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Difficulty: HardHigh Risk Behaviors

A nurse at a university health clinic is evaluating a 20-year-old client who requests a prescription for HIV pre-exposure prophylaxis (PrEP). During the risk assessment, the client discloses engaging in condomless transactional sex and sharing needles for unlicensed cosmetic injections. Which of the following is the priority nursing action?

  1. A
    Provide a referral to a community-based harm reduction program for sterile needle exchange.
  2. B
    Advise the client that stopping transactional sex is required before initiating PrEP therapy.
  3. Administer a rapid point-of-care HIV test and collect specimens for comprehensive STI screening.Answer
  4. D
    Supply the client with a list of campus financial assistance programs to address the underlying cause of the risk behaviors.

Answer

The priority action is to administer a rapid HIV test and collect specimens for comprehensive STI screening.
Before initiating pre-exposure prophylaxis (PrEP), it is a critical safety protocol to confirm the client is HIV-negative. Administering PrEP to an individual who is already HIV-positive can rapidly lead to drug-resistant strains of the virus. Therefore, obtaining a rapid HIV test and screening for other STIs is the immediate clinical priority before addressing psychosocial needs or long-term harm reduction strategies.

Step-by-Step Solution

1
Identify the client's primary clinical request and evaluate the associated medical requirements.
The client is requesting PrEP for HIV prevention, which requires strict pharmacological safety protocols.
Determining the primary clinical goal guides the prioritization of immediate nursing interventions.
2
Assess prerequisites and contraindications for the requested intervention.
PrEP is strictly contraindicated in individuals who are already HIV-positive due to the high risk of developing drug-resistant viral mutations.
Ensuring medication safety is a physiological priority.
3
Select the intervention that addresses the immediate physiological and safety requirements.
Performing a rapid HIV test and STI screening is chosen as the highest priority action.
Clinical safety and pharmacological prerequisites take precedence over long-term harm reduction education and psychosocial referrals.

Key Concept

Prioritization in PrEP Initiation and High-Risk Behaviors
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Topics

High Risk Behaviors

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