The mother of two young children has been diagnosed with HIV and expresses fear of dying. How should the nurse best respond to the patient?

Correct Answer: C

Rationale: When the patient expresses fear of dying, the best response from the nurse would be to address the patient's concerns directly by asking, "Can you tell me what concerns you most about dying?" This response shows empathy and allows the patient to express their fears and thoughts openly. By understanding the specific concerns, the nurse can provide appropriate support and guidance to help alleviate the patient's fears and anxieties. It also opens up a dialogue for the nurse to provide information and reassurance based on the patient's individual needs and feelings.

Correct Answer: C

Rationale: The nurse's best response is option C - "AIDS isn't transmitted by casual contact." This response is accurate and provides the necessary information to address the friend's concern. It is important to educate the friend that HIV/AIDS is not transmitted through casual contact such as visiting a patient in the hospital. By stating this fact clearly, the nurse can help alleviate any unfounded fears or misconceptions the friend may have about contracting HIV while visiting the patient. This response promotes understanding and helps reduce stigma associated with HIV/AIDS, while also emphasizing the importance of accurate information in preventing the spread of the virus.

Correct Answer: B

Rationale: During the primary infection stage of HIV, the patient is newly infected with the virus. At this stage, the patient's immune system has not yet produced HIV-specific antibodies, making it difficult to detect HIV infection using standard antibody tests. Instead, the virus can be detected by testing for the presence of HIV RNA or p24 antigen. The primary infection stage is characterized by a high level of viral replication and rapid spread of the virus throughout the body. In this early stage, the patient may experience flu-like symptoms such as fever, sore throat, muscle aches, and swollen lymph nodes. The absence of HIV-specific antibodies means that the patient is highly infectious and can easily transmit the virus to others. As the infection progresses, the patient will eventually develop HIV-specific antibodies, which can be detected through antibody tests.

Correct Answer: C

Rationale: Megestrol is a synthetic progestational agent that has been found to promote significant weight gain in AIDS patients with wasting syndrome by increasing body fat stores. It is commonly used to stimulate appetite and increase caloric intake in patients experiencing anorexia and weight loss due to various medical conditions, including AIDS-related wasting. Megestrol works by increasing appetite and improving food intake, leading to weight gain and improved nutritional status in patients with HIV/AIDS. It has been shown to be effective in reversing weight loss and improving quality of life in these patients. Therefore, the drug megestrol is the most appropriate choice for promoting weight gain in AIDS patients with wasting syndrome and anorexia.

Correct Answer: A

Rationale: The most appropriate nursing intervention for a patient with AIDS experiencing extreme anxiety is to teach the patient guided imagery. Guided imagery is a relaxation technique that can help the patient reduce anxiety levels, promote a sense of calm, and improve overall well-being. By teaching the patient how to use guided imagery, the nurse empowers the patient to manage her anxiety in a non-pharmacological way. This intervention promotes self-care and allows the patient to have a tool to use independently beyond the hospital setting. Giving the patient more control of her antiretroviral regimen may be beneficial for adherence but does not directly address the anxiety symptoms. Increasing the patient's activity level may be helpful for overall well-being but may not specifically target the extreme anxiety. Collaborating with the patient's physician to obtain an order for hydromorphone, a potent opioid medication, is not appropriate unless it is indicated for severe pain management, not anxiety.