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Medical Surgical Nursing 7th Edition Black Hawks Test Bank

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Medical Surgical Nursing 7th Edition Black Hawks Test Bank

ISBN-13: 978-0721602202

ISBN-10: 0721602207

 

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Medical Surgical Nursing 7th Edition Black Hawks Test Bank

ISBN-13: 978-0721602202

ISBN-10: 0721602207

 

 

 

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Free Nursing Test Questions:

Black & Hawks: Medical-Surgical Nursing: Clinical Management for Positive Outcomes, 7th Edition

Chapter 80: Management of Clients with Acquired Immunodeficiency Syndrome

 

MULTIPLE CHOICE

 

  1. A human immunodeficiency virus (HIV)–positive client is beginning therapy with antiretroviral medications. The nurse will include in the teaching plan relative to the medication that the client should
a. take the dose at any time after eating.
b. not skip a dose. If a dose is missed, double the next dose.
c. wait until the next visit before reporting significant side effects.
d. tell the prescriber if the decision is made to terminate treatment.

 

 

ANS:   d

Instruct all clients taking retrovirals as follows. Take the drug at specified intervals. Do not skip a dose. Do not increase or decrease the number of pills you take. If side effects occur, tell your physician or nurse. If you do not want to take the drugs, tell your primary care provider. If you take the drugs only periodically, it would be better not to take them at all.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 2388, 2389;

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse participating in the evaluation of a client with a known HIV infection explains that the laboratory study that will be of most significance during this process is
a. CD4+ cell count.
b. the total white blood cell count.
c. the enzyme-linked immunosorbent assay (ELISA) test.
d. the Western blot test.

 

 

ANS:   a

The most recent classification system for HIV disease in adults and adolescents is based on two monitoring parameters used to follow a client: (1) laboratory data (CD4+ cell count) and (2) clinical presentation (the person’s clinical manifestations of diseases).

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: 2380

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. A nurse with a small grant to increase knowledge of the transmission of HIV infection is trying to determine the best expenditure of the funds. The nurse should recognize that the group in which this problem of HIV infection is growing most rapidly is
a. adults older than the age of 50.
b. black teenagers.
c. gay white men.
d. blacks and Hispanics.

 

 

ANS:   a

An overlooked population of rapidly growing HIV-positive people are those older than the age of 50.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: 2377

TOP:    Nursing Process Step: N/A

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse is counseling a woman who is HIV positive and has just given birth to a baby girl. The nurse should advise the client to
a. avoid breast-feeding her infant.
b. seek professional counseling to deal with the guilt associated with the almost certain passing of the disease to her child.
c. report all of her sexual partners to the infectious disease department in order to break the chain of transmission of the disease.
d. anticipate the needs of her child immediately and make arrangements for placement in a setting where her child’s life will be comfortable.

 

 

ANS:   a

Perinatal HIV exposure can occur during pregnancy, during vaginal delivery, and postpartum through breast-feeding.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 2378

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse counseling a client who is afraid that HIV exposure has occurred would explain that the period of time it takes before HIV antibodies can be detected by laboratory tests is generally
a. 1 to 3 days.
b. 7 to 10 days.
c. 1 to 3 weeks.
d. 4 to 12 weeks.

 

 

ANS:   d

There is a “window” for seroconversion (the time it takes for a newly infected person to develop antibodies that can be detected in a laboratory specimen). On average, antibodies can be detected in 4 to 12 weeks.

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: 2382

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse teaching a client who is HIV positive should alert the client that the virus can be transmitted
a. as soon as manifestations of illness appear.
b. only to another susceptible host.
c. to anyone having contact with blood or semen.
d. once the diagnosis has been made.

 

 

ANS:   c

Modes of transmission have remained constant throughout the course of the HIV pandemic. The virus is spread through certain sexual practices, through exposure to blood, and through perinatal transmission.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 2377

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. The nurse caring for a client with acquired immunodeficiency syndrome (AIDS) whose CD4+ cell count is 100 is aware that the most effective way to prevent Pneumocystis carinii pneumonia in this client is to
a. administer prescribed oral trimethoprim-sulfamethoxazole.
b. encourage a high fluid intake.
c. place the client in protective isolation.
d. restrict the client’s visitors.

 

 

ANS:   a

Maintenance lifetime suppressive therapy for P. carinii is required with trimethoprim-sulfamethoxazole, pentamidine aerosol, atovaquone, dapsone, or clindamycin-primaquine.

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: 2387

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. An early manifestation that should alert the nurse to further evaluate a client with an HIV infection for the opportunistic infection of toxoplasmosis is:
a. discoloration of the mucous membranes.
b. cardiac dysrhythmias.
c. headache.
d. lymphadenopathy.

 

 

ANS:   c

Clinical manifestations of central nervous sytem (CNS) infections include headache, impaired cognition, hemiparesis, aphasia, ataxia, vision loss, cranial nerve palsies, motor problems, and seizures.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 2392

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. The problem the nurse should plan for when a client with AIDS is infected with the Cryptosporidium parasite is
a. delirium.
b. painful open lesions.
c. profuse, watery diarrhea.
d. severe respiratory tract infection.

 

 

ANS:   c

Clinical presentation includes profuse diarrhea, steatorrhea (1L/day), flatulence, abdominal cramping and pain, anorexia, nausea, vomiting, profound weight loss, fever, fatigue, myalgia, and electrolyte imbalance.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 2392

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse is assessing a client with AIDS for the presence of Kaposi’s sarcoma (KS). The manifestation the nurse should look for is
a. a thick, white exudate in the mouth.
b. a purple-red lesion on the body.
c. a crusty lesion on the back and groin.
d. a pustular lesion with yellow exudate.

