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HIV Infected Women - Psychological Issues

Major Psychosocial and Cultural Issues Faced by Women with HIV Infection

1. Which of the following is a gender norm that contributes to the spread of HIV infection?

A. Women and girls often have less information about HIV and fewer resources to take preventive measures.

B. Because of economic dependency and unequal power relations, women are often unable to negotiate safer sex practices.

C. Women may be subjected to forced sex, which can cause tears and lacerations in the vaginal mucosa and anal lining, thereby increasing the risk of HIV transmission.

D. All of the above.


2. Abusive male partners are more likely than other men to be HIV infected, therefore, women who experience IPV have a higher incidence and prevalence of HIV.

A. True

B. False


3. Because certain needs must be met before women can effectively manage their HIV infection, healthcare providers should be consistent in asking their HIV infected patients’ about all of the following, except:

A. Living situations

B. Whether or not they have health insurance

C. Whether or not they have enough food

D. Whether or not they have access to electricity and water


Mental Health Issues

4. The most vulnerable women are those who are triply diagnosed with all of the following, except:

A. HIV infection

B. A chronic mental illness

C. Interpersonal violence

D. A substance abuse disorder


5. Triggers that may exacerbate an existing mental health disorder among women with HIV include:

A. Beginning ART

B. Hospitalization

C. Making end-of-life and permanency planning decisions

D. All of the above


Specific Mental Health Conditions

6. HIV infected people with depression are less adherent to ARV regimens.

A. True

B. False


7. Which is the most prevalent mental health problem experience by HIV infected women?

A. Depression

B. Anxiety

C. Panic disorder

D. PTSD


Psychopharmacology

8. Psychiatrists and primary health care providers should be in regular communication with each other about clinical updates, dosing changes, and major medical events.

A. True

B. False


Substance Abuse

9. Which drug is known to increase risky sexual behavior and has been associated with an increased proportion of drug-treatment admissions in pregnancy?

A. Crack cocaine

B. Methamphetamine

C. Heroin

D. Ecstasy


10. For women, more than ten drinks per week or more than four drinks on any one occasion may put them at risk for developing alcohol dependence.

A. True

B. False


11. Which symptom of long-term alcohol abuse could also indicate peripheral neuropathy related to HIV or ART?

A. Swelling or redness of the palms of the hands

B. Unsteady gait

C. Numbness or tingling in the feet and hands

D. All of the above


12. The single most useful examination of substance abuse is:

A. Of the eyes

B. By observation of damaged nasal mucosa

C. Of hypodermic marks

D. Poor dentition


13. When performing a drug test, which of the following methods is the most available, useful, and reliable testing format to use?

A. Urine

B. Blood

C. Saliva

D. Breath


14. Harm-reduction techniques for women who are IDUs include:

A. Use clean sterile needles and syringes every time injection drugs are used.

B. Do not share needles, syringes, cotton, or cookers with others when injecting.

C. Purchase sterile equipment without a prescription from a pharmacy, if available.

D. All of the above.


15. If safer options are not adopted and needles and syringes are shared, the risk of infection can be reduced by always cleaning them in bleach and water immediately after use and just before reuse.

A. True

B. False


16. All of the following are true with regard to methadone, except:

A. Methadone suppresses withdrawal for 24 hours.

B. Methadone decreases or eliminates drug cravings.

C. Methadone is sedating.

D. Methadone is medically safe even when used continuously for 10 years or more.


17. Behavioral methods of drug and alcohol addiction treatment and prevention are employed to:

A. Identify high-risk relapse situations.

B. Develop self-monitoring of use behavior.

C. Establish competing coping responses.

D. All of the above.


18. When methadone is administered to a patient taking ZDV, the ZDV concentration is increased by _____ and the patient should be monitored for a potential increase in ZDV-related adverse effects.

A. >20%

B. >40%

C. >60%

D. >80%


Risk Factors

19. A majority of adolescent females with HIV are infected through:

A. Heterosexual intercourse

B. Homosexual intercourse

C. Perinatal transmission

D. Injection drug use


20. During their most recent sexual encounter, 84% of female high school students reported using a condom.

A. True

B. False


Issues in HIV Care for Adolescents

21. Lack of confidentiality may cause adolescents to avoid or delay needed care.

A. True

B. False


22. During an HIV risk assessment, adolescents should be assessed on which of the following?

A. If the youth knows anyone with HIV/AIDS.

B. The number of youth’s partners, age differential, and partners’ known risks.

C. A history of sex work and transactional sex.

D. All of the above.


23. Adolescents who are HIV infected are also in need of risk-reduction counseling to prevent transmission of HIV to uninfected sexual partners and to prevent acquisition of other STIs or reinfection with other HIV strains.

A. True

B. False


HIV Clinical and Psychosocial Care

24. Adolescent HIV/AIDS patients should be screened for _____, a known cause of nonadherence to medication.

A. Substance abuse

B. Depression

C. Homelessness

D. All of the above


25. Which of the following is an identified key issue that adolescents with HIV/AIDS must address in coping with their changing health status?

A. Disclosing HIV status to parents, partners, and others.

B. Becoming symptomatic.

C. Preparing for death.

D. All of the above.


Therapy to Improve Quality of Life

26. High-quality palliative care begins at disease diagnosis and is delivered simultaneously with life-prolonging therapy throughout the course of illness.

A. True

B. False


HIV as a Chronic Disease

27. Death from HIV has shifted “from fate to tragedy” and is often due to all of the following, except:

A. Nonadherence to medical care and ART.

B. Psychiatric and substance abuse comorbidities.

C. Becoming infected with a medication resistant strain.

D. Marginalization from the medical system.


28. Palliative care is the same thing as hospice and equates to end-of-life care.

A. True

B. False


Pain and Nonpain Symptoms

29. A breakthrough dose should be _____ of the total daily dosage and given every 1 hour as needed.

A. 1%

B. 5%

C. 10%

D. 20%


30. Fentanyl patches are preferred in all of the following, except for:

A. Patients with renal failure

B. Patients with hepatic failure

C. Opioid-naive patients

D. Fentanyl patches are preferred in all of the above


31. For many patients, pain is adequately relieved by the initial low-dose opioid.

A. True

B. False


32. Constipation is expected with opioids and will resolve on its own without pharmacologic intervention.

A. True

B. False


33. Distal sensory polyneuropathy is thought to be caused by the direct effects of HIV on peripheral nerves.

A. True

B. False


Advanced Illness

34. Which of the following is a principle of bereavement support to care for patients and families during difficult times?

A. View patient and family as one unit of care.

B. Enable open discussion of illness and death-related concerns.

C. Respect cultural, ethnic, and religious practices.

D. All of the above.


HIV, HBV, and HCV Exposures Are Common

35. The PEPline is a nationwide central service for reporting healthcare worker exposures.

A. True

B. False


Exposure and Transmission

36. Which of the following body fluids can transmit BBPs, even when not visibly bloody?

A. Synovial fluid

B. Vomitus

C. Feces

D. All of the above


Resistances

37. Which of the following is an important factor that should increase suspicion of resistance?

A. History of problems with medication adherence.

B. Failure to achieve undetectable viral load on ARV medications.

C. Development of detectable viral load after previously undetectable levels while on ARV medications.

D. All of the above.


Elements of a Quality Management Program

38. To be successful, a quality management program should have which key element?

A. A quality infrastructure

B. Performance measurement

C. QI activities

D. All of the above


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