Content of Examination

1. The certification examination in HIV/AIDS nursing is a written examination composed of a maximum of 250 multiple choice, objective questions with a total testing time of four (4) hours.

2. The content for the examination is described in the content outline below.

3. The questions for the examination are obtained from individuals with expertise in HIV/AIDS nursing and are reviewed for construction, accuracy, and appropriateness by the HIV/AIDS Nursing Certification Board.

4. The HIV/AIDS Certification Board, with the advice and assistance of the Professional Testing Corporation, prepares the examination.

5. The certification examination in HIV/AIDS nursing will be weighted in approximately the following manner:

I. Epidemiology and Prevention 10%
II. Pathophysiology 15%
III. Clinical Manifestations and Management 30%
IV. Psychosocial Issues 20%
V. Specific Populations 15%
VI. Ethical and Legal Issues 5%
VII. Professional and Institutional Issues 5%

Content Outline

I. Epidemiology and Prevention

1. Epidemiology
   1. Emergence/Recognition of Epidemic
   2. Basic Principles of Epidemiology
      1. Prevalence
      2. Incidence
      3. Relative Risk
   3. Global
      1. Geographic Patterns
      2. Current and Future Trends
      3. HIV-2
      4. Comparison to the United States
   4. United States
      1. Seroprevalence
      2. AIDS Case Rates
      3. Major Routes of Transmission
      4. Geographic Variations
      5. Other
   5. Projections
      1. New Infections
      2. Disease Manifestations
2. Prevention
   1. Risk Assessment
      1. Sexual History
      2. Substance Use History
      3. Violence and Trauma
      4. Occupational History
         1. Blood and Body Fluid Standard Precautions
         2. Personal Protective Equipment
         3. Postexposure Management
      5. Medical History
         1. Blood Transfusions
         2. Hemophilia
         3. Other
      6. History of Incarceration
      7. Other
   2. Risk Prevention
      1. Sexual Abstinence
      2. Parental Cautions
         1. Injection Drug Use
         2. Needle Exchange
         3. Auto Transfusions
      3. Vertical Caution
         1. Pregnancy Prevention
         2. No Breast Feeding
   3. Counseling and Testing
      1. Test Timing
      2. Pretest Counseling
      3. Anonymity Versus Confidentiality
      4. Reporting Requirements
      5. Test Results Interpretation
      6. Posttest Counseling
         1. Wellness Strategies
         2. Behavior Change
         3. Crisis Intervention
         4. Partner Notification
         5. Referrals
         6. Other
   4. Sex-related Risk Reduction
      1. Safer Sex
      2. Treatment of Sexually Transmitted Disease
      3. Partner Notification
   5. Drug Use Related Risk Reduction
      1. Cleaning Drug Paraphernalia
      2. Drug Treatment
      3. Other
   6. Vertical Risk Reduction
      1. HIV Counseling and Testing
      2. Antiretroviral Drug Use
      3. Other Strategies
   7. Occupational Risk Reduction
      1. Blood and Body Fluid Standard Precautions
      2. Personal Protective Equipment
      3. Postexposure Management

II. Pathophysiology

1. Virology
   1. Structure
   2. Life Cycle
   3. Types/Subtypes
      1. HIV-1
      2. HIV-2
   4. Mutations
2. Immunology
   1. Normal Function
   2. Alterations in HIV
3. Natural History
   1. Disease Progression
      1. Usual Course
      2. Cofactors
      3. Biological Markers
         1. Viral Load
         2. CD4+ Lymphocytes
         3. Other
   2. Classification and Staging
      1. Adult
      2. Pediatric
   3. Direct Effect of HIV
      1. Neurologic System
         1. Central
         2. Peripheral
      2. Gastrointestinal System
      3. Other
4. Diagnostic HIV Tests
   1. Antibody Test
      1. ELISA
      2. Western Blot
      3. Immunoflorescence Assay
      4. Other
   2. Viral Testing
      1. Polymerase Chain Reaction (PCR)
      2. HIV Quantification
      3. Other

