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The client has an initial positive result of an enzyme-linked immunosorbent assay (ELISA) test for human immunodeficiency virus (HIV). The client begins to cry and asks the nurse what this means. The nurse is able to provide support to the client, using knowledge that: a. The client is HIV-positive but the disease has been detected early b. The client is HIV positive but the clients CD4 cell count high c. There is a high rate of false-positive results with this test and more testing is needed before diagnosing the clients status as HIV positive d. There are occasional false-positive readings with this est, which can be cleared up by repeating it one more time Ans - C- If it is positive a second time, the Western blot a more specific is done to confirm the finding. The client is not considered positive unless the Western blot is positive. 2. Which of the following body substances most easily transmits human immunodeficiency virus (HIV)? a. Feces and saliva b. Blood and semen c. Breast milk and tears d. Vaginal secretions and urine Ans B - HIV is most easily transmitted in blood, semen, and vaginal secretions. However, it has also been found in urine, feces, saliva, tears, and breast milk. 3. Which of the following blood tests is used first to identify a response to human immunodeficiency virus (HIV) infection? a. Western blot b. CD4 T-cell count c. Erythrocyte sedimentation rate d. Enzyme- linked immunosorbent assay (ELISA) Ans D - The ELISA is the first screening test for HIV. A Western blot test confirms a positive ELISA test. Other blood tests that support the diagnosis of HIV include CD4 and CD8 counts, complete blood counts, immunoglobulin levels, p24 antigen assay, and quantitative ribonucleic acid assays. 4. Which of the following factors makes it difficult to develop a vaccine for human immunodeficiency virus (HIV)? a. HIV is a virus. b. HIV matures early. c. HIV mutates easily. d. HIV spreads through body secretions. Ans - C- HIV was first identified in 1983. By 1996, two strains existed, HIV-1 and HIV-2. This implies that even if a vaccine is developed against HIV, there is no assurance that it would be effective. This is because the virus can mutate to a form that is different from the virus for which the vaccine was developed. The facts that HIV is a virus, matures early, and spreads through body secretions do not affect the potential for vaccine development against the virus.

5. A nurse is monitoring a client with acquired immunodeficiency syndrome (AIDS) for early signs of Kaposis sarcoma. The nurse observes the client for lesions that are: a. Unilateral raised, and bluish-purple in color b. Bilateral, flat, and pink, turning to dark violet or black in color c. Unilateral, red, raised, and resembling a blister d. Bilateral, flat, and brownish and scaly on appearance Ans - B- Kaposis sarcoma generally starts with an area that is flat and pink and changes to a dark violet or black color. The lesions usually are present bilaterally. They may appear in many areas of the body and are treated with radiation, chemotherapy, and cryotherapy. 6. What is the average length of time from human immunodeficiency virus (HIV) infection to the development of acquired immunodeficiency syndrome (AIDS)? a. Less than 5 years b. 5 to 7 years c. 10 years d. More than 10 years Ans C- Epidemiologic studies show the average time from initial contact with HIV to the development of AIDS is 10 years. 7. Carticosteroids are potent suppressors of the bodys inflammatory response. Which of the following conditions or actions do they suppress? a. Sympathetic response b. Pain receptors c. Immune response d. Neural transmission Ans - C. Corticosteroids suppress eosinophils, lymphocytes, natural- killer cells, and other microorganisms, inhibiting the natural inflammatory process in an infected or injured part of the body. This promotes resolution of inflammation, stabilizies lysosomal membranes, decreases capillary permeability, and depresses phagocytosis of tissues by white blood cells, thus blocking the release of more inflammatory materials. Corticosteroids dont affect neural transmission, pain receptors, or the sympathetic response. 8. Hepatitis B immunizations should not be given to which of the following groups? a. Immunosuppressed client b. Immigrants c. Health care professionals d. Individuals older than age 65 Ans A -The immune system of immunosuppressed clients cannot handle the hepatitis B vaccine. Elderly clients, health care professionals, and immigrants are all candidates for the vaccine and may need the protection. 9. For a client with acquired immunodeficiency syndrome (AIDS), the nurse should follow standard precautions and take which of the following actions to protect herself when performing mouth care on the client? a. Use reverse isolation. b. Place the client in a private room. c. Put on mask, gloves, and a gown.

