HIV/AIDS: State of Washington Mandatory 7 Hour Training

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1. HIV is a

  a. Bacteria that is dispersed through the air on droplet nuclei.

  b. Fungus that is transmitted through direct contact.

  c. Virus that is transmitted through blood.

  d. None of the above.


2. All people who have HIV infection have AIDS.

  a. True

  b. False


3. Acquired Immune Deficiency Syndrome (AIDS) is diagnosed when the Western Blot confirmatory test is positive.

  a. True

  b. Fales


4. The cells that the HIV virus attacks in the blood are the:

  a. Tau in the tangles and plaques.

  b. Islets of Langerhans.

  c. The T-helper lymphocytes or CD4 cells.

  d. HIV does not attack cells in the blood.


5. The window period is the period of time

  a. After the virus enters the body and attacks the T4 cells until the body produces antibodies to the virus.

  b. Between HIV infection and the appearance of the first symptoms.

  c. From HIV infection until the start of persistent symptoms of AIDS.

  d. None of the above.


6. Viral transmission is the initial infection with HIV. When a person is infected with HIV, they will probably have virus circulating in their bloodstream, and may become infectious to others within five days. The person may be infectious before the onset of any symptoms. They will remain infectious for the rest of their lives.

  a. True

  b. False


7. All the following are true about Primary infection EXCEPT:

  a. It occurs in the first few weeks of HIV infection.

  b. Because antibodies have not yet been developed, those with primary infection cannot pass HIV on to others.

  c. Typically, people have a very high amount of virus in their bloodstream during this stage.

  d. Symptoms include fever, swollen glands in the neck, armpits and/or groin, rash, fatigue and sore throat.


8. High risk behaviors for HIV transmission include:

  a. Unprotected heterosexual contact where there may be an exchange of blood, semen or vaginal secretions.

  b. Unprotected homosexual contact where there may be an exchange of blood, semen or vaginal secretions.

  c. Sharing injecting drug equipment such as syringes and needles.

  d. All of the above.


9. HIV can be transmitted from someone who is HIV positive through the blood and body fluids to another person through the 2nd person’s skin abrasions and mucus membranes, such as might occur during sex.

  a. True

  b. False


10. Seroconversion is:

  a. Occurs after infection; it is when antibodies are produced that would show positive on an HIV test.

  b. The time frame may vary from person to person, with most people having HIV antibodies detectable within the first 3-6 months of infection.

  c. Detectable for life in most cases.

  d. All of the above.


11. All the following are true about opportunistic infections EXCEPT:

  a. They have a high potency ratio, making even one exposure a very high risk.

  b. These infections are more destructive because of HIV’s assaults on the immune system.

  c. These infections are not generally seen in persons with healthy immune systems.

  d. They are sometimes called AIDS defining illnesses.


12. Universal/Standard precautions requires that one always assumes that the blood or body fluids of another person could be positive for HIV (or other bloodborne pathogens), thereby always taking barrier precautions to avoid any infection through bloodborne transmission.

  a. True

  b. False


13. After occupational exposure to HIV in the workplace, the employee should:

  a. Follow facility protocols and policies.

  b. Obtain evaluation as soon as is possible; prophylactic treatment should begin within 2-24 hours

  c. Obtain permission to test the source for HIV infection, if possible.

  d. All of the above.


14. All positive Western Blot tests must be confirmed by the ELISA.

  a. True

  b. False


15. Partner notification consists of:

  a. Confidentially notifying partners of persons who have been tested for HIV, so that they are aware that their partner has had the HIV test.

  b. Confidentially notifying the sexual and drug equipment sharing partners of those who have tested positive for HIV infection, and that they should also be tested.

  c. Informing spouses of persons who are taking antiretroviral medications about the complex medical regimen, in order for the spouse to promote the taking of these medications.

  d. Anonymously contacting the partners of persons who have side effects to the highly active antiretroviral medications.


16. It is recommended that victims of sexual assault:

  a. Go directly to the nearest hospital emergency room, without changing their clothing, bathing or showering first.

  b. Testing directly after a sexual assault can provide baseline information on the victim’s status regarding HIV and other STDs, useful for clinical treatment and in legal and criminal action.

  c. In Washington State, victims of convicted sexual offenders may learn the attacker’s HIV status; however, the victim needs to consider whether to start post-exposure prophylaxis (PEP)

  d. All of the above.


17.

A person with untreated HIV infection will experience several stages in infection. These include:

  • Viral transmission,
  • Primary HIV infection,
  • Seroconversion,
  • Asymptomatic HIV infection,
  • Symptomatic HIV infection, and
  • AIDS.


  a. True

  b. False


18. Viral transmission is the same as the initial infection with HIV. When a person becomes infected with HIV, they:

  a. Will probably have virus circulating in their bloodstream, and may become infectious to others within five days.

  b. The person may be infectious before the onset of any symptoms.

  c. They will remain infectious for the rest of their lives.

  d. All of the above.


