted? - through contact with certain body fluids
-blood
-semen
-vaginal secretions
-breast milk
Name...
ATI MED SURG EXAM WITH RATIONALE %PASS human immunodeficiency virus (HIV) - retrovirus that causes immunosuppression making person more susceptible to infections How can HIV be transmitted? - through contact with certain body fluids -blood -semen -vaginal secretions -breast milk Name the MOST common mode of transmission of HIV. - unprotected sex with an HIV -
infected partner How can HIV be transmitted perinatally? - during pregnancy, delivery or breastfeeding name the target cells for HIV - CD4+T cells When a persons CD4+T cell count drops to <500 cells/uL, what will happen? - immune problems begin The normal CD4+T cell range - 800-1,200 cells/uL When a persons CD4+T cell count reaches <200 what will happen? - severe problems develop AIDS When the body cannot regulate immune responses, what can happen? - it allows for opportunistic diseases to develop How will a pt present if they have HIV? - FLULIKE SYMPTOMS -fever -swollen lymph nodes -sore throat -headache -malaise -nausea -muscle and join pain -diarrhea If a pt has pneumocystis jiroveci pneumonia what can you diagnose them with? - AIDS How is HIV progression monitored? - 1. CD4+T counts 2. Viral load -lower viral load the less active the disease Goals of HIV - (1) monitoring HIV dis ease progression and immune function (2) initiating and monitoring antiretroviral therapy (ART) (3) preventing the development of opportunistic diseases (4) detecting and treating opportunistic diseases (5) managing symptoms (6) preventing or decreasing co mplications of treatment (7) preventing further transmission of HIV Testing for HIV is the only.... - sure method of determining HIV infection ART can significantly slow HIV progression, but it... - -is complex -has side effects -does not work for everyone -is expensive A pregnant woman with asymptomatic chronic human immunodeficiency virus (HIV) infection is seen at the clinic. The pt states "I am very nervous about making my baby sick." which info will the nurse include when teaching the pt? a) The antiretroviral medications used to treat HIV infections are teratogenic b) Most infants born to HIV -positive mother are not infected with the virus c) Because it is an early stage of HIV infection, the infant will not contract HIV d) Her newborn will b e born with HIV unless he uses ART therapy - b) Most infants born to HIV -positive mother are not infected with the virus A diagnosis of AIDS can be made for a pt with HIV with: a) A CD4+T cell count <500/uL b) A WBC count <3000/uL c) Development of oral candidiasis (thrush) d) Onset of Pneumocystis jiroveci pneumonia - d) Onset of Pneumocystis jiroveci pneumonia The nurse is teaching a newly diagnosed 34 -year-old male about his HIV infection. Which statement by the pt would indicate the pt needs additional education? a) I will need to take my HIV meds daily for the rest of my life b) Although I only take one pill, it has multiple medications combined into a single tab c) I should notify my HIV provider if I get fevers that do not go away w ith Tylenol or Aspirin d) Once my viral load is undetectable, I don't have to worry about taking my meds every day - d) Once my viral load is undetectable, I don't have to worry about taking my meds every day The nurse is caring for a pt who is receiving antiretroviral therapy (ART) for treatment of AIDS. Which assessment BEST indicates that the pts condition is improving? a) Decreased viral load b) Increased drug resistance c) Decreased CD4+T cell count d) Increased aminotransferase levels - a) Decreased viral load Clinical manifestations of pulmonary embolism have a rapid onset. Dyspnea occurs due to reduced blood flow to the lungs. A nurse is providing discharge teaching to a client who is postop following a rhinoplasty. Which of the following instruc tions should the nurse include? a) apply warm compresses to the face b) take aspirin 650 milligrams by mouth for mild pain c) close your mouth when sneezing d) lie on your back with your head elevated 30 degrees when resting - d) lie on your back with yo ur head elevated 30 degrees when resting The nurse should instruct the client to rest in the semi -Fowler's position to prevent aspiration of nasal secretions. A nurse is planning care for a client who has COPD and is malnourished. Which of the following recommendations to promote nutritional intake should the nurse include in the plan? a) eat high calorie foods first b) increase intake of water at meal times c) perform active range of motion exercises before meals d) keep saltine crackers nearby for snacking - a) eat high calorie foods first The client who has COPD often experiences early satiety. Therefore, the client should eat calorie -dense foods first. A nurse is assessing a client who has fluid overload from a cardi ovascular disorder. which of the following manifestations should the nurse expect? (select all that apply) a) jugular vein distension b) moist crackles c) postural hypotension d) increased heart rate e) fever - a) jugular vein distension b) moist crackles d) increased heart rate The increase in venous pressure due to excessive circulating blood volume results in neck vein distension. This is an indicator of pulmonary edema that can quickly lead to death. Fluid volume excess, or hypervolemia, is a n expansion of fluid volume in the extracellular fluid compartment. This results in increased heart rate and bounding pulses. A nurse is planning care for a client who has been admitted for treatment of a malignant melanoma of the upper leg without metast asis. the nurse should plan to prepare the client for which of the following procedures? a) curettage b) external radiation therapy c) regional chemotherapy d) surgical excision - d) surgical excision The therapeutic approach to malignant melanoma depend s on the level of invasion and the depth of the lesion. Surgical excision is the treatment of choice for small, superficial lesions. Deeper lesions require wide local excision, followed by skin grafting. A nurse is caring for a client who has a lesion on the back of his right hand. the client asks the nurse which type of skin cancer is the most serious. Which of the following responses by the nurse is appropriate? a) basal cell carcinomas b) melanomas c) actinic keratoses d) squamous cell carcinomas - b) melanomas Melanomas are malignant neoplasms with atypical melanocytes in both the epidermis, the dermis, and sometimes the subcutaneous cells. It is the most lethal type of skin cancer, often causing metastases in the bone, liver, lungs, spleen, the CNS, and lymph nodes. A nurse is assessing a client who has a lesion on his skin. Which of the following findings is a clinical manifestation of malignant melanoma? a) rough, dry, scaly lesion b) firm nodule with crust c) pearly papule with ulcerated center
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