NUR 3540: INFECTION AND HUMAN IMMUNODEFICIENCY VIRUS INFECTION
LEWIS: MEDICALSURGICAL NURSING, 10TH EDITION EXAM WITH ANSWERS
1. The nurse is advising a clinic patient who was exposed a week ago to human
immunodeficiency virus (HIV) through unprotected sexual intercourse. The patient’s antigen and
antibody test has just been reported as negative for HIV. What instructions should the nurse give to
this patient?
a. “You will need to be retested in 2 weeks.”
b. “You do not need to fear infecting others.”
c. “Since you don’t have symptoms and you have had a negative test, you do not have HIV).”
d. “We won’t know for years if you will develop acquired immunodeficiency syndrome (AIDS).”
ANS: AHIV screening tests detect HIVspecific antibodies or antigens, but typically it takes a
several week delay after initial infection before HIV can be detected on a screening test.
Combination antibody and antigen tests (also known as fourthgeneration tests) decrease the window
period to within 3 weeks after infection. It is not known based on this information whether the
patient is infected with HIV or can infect others.
DIF: Cognitive Level: Apply (application) REF: 221TOP: Nursing Process: Implementation MSC:
NCLEX: Physiological Integrity
, 2. A patient who has a positive test for human immunodeficiency virus (HIV) antibodies is admitted to
the hospital with Pneumocystis jiroveci
+
pneumonia (PCP) and a CD4 Tcell count of less than 200 cells/mL. Based on diagnostic criteria
established by the Centers for Disease Control
and Prevention (CDC), which statement by the nurse is correct?
a. “The patient will develop symptomatic HIV infection within 1 year.”
b. “The patient meets the criteria for a diagnosis of acute HIV infection.”
c. “The patient will be diagnosed with asymptomatic chronic HIV infection.”
d. “The patient has developed acquired immunodeficiency syndrome (AIDS).”
ANS: DDevelopment of PCP meets the diagnostic criteria for AIDS. The other responses indicate
earlier stages of HIV infection than is indicated by the PCP infection.
DIF: Cognitive Level: Understand (comprehension) REF: 221TOP: Nursing Process: Assessment MSC:
NCLEX: Physiological Integrity
3. A patient informed of a positive rapid antibody test result for human immunodeficiency
virus (HIV) is anxious and does not appear to hear what the nurse is saying. What action by the
nurse is most important at this time?
,a. Teach the patient how to reduce risky behaviors.
b. Inform the patient about the available treatments.
, c. Remind the patient about the need to return for retesting to verify the results.
d. Ask the patient to identify individuals who had intimate contact with the patient.
ANS: CAfter an initial positive antibody test result, the next step is retesting to confirm the results.
A patient who is anxious is not likely to be able to take in new information or be willing to
disclose information about the HIV status of other individuals.
DIF: Cognitive Level: Analyze (analysis) REF: 222 TOP: Nursing Process: Implementation MSC:
NCLEX: Psychosocial Integrity
4. A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS) tells the
nurse, “I feel obsessed with morbid thoughts about dying.” Which response by the nurse is
appropriate?
a. “Thinking about dying will not improve the course of AIDS.”
b. “Do you think that taking an antidepressant might be helpful?”
c. “Can you tell me more about the thoughts that you are having?”
d. “It is important to focus on the good things about your life now.”
ANS: CMore assessment of the patient’s psychosocial status is needed before taking any other action.
The statements, “Thinking about dying will not improve the course of AIDS” and “It is important to
LEWIS: MEDICALSURGICAL NURSING, 10TH EDITION EXAM WITH ANSWERS
1. The nurse is advising a clinic patient who was exposed a week ago to human
immunodeficiency virus (HIV) through unprotected sexual intercourse. The patient’s antigen and
antibody test has just been reported as negative for HIV. What instructions should the nurse give to
this patient?
a. “You will need to be retested in 2 weeks.”
b. “You do not need to fear infecting others.”
c. “Since you don’t have symptoms and you have had a negative test, you do not have HIV).”
d. “We won’t know for years if you will develop acquired immunodeficiency syndrome (AIDS).”
ANS: AHIV screening tests detect HIVspecific antibodies or antigens, but typically it takes a
several week delay after initial infection before HIV can be detected on a screening test.
Combination antibody and antigen tests (also known as fourthgeneration tests) decrease the window
period to within 3 weeks after infection. It is not known based on this information whether the
patient is infected with HIV or can infect others.
DIF: Cognitive Level: Apply (application) REF: 221TOP: Nursing Process: Implementation MSC:
NCLEX: Physiological Integrity
, 2. A patient who has a positive test for human immunodeficiency virus (HIV) antibodies is admitted to
the hospital with Pneumocystis jiroveci
+
pneumonia (PCP) and a CD4 Tcell count of less than 200 cells/mL. Based on diagnostic criteria
established by the Centers for Disease Control
and Prevention (CDC), which statement by the nurse is correct?
a. “The patient will develop symptomatic HIV infection within 1 year.”
b. “The patient meets the criteria for a diagnosis of acute HIV infection.”
c. “The patient will be diagnosed with asymptomatic chronic HIV infection.”
d. “The patient has developed acquired immunodeficiency syndrome (AIDS).”
ANS: DDevelopment of PCP meets the diagnostic criteria for AIDS. The other responses indicate
earlier stages of HIV infection than is indicated by the PCP infection.
DIF: Cognitive Level: Understand (comprehension) REF: 221TOP: Nursing Process: Assessment MSC:
NCLEX: Physiological Integrity
3. A patient informed of a positive rapid antibody test result for human immunodeficiency
virus (HIV) is anxious and does not appear to hear what the nurse is saying. What action by the
nurse is most important at this time?
,a. Teach the patient how to reduce risky behaviors.
b. Inform the patient about the available treatments.
, c. Remind the patient about the need to return for retesting to verify the results.
d. Ask the patient to identify individuals who had intimate contact with the patient.
ANS: CAfter an initial positive antibody test result, the next step is retesting to confirm the results.
A patient who is anxious is not likely to be able to take in new information or be willing to
disclose information about the HIV status of other individuals.
DIF: Cognitive Level: Analyze (analysis) REF: 222 TOP: Nursing Process: Implementation MSC:
NCLEX: Psychosocial Integrity
4. A patient who is diagnosed with acquired immunodeficiency syndrome (AIDS) tells the
nurse, “I feel obsessed with morbid thoughts about dying.” Which response by the nurse is
appropriate?
a. “Thinking about dying will not improve the course of AIDS.”
b. “Do you think that taking an antidepressant might be helpful?”
c. “Can you tell me more about the thoughts that you are having?”
d. “It is important to focus on the good things about your life now.”
ANS: CMore assessment of the patient’s psychosocial status is needed before taking any other action.
The statements, “Thinking about dying will not improve the course of AIDS” and “It is important to