19. The 2008 case definition revision for HIV and AIDS was revised into a single case definition for HIV infection that includes AIDS and incorporates the HIV infection classification system. All the following are true EXCEPT:

  a. Laboratory-confirmed evidence of HIV infection is now required to meet the surveillance case definition for HIV infection.

  b. A positive HIV test OR an AIDS indicator condition OR a CD4 count of less than 200 cells/mm.

  c. Diagnostic confirmation of an AIDS-defining condition alone, without laboratory-confirmed evidence of HIV infection, is no longer sufficient to classify an adult or adolescent as HIV infected for surveillance purposes.

  d. This definition applies to adults and adolescents age 13 and older.


20. Among the AIDS indicator conditions are:

  a. Candidiasis, tuberculosis, cryptosporidiosis and SARS.

  b. Avian flu, histoplasmosis and nocardiosis.

  c. Candidiasis, tuberculosis, cryptosporidiosis and histoplasmosis.

  d. Histoplasmosis, candidiasis, lymphoma and SARS.


21. Since 1996, highly active antiretroviral therapy (HAART) has largely been responsible for the reduction in AIDS deaths.

  a. True

  b. False


22. Access to medical care and adherence to complex medication regimens is not generally a problem for persons with HIV infection, mainly because one can start and stop taking HAART at will with no concern for drug resistance.

  a. True

  b. False


23. Some common side effects to HAART include all the following EXCEPT:

  a. Nausea, diarrhea and osteoporosis

  b. Numbness in feet and hands (peripheral neuropathy) and changes in body fat distribution (lipodystrophy).

  c. Vomiting, weight gain and restlessness.

  d. Diabetes or other metabolic changes.


24. In an HIV-infected person, TB disease can develop in the following ways:

  a. A person who already has latent TB infection can become infected with HIV, and then TB disease can develop as the immune system is weakened.

  b. A person who has HIV infection can become infected with M. tuberculosis, and TB disease can then rapidly develop because their immune system is not functioning.

  c. Both A and B.

  d. Neither A or B.


25.

The presence of infection with other sexually transmitted diseases (STDs) increases the risk of HIV transmission because:

  • STDs like syphilis and symptomatic herpes can cause breaks in the skin, which provide direct entry for HIV;
  • Inflammation from STDs, such as chlamydia, makes it easier for HIV to enter and infect the body;
  • HIV is often detected in the pus or other discharge from genital ulcers from HIV-infected men and women;
  • Sores can bleed easily and come into contact with vaginal, cervical, oral, urethral and rectal tissues during sex ;
  • Inflammation appears to increase HIV viral shedding and the viral load in genital secretions.


  a. True

  b. False


26. Sexually transmitted diseases (STDs) can be prevented through:

  a. Abstaining from sex or being in a mutually monogamous relationship with an uninfected partner or changing the ways you have sex so that there is no risk of infection.

  b. Learning that of the birth control methods, other than abstaining, only condoms are effective in limiting the spread of STDs and HIV, and that they must be used correctly and consistently every time you have sex.

  c. Both A and B.

  d. Neither A or B.


27. Hepatitis B (HBV) is transmitted the same way as HIV, through sexual intercourse and sharing needles. HBV is much more concentrated in blood, and it is more infectious than HIV.

  a. True

  b. False


28. Which of the following statements regarding HIV and HCV co-infections are true:

  a. Many people who become infected with HIV from injection drug use are already infected with HCV. Some estimate that 40% of HIV-infected people in the U.S. are also infected with HCV.

  b. People who are co-infected with both viruses and have immune system impairment, may progress faster to serious, chronic or fatal liver damage.

  c. Treating HIV in someone with HCV may be complicated, because many of the medicines that are used to treat HIV may damage the liver.

  d. All of the above.


29. When a licensed healthcare provider makes a diagnosis of AIDS, or receives a confirmed HIV positive test, a confidential case report must be submitted to the local health jurisdiction within 3 days.

  a. True

  b. False


30. Positive HIV results obtained through anonymous testing are:

  a. Submitted to the local health jurisdiction within 3 days.

  b. Required to initiate partner notification immediately.

  c. Not reportable. However, once a patient with positive results seeks medical care for conditions related to HIV or AIDS, the provider is required to report the case to the local health departments.

  d. None of the above.


