Nursing Board Exam Reviewer Part 3 of 5

291. Of the following blood tests, which confirms the presence of antibodies to HIV?

a)      Enzyme-linked immunoabsorbant assay (ELISA)
ELISA, as well as Western blot assay, identifies and confirms the presence of antibodies to HIV.

b)      Erythrocyte sedimentation rate (ESR)
The ESR is an indicator of the presence of inflammation in the body.

c)      p24 antigen
The p24 antigen is a blood test that measures viral core protein.

d)      Reverse transcriptase
Reverse transcriptase is not a blood test. Rather, it is an enzyme that transforms single-stranded RNA into a double-stranded DNA.

292. When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean

a)      his body has not produced antibodies to the AIDS virus.
A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn.

b)      he has not been infected with HIV.
A negative test result should be interpreted as demonstrating that if infected, the body has not produced antibodies (which take from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged.

c)      he is immune to the AIDS virus.
The test result does not mean that the patient is immune to the virus, nor does it mean that the patient is not infected. It just means that the body may not have produced antibodies yet.

d)      antibodies to the AIDS virus are in his blood.
When antibodies to the AIDS virus are detected in the blood, the test is interpreted as positive.

293. Which of the following substances may be used to lubricate a condom?

a)      K-Y jelly
K-Y jelly is water-based and will provide lubrication while not damaging the condom.

b)      Skin lotion
The oil in skin lotion will cause the condom to break.

c)      Baby oil
Baby oil will cause the condom to break.

d)      Petroleum jelly
The oil in petroleum jelly will cause the condom to break.

294. More than 500 CD4+ T lymphocytes/mm3 indicates which stage of HIV infection?

a)      CDC category A – HIV asymptomatic
More than 500 CD4+ T lymphocytes/mm3 indicates CDC category A – HIV asymptomatic.

b)      Primary infection (acute HIV infection or acute HIV syndrome)
The period from infection with HIV to the development of antibodies to HIV is know as primary infection.

c)      CDC category B – HIV symptomatic
200-499 CD4+ T lymphocytes/mm3 indicates CDC category B – HIV symptomatic.

d)      CDC category C – AIDS
Less than 200 CD4+ T lymphocytes/mm3 indicates CDC category C – AIDS.

295. The term used to define the balance between the amount of HIV in the body and the immune response is

a)      viral set point
The viral set point is the balance between the amount of HIV in the body and the immune response.

b)      window period
During the primary infection period, the window period occurs since a person is infected with HIV but negative on the HIV antibody blood test.

c)      primary infection stage
The period from infection with HIV to the development of antibodies to HIV is known as the primary infection stage.

d)      viral clearance rate
The amount of virus in circulation and the number of infected cells equals the rate of viral clearance.

296. Which of the following statements reflect the treatment of HIV infection?

a)      Treatment of HIV infection for an individual patient is based on the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).
Although specific therapies vary, treatment of HIV infection for an individual patient is based on three factors: the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).

b)      Treatment should be offered to all patients once they reach CDC category B – HIV symptomatic.
Treatment should be offered to all patients with the primary infection (acute HIV syndrome).

c)      Treatment should be offered to only selected patients once they reach CDC category B – HIV symptomatic.
Treatment should be offered to all patients with the primary infection (acute HIV syndrome).

d)      Treatment should be offered to individuals with plasma HIV RNA levels less than 55,000 copies/mL (RT-PCR assay.)
In general, treatment should be offered to individuals with fewer than 350 CD4+ T cells/mm3 or plasma HIV RNA levels exceeding 55,000 copies/mL (RT-PCR assay).

297. Which of the following body substances causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle?

a)      Histamine
When cells are damaged, histamine is released.

b)      Bradykinin
Bradykinin is a polypeptide that stimulates nerve fibers and causes pain.

c)      Serotonin
Serotonin is a chemical mediator that acts as a potent vasoconstrictor and bronchoconstrictor.

d)      Prostaglandin
Prostaglandins are unsaturated fatty acids that have a wide assortment of biologic activity.

298. Which type of hypersensitivity reaction involves immune complexes formed when antigens bind to antibodies?

a)      Type III
Type III hypersensitivity is associated with systemic lupus erythematosus, rheumatoid arthritis, serum sickness, certain types of nephritis, and some types of bacterial endocarditis.

b)      Type I
Type I or anaphylactic hypersensitivity is an immediate reaction, beginning within minutes of exposure to an antigen.

c)      Type II
Type II, or cytotoxic, hypersensitivity occurs when the system mistakenly identifies a normal constituent of the body as foreign.

d)      Type IV
Type IV, or delayed-type, hypersensitivity occurs 24-72 hours after exposure to an allergen.

299. When the patient’s eosinophil count is 50-90% of blood leukocytes, the nurse interprets the result as

a)      indicative of idiopathic hypereosinophilic syndrome.
When eosinophils make up 50-90% of white cell count, the patient is demonstrating severe eosinophilia.

b)      indicating an allergic disorder.
Moderate eosinophilia, 15-40% of white cell count consisting of eosinophils, are found in patients with allergic disorders.

c)      suggesting an allergic reaction.
A level between 5 and 15% eosinophils is nonspecific but does suggest allergic reaction.

d)      normal.
Eosinophils normally make up 1-3% of the total number of white blood cells.

300. Which of the following interventions is the single most important aspect for the patient at risk for anaphylaxis?

a)      Prevention
People who have experienced food, medication, idiopathic, or exercise-induced anaphylactic reactions should always carry an emergency kit containing epinephrine for injection to prevent the onset of the reaction upon exposure.

b)      Use of antihistamines
While helpful, the patient may require epinephrine to treat a potential reaction.

c)      Desensitization
While helpful, there must be no lapses in desensitization therapy because this may lead to the reappearance of an allergic reaction when the medication is re-instituted.

d)      Wearing of medical alert bracelet
The medical alert bracelet will assist those rendering aid to the patient who has experienced an anaphylactic reaction

Source : Smeltzer and Bare/ Brunner and Suddarth CD

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