- Read the article on page 301.
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Purpose: To provide information about how nurses can provide pre-exposure prophylaxis (PrEP-RN) in sexually transmitted infection (STI) clinics.
Learning Objectives/Outcomes: After completing this continuing education activity, you should be able to:
- 1. Identify the epidemiology of HIV infection and issues related to PrEP.
- 2. Specify how nurses can provide PrEP in an outpatient STI clinic.
- 1. The only medication approved for PrEP in the U.S. and Canada is the fixed combination of emtricitabine (FTC) plus tenofovir disoproxil fumarate (TDF) in which doses?
- a. 200 mg FTC + 150 mg TDF
- b. 300 mg FTC + 200 mg TDF
- c. 400 mg FTC + 250 mg TDF
- 2. In the 2015 study by Pathela et al., more than 1 in 20 men were diagnosed with HIV within 1 year of a diagnosis of
- a. syphilis.
- b. chlamydia.
- c. human papillomavirus.
- 3. According to the Centers for Disease Control and Prevention (2018), the rates of HIV acquisition are higher in what group compared to other populations that are affected by HIV?
- a. transgender persons
- b. men who have sex with men (MSM)
- c. persons who share injection drug paraphernalia
- 4. In the U.S. in 2016, the rate of HIV infection among women in which ethnic communities was disproportionately higher than for females of other ethnicities?
- a. Native American, Alaskan Native, and Native Hawaiian
- b. Hispanic, Latina
- c. African, Caribbean, Black
- 5. According to the PrEP-RN model described in this article, persons who should be actively offered PrEP include all of the following except
- a. anyone after post-exposure prophylaxis (PEP) use.
- b. persons from global endemic areas.
- c. MSM with rectal gonorrhea.
- 6. A targeted approach recommended by the authors to increase PrEP awareness is
- a. using mass media strategies.
- b. placing brochures in public restrooms.
- c. educating staff in STI clinics about PrEP.
- 7. At the first clinic visit, the authors note that patients should be assessed for symptoms of acute HIV infection that they have at the visit and in the preceding 4 weeks, such as
- a. myalgias.
- b. nonproductive cough.
- c. conjunctivitis.
- 8. Known contraindications to FTC/TDF include
- a. estimated glomerular filtration rate (eGFR) > 60 mL/min.
- b. elevated liver enzyme levels.
- c. HIV-positive status.
- 9. Serology testing at the first clinic visit includes testing for
- a. gonorrhea.
- b. chlamydia.
- c. hepatitis A, B, and C.
- 10. According to the PrEP-RN model, what laboratory test is used to calculate an eGFR?
- a. albumin
- b. creatinine
- c. blood urea nitrogen
- 11. The model used in this article calculates the eGFR using the more accurate
- a. Chronic Kidney Disease Epidemiology (CKD-Epi) Collaboration formula.
- b. Cockcroft-Gault formula.
- c. Modification of Diet in Renal Disease (MDRD) Study formula.
- 12. Risk reduction counseling for patients who will be starting PrEP include all of the following except the
- a. use of PEP for missed FTC/TDF doses.
- b. fact that PrEP is effective with or without condom use.
- c. importance of safer drug use equipment.
- 13. The first prescription for FTC/TDF in the PrEP-RN model is for
- a. 1 month.
- b. 2 months.
- c. 3 months.
- 14. According to the eGFR management pathway for the 1st visit, if the eGFR is <60 mL/min and the last sexual contact (LSC) was >3 days ago, what is the next step?
- a. If the LSC was high risk, page infectious diseases practitioner on-call for referral in <24 hours.
- b. Prescribe FTC/TDF.
- c. No action is indicated.
- 15. Side effects from FTC/TDF include
- a. dry mouth.
- b. insomnia.
- c. bloating.
- 16. After the initial prescription, patients who follow the PrEP-RN program have clinic visits every
- a. month.
- b. 3 months.
- c. 6 months.
- 17. In the PrEP-RN model at the clinic described in this article, how long are services provided before patients are referred to an external provider for continuation of care?
- a. 6 to 12 months
- b. 14 to 16 months
- c. 18 to 24 months
- 18. Research by O’Byrne, et al. (2017) revealed that a total of how many patients who completed a single course of PEP went on to acquire HIV within 12 months due to a new exposure to HIV not treated with PEP?