Chapter 21: Care of Clients with HIV Disease and Other Immune DeficienciesTest BankMULTIPLE CHOICE1.Which action by the nurse is most effective to prevent becoming exposed to the human immune deficiency virus (HIV)?a.Always use Standard Precautions with all clients in the workplace.b.Place clients who are HIV positive in Contact Precautions.c.Wash hands before and after contact with clients who are HIV positive.d.Convert parenteral medications to an oral form for clients who are HIV positive.ANS:AThe best prevention for health care providers is the consistent use of Standard Precautions with all clients, as recommended by the Centers for Disease Control and Prevention (CDC). Contact Precautions are not indicated unless the client has an infection such as Clostridium difficile or MRSA (methicillin-resistant Staphylococcus aureus).DIF:Cognitive Level: Application/Applying or higherREF:N/ATOP:Client Needs Category: Safe and Effective Care Environment (Safety and Infection ControlStandard Precautions/Transmission-Based Precautions/Surgical Asepsis)MSC:Integrated Process: Nursing Process (Implementation)2.The nurse is caring for a young client who has acquired immune deficiency syndrome (AIDS) and a very low CD4+ cell count. The nurse is teaching the client how to avoid infection at home. Which statement by the client indicates that additional teaching is needed?a.I will let my sister clean my pet iguanas cage from now on.b.My brother will change the kitty litter box from now on.c.It will seem funny but Ill run my toothbrush through the dishwasher.d.I will not drink juice that has been sitting out for longer than an hour.ANS:AImmune compromised clients should avoid having reptiles or turtles as pets and should avoid changing cat litter to help prevent opportunistic infections. Drinking juice that has been at room temperature for longer than 1 hour can lead to opportunistic infection and should be avoided. Clients should clean their toothbrushes daily by running them in the dishwasher or rinsing them in liquid laundry bleach.DIF:Cognitive Level: Application/Applying or higherREF:N/ATOP:Client Needs Category: Health Promotion and Maintenance (Self-Care)MSC:Integrated Process: Teaching/Learning3.The nurse is working with a client at a public health clinic. The client says to the nurse, The doctor said that my CD4+ count is 450. Is that good? What is the nurses best response?a.Your count is high so you can cut back on your medication.b.Your count is normal because your medications are working well.c.Your count is a bit low and you are susceptible to infection.d.Your count is very low and you actually now have AIDS.ANS:CA CD4+ T-cell count of 450 cells/mm3 of blood is low, and the client is at increased risk for developing an infection. Normal CD4+ counts range from 800 to 1000 cells/mm3. To be diagnosed with AIDS, a client must have a CD4+ T-cell count of