Chapter 42: Immunodeficiency and HIV Infection/AIDS: Nursing Management
Unit IX: Alterations in Immunological Function
MULTIPLE CHOICE
1. A patient is inoculated with a vaccine. This type of immunity of is called:
a. artificial immunity.
c. natural immunity.
b. humoral immunity.
d. systemic immunity.
ANS: A
Artificial immunity is acquired from inoculation with a vaccine containing live or killed infectious
organisms. Natural immunity occurs from actually acquiring the disease. Systemic immunity is
transferred from the mother across the placenta to the fetus. Humoral immunity is antibody-mediated
immunity.
PTS: 1
2. A pregnant woman diagnosed with human immunodeficiency virus (HIV) is asking about her baby’s
risk of infection. Which of the following does put the newborn at risk?
a. Bottle-feeding
c. Kissing the baby
b. Changing diapers
d. Vaginal birth
ANS: D
Breastfeeding and vaginal birth put the newborn at risk for HIV. HIV cannot be transmitted by
changing diapers (feces) or kissing the baby (saliva).
PTS: 1
3. A health care provider has accidentally been stuck with a used needle. The health care provider is
going to be tested for human immunodeficiency virus (HIV). Which of the following would be the
testing schedule for the health care provider?
a. Tested at two months, four months, and then at six months
b. Tested immediately and then again at two months
c. Tested immediately and then again at six months
d. Tested in six months and then again in one year
ANS: C
The health care provider should be tested immediately to show if any preexisting infection exists.
Seroconversion usually occurs in one to three months but can take up to six months. Testing at two
months is too late to discover a preexisting infection and can be too early to detect a new infection.
Testing at six months or one year would not detect a preexisting infection.
PTS: 1
4. Which of the following CD4+ count would be used to confirm the diagnosis of acquired
immunodeficiency syndrome (AIDS)?
a. 155 cells/mcL
c. 455 cells/mcL
b. 255 cells/mcL
d. 755 cells/mcL
ANS: A
A CD4+ count of less than 200 cells/mcL is used as a criterion to establish the diagnosis of AIDS. In
cell counts less than 500 to 600 cells/mcL, antiviral therapy should be initiated. Cell counts greater
than 600 cells/mcL are in the normal range.
PTS: 1
5. The most common infection that occurs in the patient with progressing human immunodeficiency virus
(HIV) is:
a. cytomegalovirus infection.
c. Pneumocystis carinii pneumonia.
b. Mycobacterium tuberculosis.
d. Streptococcus pneumoniae.
ANS: C
As the immune system becomes overpowered, opportunistic infections can occur. The most common
infection is Pneumocystis carinii pneumonia.
PTS: 1
6. A patient diagnosed with human immunodeficiency virus (HIV) is asking about how the immune
system works. The patient is correct when stating that T lymphocytes are involved in which type of
immunity?
a. Antibody-mediated immunity
c. Complement immunity
b. Cell-mediated immunity
d. Humoral immunity
ANS: B
In cell-mediated immunity, the T lymphocytes are the active cells. B cells are responsible for humoral
or antibody-mediated immunity. The complement system is involved in the humoral immune response.
PTS: 1
7. A patient diagnosed with acquired immunodeficiency syndrome (AIDS) six years ago has a purple
lesion located on the inner thigh. This lesion is most likely to be:
a. AIDS-related syndrome.
c. cachexia.
b. Burkitt’s lymphoma.
d. Kaposi’s sarcoma.
ANS: D
Kaposi’s sarcoma presents as abnormal lesions that appear purple or blue-red in color. They can be
found anywhere but are common on the feet, arms, thighs, perineal area, and face. Cachexia is tissue
wasting. Burkitt’s lymphoma is characterized by enlarged lymph nodes. AIDS- related syndrome is a
collection of symptoms and infections resulting from the specific damage to the immune system
caused by the HIV virus.
PTS: 1
8. Which of the following tests can be used to initially identify human immunodeficiency virus (HIV)
antibodies present?
a. Enzyme-linked immunosorbent assay (ELISA)
b. Platelet count
c. Red blood cell count
d. Western blot
ANS: A
The ELISA test detects HIV antibodies. The Western blot is used as a confirmatory test to a positive
ELISA test. Red blood cell counts and platelet counts are part of standard blood studies.
PTS: 1
9. A patient with acquired immunodeficiency syndrome (AIDS) is sitting alone crying. Which of the
following is an appropriate response for the nurse to give?
a. “Everything will be okay.”
b. “Let me call your doctor about your depression.”
c. “What’s wrong now?”
d. “Would you like to talk?”
ANS: D
Asking the patient if he or she would like to talk allows the patient an opportunity to express his or her
feelings. The other responses give the patient false reassurance or put off the patient.
PTS: 1
10. Which of the following activities would present the least risk of exposure to human immunodeficiency
virus (HIV)?
a. Exposure to used needles
c. Perinatal exposure
b. Multiple sex partners
d. Teeth cleaning
ANS: D
Teeth cleaning is a procedure in a dental office that routinely sterilizes its equipment and is not
considered to present an increased risk of exposure HIV.