III. Clinical Manifestations and Management

1. Assessment
   1. History
      1. Activities of Daily Living
      2. Nutritional
      3. Major Illnesses
      4. Medication
      5. Psychosocial
      6. Sexual
      7. Substance Use
      8. Occupational
      9. Social
      10. Travel
   2. Physical Examination
      1. Anthropometric Measures
      2. Mental Status
      3. Body Systems
   3. Laboratory Evaluations
      1. Hematologic
      2. Immunologic
      3. Chemistry
      4. Chest X-ray
      5. Viral Load
      6. Other
2. Treatment Goals
   1. Suppression of Disease Process
   2. Wellness Strategies
   3. Client/Family Education
   4. Symptom Management
   5. Opportunistic Disease Management
      1. Prophylaxis
      2. Treatment
3. Treatment of HIV Infection
   1. Pharmacological
      1. Antiretroviral
         1. Monotherapy
         2. Highly Active Antiretroviral Therapy (HAART)
         3. Other
      2. Immune Modulators
      3. Protease Inhibitors
      4. Vaccines
      5. Reverse Transcriptase Inhibitors
      6. Nonnucleoside Reverse Transcriptase Inhibitors
      7. Other
   2. Complementary Therapies
4. Opportunistic Infections
   1. Bacterial
      1. Mycobacterium
         1. Tuberculosis
         2. Mycobacterium Avium Complex
      2. Other (e.g., Syphilis, Salmonella)
   2. Fungal
      1. Candida
      2. Cryptococcus
      3. Histoplasmosis
      4. Other
   3. Protozoal
      1. Pneumocystis Carinii
      2. Toxoplasmosis
      3. Cryptosporidiosis
      4. Other (e.g., Microsporidiosis)
   4. Viral
      1. Herpes Family
         1. Herpes Simplex Virus
         2. Cytomegalovirus
         3. Varicella Zoster Virus
         4. Other
      2. Human Papilloma Virus (HPV)
      3. Hepatitis
      4. Other (e.g., Progressive Multifocal Leukoencephalopathy (PML))
5. Neoplasms
   1. AIDS Related Lymphoma
      1. Non-Hodgkin's Lymphoma
      2. Primary CNS Lymphoma
   2. Kaposi's Sarcoma
   3. Cervical
   4. Other
6. Neurological and Neuropsychiatric Disorders
   1. HIV Encephalopathy
   2. Peripheral Neuropathy
   3. Complications of Opportunistic Infections
   4. Psychiatric Complications of HIV Disease
      1. Mood Disorders
      2. Anxiety Disorders
      3. Adjustment Disorders
      4. Organic Mental Disorders
   5. Other
7. Other HIV-related Conditions
   1. Wasting Syndrome
   2. Constitutional Symptoms
   3. Idiopathic Thrombocytopenic Purpura (ITP)
   4. Other
8. Management of Organ System Complications
   1. Cardiac
   2. Pulmonary
   3. Gastrointestinal
   4. Renal
   5. Endocrine
   6. Genitourinary
   7. Musculoskeletal
   8. Dermatologic
   9. Sensory
   10. Hematologic
       1. Anemia
       2. Neutropenia
       3. Other
9. Pain Management
   1. Pharmacologic Therapy
   2. Behavioral Interventions
   3. Complementary Therapies
   4. Chemical Dependency Issues
10. Nutrition Management
11. Symptom Management
    1. Fever
    2. Cough
    3. Dyspnea
    4. Diarrhea
    5. Nausea and Vomiting
    6. Anorectal
    7. Vaginal
    8. Impaired Skin Integrity
    9. Odynophagia
    10. Falls Risk
    11. Fatigue
12. Infection Control
    1. Central Venous Access Devices
    2. Other (e.g., Food, Water)
13. Perinatal Transmission