31. During the stage of Symptomatic HIV Infection, common symptoms include:

  1. Fever, Fatigue, Nausea, Vomiting or Diarrhea.
  2. Urinary or fecal incontinence.
  3. Confusion, dementia, vision or hearing loss.
  4. Pain in joints, muscles or nerves, difficulty breathing.
  5. Yeast infections in the mouth, chronic pneumonias, sinusitis, or bronchitis.
  6. Loss of muscle tissue and body weight.


  a. 2, 3 and 6.

  b. 1, 4 and 5.

  c. None of the above.

  d. All of the above.


32. Violations of Washington States confidentiality laws related to HIV:

  a. Are considered a misdemeanor.

  b. May result in civil liability actions for reckless or intentional disclosure up to $10,000 or actual damages, whichever is greater.

  c. Are the responsibility of the county's health officer to investigate potential breaches of confidentiality of HIV identifying information and report those to the DOH.

  d. All of the above.


33. HIV infection and AIDS are medical conditions that are considered disabilities under the Washington State Law Against Discrimination (RCW 49.60) and the federal Americans with Disability Act (ADA). This means that it is illegal to discriminate against someone who has AIDS or is HIV infected. It is also illegal to discriminate against someone who is ‘believed’ to have AIDS or HIV infection, even though that person is not, in fact, infected. The areas covered in the law are:

  a. Employment; and rental, purchase or sale of apartment, house or real estate.

  b. Places of public accommodation (restaurants, theaters, etc.); and applying for a loan or credit card, or other credit transactions.

  c. Healthcare, legal services, home repairs, and other personal services available to the general public; and certain insurance transactions.

  d. All of the above.


34.

When a person goes for a job interview or is hired, the employer:

  • Cannot ask questions directed at the perception or presence of HIV infection or AIDS, unless based on a "bona fide" occupational qualification, which at this time, according to CDC and WAC 246-100-206(11), does not exist.
  • Cannot require a blood test to determine HIV infection, unless HIV status limits the ability to perform the work, i.e. overseas assignment in country that requires HIV certification.
  • Cannot require a physical exam directed to identify HIV infection, except for exams necessary to evaluate the need for, or nature of, reasonable accommodation or specific job-related conditions.
  • Cannot ask questions about lifestyle, living arrangements, or sexual orientation.


  a. True

  b. False


35. In Washington State, healthcare providers who have knowledge that a specific patient is failing to comply with infection control measures (e.g., acquisition of a new STD, sex without disclosure of HIV status prior to sexual partners, failure to disclose HIV status to needle-sharing partners, or donating or selling HIV-infected blood, etc.) should contact the local public health officer to discuss the circumstances of the case and to determine if the name of the person should be reported for investigation and follow-up.

  a. True

  b. False


36. Persons with HIV/AIDS and their families and friends face a multitude of difficult realities. Among them are:

  a. Although with the advent of antiretroviral drugs, persons who are HIV infected, can live 10-12 years or more without developing symptoms, persons with AIDS still die prematurely. 90% of all adults with AIDS are in the prime of life and may not be prepared to deal with death and dying.

  b. People who are living with HIV face the need to practice "safer sex" and take medications for the remainder of their lives; and the infections and malignancies that accompany AIDS along with some of the medications, can diminish and disfigure the body.

  c. Men who have sex with men, and injection drug users, who may already be stigmatized and subjected to social and job-related discrimination, may encounter even more societal pressure and stress with a diagnosis of AIDS.

  d. All of the above.


37.

Grief may be best understood as a process that doesn't involve a straight line. People do not move predictably step-by-step through the various stages of their grieving, but progress at their own speed. There seem to be discreet phases of grief, including:

  • shock and numbing
  • yearning and searching
  • disorganization and despair
  • some degree of reorganization


  a. True

  b. False


38. The Centers for Disease Control and Prevention estimates that among women who have been infected with HIV:

  a. The majority have become HIV positive through the use of injecting drug equipment.

  b. More than 70% have become HIV positive through heterosexual sexual contact.

  c. Women are more vulnerable to heterosexual transmission of HIV due to substantial mucosal exposure to seminal fluids.

  d. Both B and C.


39. African Americans and Hispanics specifically have disproportionately lower rates of AIDS cases in the U.S., despite the fact that there are no biological reasons for the disparities.

  a. True

  b. False


40. Confidentiality of medical information means that a person’s medical information (including HIV testing and HIV results) may not be disclosed to anyone unless the individual signs a release of information form. However, there are exceptions to this. Medical information can be disclosed under certain circumstances including:

  a. When it is given from one health provider to another health care provider for related on-going medical care of the patient, or to a third party payor.

  b. In a life or death emergency.

  c. In the case of reporting notifiable conditions to the local health jurisdiction or the DOH.

  d. All of the above.