The nurse is reviewing assessment data for several patients who ...

[scienceeasy]

The nurse is reviewing assessment data for several patients who are suspected of exposure to HIV. Which patients demonstrate findings consistent with HIV exposure?
 
  1. Patients A and C
  2. Patient A only
  3. Patients B and D
  4. Patient C only

Question 2

The nurse on the transplant unit is reviewing assessment data for a group of patients. Which patients should the nurse realize are at greatest risk for graft-versus-host disease?
 
  1. Patients A and C
  2. Patient A only
  3. Patient B only
  4. Patient D only

[izzat]

Answer to Question 1

Correct Answer: 2

Patient A's ELISA and Western Blot + tests were positive. ELISA and Western Blot + is indicative of seroconversion for HIV. A slight decrease in CD4 may also be present at this time. Most patients develop an acute mononucleosis-type illness within days to weeks after contracting the virus. Typical manifestations include fever, sore throat, arthralgias and myalgias, headache, and rash. The other patients' ELISA and Western Blot + tests were negative.

Answer to Question 2

Correct Answer: 3

Graft-versus-host disease (GVHD) is a potentially fatal complication of stem cell transplantation to immunocompromised patients. Acute GVHD occurs within the first 100 days following a transplant and primarily affects the skin, liver, and gastrointestinal tract. The patient develops a maculopapular pruritic rash beginning on the palms of the hands and soles of the feet. The rash may spread to involve the entire body and lead to desquamation. Gastrointestinal manifestations include abdominal pain, nausea, and bloody diarrhea. GVHD that lasts longer than 100 days is said to be chronic. If it is limited to the skin and liver, the prognosis is good. If multiple organs are involved, the prognosis is poor.