IV. Psychosocial Issues

1. Psychological Stages of Response
   1. Initial Crisis
      1. Shock
      2. Denial
      3. Disbelief
      4. Numbness
      5. Anger
      6. Guilt
      7. Blaming
      8. Helplessness
      9. Hopelessness
   2. Transitional
      1. Relationships
         1. Sexual
         2. Family
         3. Work
      2. Fears
         1. Disclosure
         2. Abandonment
         3. Intimacy
         4. Loss of Control
         5. Stigma
      3. Losses
         1. Self-esteem
         2. Body Image
         3. Sexuality
         4. Financial
         5. Sense of Future
         6. Isolation
         7. Other
   3. Acceptance
      1. Focus on Living
      2. Active Participation in Health Care
      3. Living in Present
      4. Reengagement in Relationships
   4. Preparatory
      1. Making Decisions
      2. Dealing with Unresolved Issues
2. Social Support Systems
   1. Impact on Family
   2. Care for the Caregiver
   3. Community Resources
   4. Other
3. Crisis Intervention
   1. Prevention
      1. Suicide
      2. Violence
      3. Other
   2. Enhancing Coping Skills
   3. Psychiatric Referral
   4. Mobilizing Support Systems
   5. Other
4. Addiction
   1. Etiologies
   2. Social and Environmental Factors
   3. Impact on Behavior
      1. Client
      2. Care Providers
5. Spiritual Issues
   1. Belief Systems
      1. Client
      2. Care Providers
   2. Organized Religion
   3. Spiritual Counseling
6. Death and Dying
   1. Stages
   2. Bereavement
      1. Grief
      2. Loss

V. Specific Populations

1. Cultural Considerations
   1. Belief Systems
   2. Social Systems
   3. Discrimination
2. Gender
   1. Men
   2. Women
   3. Transgender
3. Age-related
   1. Pediatric
   2. Adolescents
   3. Adults
   4. Geriatrics
4. Racial-Ethnic
   1. African-Americans
   2. Latinos/Hispanics
   3. Native Americans
   4. Undocumented Immigrants
   5. Other
5. Environmental
   1. Rural
   2. Urban
   3. Homeless
   4. Incarcerated
   5. Other
6. Disabilities
   1. Hearing Impaired
   2. Chronically Mentally Ill
   3. Developmentally Delayed
   4. Other
7. Hemophiliacs
8. Substance Users
9. Occupational
   1. HIV-positive Health Care Workers
   2. Sex Industry Workers
   3. Other
10. Dual Diagnosis

VI. Ethical and Legal Issues

1. Framework
2. Ethics Related to Testing
   1. Discrimination
   2. Partner Notification
   3. Ethics Related to Prenatal Counseling and Testing
   4. Mandatory Testing
3. Deliberate Unsafe Behaviors
4. Obligation to Care
5. Decision Making
6. End-of-life Decisions
7. Access to Care and Treatment
8. Research
   1. Biomedical
   2. Behavioral
9. Informed Consent
10. Confidentiality
11. Documentation
12. Duty to Warn/ Due Process
13. Guardianship
14. Advance Directives
    1. Living Will
    2. Surrogate Decision Maker
       1. Proxy
       2. Power of Attorney for Medical Decisions
    3. Resuscitation

VII. Professional and Institutional Issues

1. Case Management
   1. Insurance
   2. Entitlements
   3. Community Resources
   4. Continuity of Care
   5. Client Advocacy
   6. Coordination of Care
   7. Client/Family Education
2. Nurse as Care Provider
   1. Safety
      1. Standard Precautions
      2. Postexposure Guidelines
      3. Environmental
   2. Self-care
      1. Wellness Strategies
         1. Stress Management
         2. Other
      2. Other
   3. Professional Development
   4. Standards of Care
   5. Attitudes Towards Clients
   6. Other
3. Managed Care

Sample Examination Questions

In the following questions, choose the one best answer.

1. HIV transmission has been most often associated with which of the following?
   1. Blood transfusions
   2. Injection drug use
   3. Perinatal transmission
   4. Unprotected sexual activity

2. What is the most important nursing response for a client with a newly established AIDS diagnosis and vague thoughts about suicide?
   1. Arrangement for constant observation
   2. Referral for antidepressant medication
   3. Further assessment for suicidal risk
   4. Immediate referral to psychiatric clinician

3. Which of the following is used to indicate the presence of HIV antigen?
   1. p24
   2. ELISA
   3. Western blot
   4. Immunofluorescence assay

4. Infants born to HIV-seropositive mothers are likely to
   1. not become infected in utero.
   2. remain HIV-seropositive.
   3. develop AIDS within the first year of life.
   4. become seronegative if they are not infected.