d. Wear gloves. Ans D - Standard precautions stipulate that a health care worker who anticipates coming into contact with a clients blood or body fluids must wear gloves. Reverse isolation is used to protect the client from the health care worker, not the other way around. A private room doesnt provide barrier protection, an essential step in standard precautions. A mask is needed only for anticipated contact with airborne droplets of blood or body fluids; a gown is needed only for anticipated contact with splashes of blood or body fluids. Neither is the case when performing oral hygiene. 10. Which of the following conditions or factors may cause an acquired immune deficiency? a. Age b. Genetics c. Environment d. Medical treatments Ans - D- Immune deficiencies may result from medical treatments, such as medications, radiation, or transplants. This etiology is called iatrogenic. Immune function may decline with age, but it isnt considered the cause of acquired immune deficiency. Genetics and environment havent been shown to be factors in acquired immune deficiency. 11. Which of the following organs are parts of the immune system? a. Parotids and tonsils b. Adrenals and kidneys c. Lymph nodes and thymus d. Pancreas and liver Ans C - The immune system includes the lymph nodes, thymus, spleen, and tonsils. The parotid is a salivary gland which is part of the digestive system. The adrenals are endocrine organs. Kidneys belong to the urinary system. The liver is part of the digestive system. The pancreas belongs to the digestive and endocrine systems. 12. Which of the following definitions best explains the function of the thymus gland in the immune system? a. The thymus gland is a reservoir for blood. b. The thymus gland stores blood cells until they mature. c. The thymus gland protects the body against ingested pathogens. d. The thymus gland removes bacteria and toxins from the circulatory system. Ans B - Bone marrow produces immature blood cells (stem cells). Those that become lymphocytes migrate to the bone marrow for maturation (to B lymphocytes) or to the thymus for maturation (to T Lymphocytes). These lymphocytes are responsible for cellmediated immunity. The spleen is a reservoir for blood cells. The tonsils shield against airborne and ingested pathogens, and the lymph nodes remove bacteria and toxins from the bloodstream. 13. T cells are involved in which of the following types of immunity? a. Humoral immunity b. Cell- mediated immunity c. Antigen- mediated immunity d. Immunoglobulin- mediated immunity

Ans B - T cells are responsible for cell- mediated immunity, in which the T cells respond directly to the antigen. B cells are responsible for humoral or immunoglobulinmediated immunity. There is no antigen- mediated immunity. Remember TIC T Is Cellmediated 14. Which of the following symptoms is a classic sign of systemic lupus erythematosus (SLE)? a. b. c. d. Vomiting Weighing Difficulty urinating Superficial lesions over the cheeks and nose

Ans D - Although all these symptoms can be signs of SLE, the classic sign is the butterfly rash over the cheeks and nose 15. Instructions for a client with systemic lupus erythematosus (SLE) would include information about which of the following blood dyscrasias? a. Dresslers syndrome b. Polycythemia c. Thrombocytopenia d. von Willebrands disease Ans - C. Thrombocytopenia is linked to immunologic disorders, such as SLE and human immunodeficiency virus. The disorder known as von Willebrands disease is a type of hemphilia and isnt linked to SLE. Moderate to sever anemia is associated with SLE, not polycythemia. Dresslers syndrome is pericarditis that occurs after a myocardial infarction and isnt linked to SLE. 16. Systemic lupus erythematosus (SLE) primarily attacks which of the following tissues? a. Connective b. Heart c. Lung d. Nerve Ans A - SLE is chronic, inflammatory, autoimmune disorder that primarily affects connective tissue. It also affects the skin and kidneys and may affect the pulmonary, cardiac, neural, and renal systems. 17. Which of the following conditions is a sign of neurologic involvement in systemic lupus erythematosus (SLE)? a. Facial tic b. Psychosis c. Extremity weakness d. Cerebrovascular accidents Ans B -Neurologic involvement may be shown by psychosis, seizures, and headaches. Tics and cerebrovascular accidents arent related to SLE. Weakness may be present, but its usually related to muscle atrophy, not neurologic involvement.

18. The nurse assesses a patient in the doctors office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)? a. Facial erythema, profuse proteinuria, pleuritis, fever, and weight loss b. Pericarditis, photosensitivity, polyarthalgia, and painful mucous membrane ulcers c. Weight gain, hypervigilance, hypothermia, and edema of the legs d. Hypotherlmia, weight gain, lethargy, and edema of the arms Ans - A An autoimmune disorder characterized by chronic inflammation of the connective tissues, SLE causes fever, weight loss, malaise, fatigue, skin rashes, and polyarthralgia. Nearly half of patients with SLE have facial erythema, the classic butterfly rash. SLE also may cause profuse proteinuria, pleuritis, pericarditis, photosensitivity, and painless mucous membrane ulcers. Weight gain, hypervigilance, hypothermia, and edema of the legs and arms do not suggest SLE. 19. After an extensive diagnostic workup, a patient is diagnosed with systemic lupus erythematosus (SLE). Which statement about the incidence of SLE is true? a. SLE is most common in women between ages 45 and 60 b. SLE affects more whites than blacks c. SLE tends to occur in families d. SLE is more common in underweight than overweight persons ANS. C SLE has familial basis. Also, when one twin has the disease, the other twin has a 60% to 70% chance of developing it, suggesting a genetic predisposition. SLE strikes nearly 10 times as many women as men and in most common in women between ages 15 and 40. SLE affects more black women than white women,; its incidence is about 1 in every 250 Black women, compared to 1 in every 700 white women. Being overweight, not underweight, is thought to increase autoimmunity and thus heighten the risk for SLE and other autoimmune disorders.