 

 

ANS:   b

Clinical presentation generally starts with an initial “patch” that is flat, pink, looks like a bruise, and is symmetrical on both sides of the body. Later it turns into dark violet or black plaques.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 2393

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity

 

  1. A client with an HIV infection is receiving zidovudine (Retrovir). The nurse counsels the client about the major problem with this medical protocol, which is
a. side effects.
b. noncompliance with its complex regimen.
c. cost.
d. long-term administration schedule.

 

 

ANS:   b

Noncompliance relative to the complexity of the regimen is the major concern about the use of this drug.

 

DIF:    Cognitive Level: Application

REF:    Text Reference: 2386, Integrating Pharmacology Box – Understanding HAART;

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse explains that currently the drug that is best for treating HIV wasting syndrome is
a. human growth hormone.
b. megestrol acetate.
c. dronabinol.
d. thalidomide.

 

 

ANS:   a

The drug used most successfully to treat wasting is human growth hormone.

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: 2394

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. The suggestions a nurse could make to a client with AIDS who is experiencing night sweats is
a. limit fluid intake after supper.
b. drink all liquids in the morning.
c. keep liquids at the bedside to drink.
d. take aspirin if awakened in the night.

 

 

ANS:   c

Teach the client how to manage chronic recurrent night fever and night sweats by taking the antipyretic of choice before going to sleep; having a change of bedclothes nearby; keeping a plastic cover on the pillow; placing a towel over the pillow in case of profuse diaphoresis; and keeping liquids at the bedside to drink.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 2395

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. In order to conserve energy, the nurse would encourage the client with AIDS who has a nursing diagnosis of Fatigue to
a. bathe before eating breakfast.
b. sit down while showering.
c. use easy to clean forks and knives.
d. rest after every third major activity.

 

 

ANS:   b

Promote rest and activity by developing a plan of daily activities that alternates short activities with rest periods. Evaluate the client’s needs and point out ways to conserve energy, such as sitting down while dressing, shaving, or preparing food; sitting on a shower chair while bathing; or using disposable items for eating so that no cleanup is needed.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 2395

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. A client with AIDS has a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements. The nurse should
a. encourage sweet foods and desserts that appeal to the taste.
b. encourage the client to dine alone to focus on food intake.
c. instruct the client to prepare meals, then divide and freeze them.
d. tell the client to eat large meals to result in greater intake.

 

 

ANS:   c

Interventions include eating small meals frequently throughout the day; preparing meals ahead of time so they can be divided into individual servings and frozen until ready to use; encouraging the client to dine with family and friends; and consuming more nutrient-dense foods and beverages rather than filling up on low-calorie items.

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: 2396

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. When a client with AIDS experiences pain while swallowing, the nurse could suggest
a. eating very cold foods.
b. drinking acidic juices such as orange juice.
c. increasing the intake of well-cooked eggs and noodle dishes.
d. avoiding the use of straws while drinking.

 

 

ANS:   c

Encourage the client to eat foods at room temperature; choose mild foods and drinks, such as apple juice rather than orange juice; eat nonabrasive foods that are easy to swallow (well-cooked eggs, noodle dishes); use a straw while drinking.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: 2396

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. The situation that would be least helpful to manage pain in the AIDS client who is an injecting drug user is
a. having multiple practitioners prescribing medications.
b. refusing to fill lost prescriptions.
c. carefully rationing narcotic prescriptions.
d. limiting rescue doses of narcotic analgesics on a monthly basis.

 

 

ANS:   a

Helpful guidelines include having a single practitioner prescribe medications.

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: 2397

TOP:    Nursing Process Step: N/A

MSC:   NCLEX: Health Promotion and Maintenance

 

  1. When the AIDs client refuses pain medication because he or she is not in pain presently, the nurse should explain that
a. refraining from using the medication makes its effectiveness last longer.
b. taking the medication on schedule keeps the blood level constant.
c. skipping a dose will decrease diarrhea
d. using the drug will increase the appetite.

 

 

ANS:   b

Taking pain medication on a schedule keeps the blood level constant and incidentally helps control diarrhea by the side effect of constipation.

 

DIF:    Cognitive Level: Application             REF:    Text Reference: 2397

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. The nurse counsels other co-workers that the suggested remedy for HIV exposure is
a. combination antiretrovirals for 4 weeks.
b. single antiretrovirals for 2 weeks.
c. combination antiretrovirals with CD4+ count every month.
d. single antiretrovirals for 2 months.

 

 

ANS:   a

The current remedy for accidental exposure to HIV is combination antiretrovirals for 4 weeks.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: 2378

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

  1. The client who has a positive enzyme immunoassay test asks the nurse if that means that he is HIV positive. The nurse’s most helpful response would be
a. “Yes, you should seek medical care for antiretroviral drugs.”
b. “No, you need to have the Western blot test to confirm that you are positive.”
c. “Yes, but antiretrovirals will probably combat the infection now.”
d. “No, many people have positive enzyme immunoassays.”

 

 

ANS:   b

If the enzyme immunoassay is positive, the Western blot test is needed to confirm an HIV-positive status.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: 2382

TOP:    Nursing Process Step: Intervention

MSC:   NCLEX: Physiological Integrity

 

 

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