PTS: 1
11. A nurse is teaching a small group about human immunodeficiency virus (HIV) at a health clinic.
Which of the following statements by the group will need further clarification?
a. “Condoms should be used during sexual contact.”
b. “Exposure can occur to a baby during pregnancy.”
c. “HIV-infected mothers can breastfeed their babies.”
d. “Needles should never be reused or shared.”
ANS: C
Exposure to HIV can occur while breastfeeding an infant.
PTS: 1
12. The nurse is caring for a patient with human immunodeficiency virus (HIV). Which of the following
precautions is best in the care of the patient?
a. Gloves and an N-95 mask
b. Gown, gloves, and mask if splashing with body fluids is likely
c. Gown, gloves, mask, and placement into a negative-pressure room
d. Only hand washing is needed
ANS: B
Standard precautions should be following when handling any body fluids and blood. An N-95 mask
and a negative-pressure room are not necessary. Hand washing is always recommended but should
also include other precautions if contact with body fluids or blood is likely.
PTS: 1
13. A patient with acquired immunodeficiency syndrome (AIDS) is prescribed zidovudine (AZT). Which
of the following is not an important point in administering the medication?
a. AZT can be given to prevent maternal-fetal transmission.
b. AZT may cause anemia.
c. AZT taken orally must be administered every four hours around the clock.
d. Intravenous AZT should be given rapidly.
ANS: D
Intravenous AZT should not be given rapidly. The preparation should infuse over 60 minutes.
PTS: 1
14. A patient with acquired immunodeficiency syndrome (AIDS) is prescribed nevirapine (Viramune).
Which of the following is not an important point in administering the medication?
a. Do not use if pregnant.
b. If a dose is missed, double the next dose.
c. Stop using if severe blistering rash occurs.
d. Viramune enters the breast milk.
ANS: B
If a dose is missed, the patient should not double the next dose. The medication should be taken only
as scheduled.
PTS: 1
15. A patient with rheumatoid arthritis receives a prescription for indomethacin. Which of the following
statement by the patient indicate the need for further instruction about indomethacin?
a. “I have to let my doctor know if I need to start blood pressure medications.”
b. “I have to make sure I get my kidneys tested as scheduled.”
c. “I need to get my eyes checked regularly.”
d. “This medication shouldn’t upset my stomach.”
ANS: D
Indomethacin can cause nausea, dyspepsia, gastrointestinal pain, diarrhea, vomiting, constipation, and
flatulence. The patient should regularly have his or her eyes, kidneys, and liver checked for
impairment.
PTS: 1
16. Which of the following is not an intervention for the patient taking hydroxychloroquine sulfate
(Plaquenil)?
a. Telling the patient to take the medication on an empty stomach.
b. Telling the patient that alcohol consumption is contraindicated.
c. Asking the patient to report any vision changes.
d. Asking the patient to report tinnitus.
ANS: A
Plaquenil should be administered with food or milk to decrease the number of gastrointestinal
symptoms that can occur.
PTS: 1
17. A patient is diagnosed with systemic lupus erythematosus (SLE). The nurse is preparing to discuss
discharge instructions. Which of the following would not be including in the instructions?
a. “Activity will need to be decreased during an exacerbation.”
b. “Body temperature should be monitored.”
c. “Corticosteroid treatment must be slowly tapered off.”
d. “Sunbathing decreases symptoms.”
ANS: D
Exposure to sunlight exacerbates the disease process. Body temperature should be monitored for
increases and possible infection. Corticosteroid treatment cannot be abruptly stopped. Activity with
rest periods should be encouraged.
PTS: 1
MULTIPLE RESPONSE
1. Which of the following exposure types cannot transmit human immunodeficiency virus (HIV)? Select
all that apply.
a. Blood
d. Saliva
b. Breast milk
e. Semen
c. Emesis
f. Sweat
ANS: C, D, F
HIV can be transmitted only under specific conditions that permit contact with infected body fluids.
Common high-risk sources are infected blood via contaminated needlestick or sharp object, contact
with infected breast milk, mucous secretions (vaginal, semen), and exposure to blood in the laboratory.
HIV is not transmitted through tears, saliva, urine, emesis, sputum, feces, or sweat.
PTS: 1
COMPLETION
1. A type of bone marrow transplant (BMT) that uses bone marrow donated by an identical twin is called
a(n) ________________________________________.
ANS:
syngeneic transplant
A syngeneic transplant uses bone marrow donated by an identical twin. An autologous transplant is the
removal of bone marrow cells from the individual; the cells are treated and stored and then returned
after the individual receives intensive chemotherapy or radiation.
PTS: 1
SHORT ANSWER
1. This occurs when a transfusion of blood or a tissue transplant becomes incompatible with the host.
ANS:
Graft-versus-host disease
Graft-versus-host disease is the result of a transfusion of blood or a tissue transplant with cells that are
incompatible with the host.
PTS: 1