PYC2605/202/2/2016

Tutorial letter 202/2/2016

HIV/Aids care and counselling

PYC2605

Semester 2

Department of Psychology

Feedback on Assignment 02.

1 INTRODUCTION

Dear Student,

We hope that you are enjoying your module in HIV/Aids care and counselling. If you find the
course helpful, please tell your friends and colleagues about it. Remember, it is possible for
students to enrol only for this one module for non-degree purposes, if they wish to do so.
The only prerequisite for the course is matric (Standard 10/Grade 12). It may also interest
you to know that almost 6 000 students enrol for the HIV/Aids care and counselling course
(PYC2605) per year!

The main purpose of this tutorial letter is to give feedback on Assignment 02. However,
before we do so, let’s address some other issues first.

Assignment issues

In the previous semester, many students did not get examination admission because (a)
their assignments were never received by Unisa; (b) the assignments reached Unisa after
the closing date; and (c) the assignments were submitted in the wrong semester. Please
note that it is your own responsibility to make sure that Unisa has received and marked your
assignments. Please check myUnisa regularly to see if your assignment has been received
and marked. If you check the system regularly and it seems that your assignment was not
received or marked, please direct your enquiries to the Students Assessment and
Assignment Department. Please do not contact your lecturers to find out what happened to
your assignments. Your multiple choice assignments go directly to the Assignment section to
be marked by computer. Unfortunately, lecturers do not see your multiple choice
assignments at all.

Please note that you have to submit Assignment 01 to gain examination admission. Together
Assignments 01 and 02 contribute 20% to your final year mark.

Please take careful note of your assignment closing dates. In each semester there are
two multiple choice assignments each with a specific closing date and unique
number.
Make sure that you know exactly if you are registered for the first or for the second
semester. Use the assignment closing date and unique number of that specific semester
ONLY on your mark reading sheet. If you are registered for the 2 nd semester, please do not
use the 1st semester unique numbers. Your assignment will NOT be registered on the
system and it will get lost.

Electronic Learning Units and Open Electronic Resources

Do you enjoy the online module? We surely had a lot of fun compiling it! Some students find
the online approach a bit daunting but keep in mind that the purpose of the online module is
only to guide you through the prescribed book and to challenge you to think differently about
HIV and Aids and to motivate you to do things in your communities. There will be neither
examination questions directly on the content of the electronic learning units, nor on the
open educational resources (e.g. videos and webpages). The examination questions are
based on your prescribed book only, and Tutorial Letter 101/2016 (Section 7.1 Syllabus:
What to study for the exam) indicates what to study in your prescribed book.

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Declaration Letters

As discussed in Tutorial Letter 101/2016, you will automatically receive a Declaration Letter
after successful completion of this module. Please note that we cannot re-issue this Letter of
Declaration if you do not receive it the first time or lose it. Please make sure that you receive
your Declaration

Letter by following three simple steps:

(a) Make sure that Unisa has your most recent postal address. We will send your
Declaration Letter to the address that you registered with Unisa. If your address
changed, please notify Unisa (not the Psychology Department) to change your address
on the student system (fill in the form at the back of my Studies @ Unisa and send it
to The Registrar (Academic), PO Box 392, UNISA 0003). You can also change your
details by logging into myUnisa.
(b) Please make sure that all outstanding fees are paid. If your study fees are in arrears,
Unisa will unfortunately not release your exam results, and we will not be able to issue
the Declaration Letter either.
(c) Return all your library books that are outstanding. Unisa will not release your exam
results if you still have library books in your possession.

Note: We do NOT print or issue the letters of declaration in our offices in the Department of
Psychology. Please do not visit us on campus to issue the letters because we are not able to
do so.

The examination paper

Tutorial Letter 102 contains a practice examination paper to familiarise you with what to
expect in the examinations. Please make use of the opportunity to see if you can complete it
(without your prescribed book) within the two hours allowed for the paper. DO NOT send
your answers to Unisa to be marked. You will find the answers at the back of the tutorial
letter for you to mark your own paper. Old examination papers for this module are available
on myUnisa.

Feedback on Assignment 02

The purpose of this assignment was to help you to assess where you are in terms of your
HIV and Aids reading and comprehension skills, knowledge and attitudes at this early stage
of your studies. Use your assignment mark and our feedback to sensitise you to possible
problems in your [Link] 1 gives a summary of the correct answers to Assignment 02.

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Table 1: Correct answers to Assignment 02.

Question Assignment 2 Question Assignment 2

correct answer correct answer
1 3 11 2
2 1 12 2
3 1 13 4
4 4 14 1
5 1 15 2
6 2 16 4
7 2 17 3
8 1 18 2
9 3 19 1
10 3 20 4

Students generally did very well in Assignment 02. I will now discuss each one of the
questions in more detail.

QUESTION 1

It is very important for Aids counsellors to know the terminology of sex practices practised by
their clients. If your client has oral-penile contact or oral sex performed on a male partner, it
is called

(1) anilingus
(2) cunnilingus
(3) fellatio
(4) femilingus

Feedback on Question 1
The correct answer is 3. The performance of oral sex on a man is called fellatio. Anilingus is
oral-anal sex (option 1 incorrect), cunnilingus is oral sex on a woman (option 2 incorrect),
and femilingus is oral sex on a woman by a woman (option 4 incorrect). Read p. 177 in your
prescribed book for more information.

QUESTION 2
Dancing, singing, rituals and ceremonies are often used in traditional African communities for
healing or educational purposes. Should these forms of dramatisation be encouraged by
Aids educators?

(1) Yes, it should be encouraged, because dramatisation helps people to overcome their
anxiety and to express their emotions.
(2) No, it should be discouraged, because dramatisation distracts people’s attention from
the real, serious issues of Aids.
(3) Yes, it should be encouraged, because dramatisation helps people to relax and to
forget the serious realities of Aids.
(4) No, it should be discouraged, because dramatisation discourages people from
accepting and integrating threatening issues into their own personal reality.

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Feedback on Question 2
The correct answer is 1. In addition it helps them to accept and integrate threatening parts of
themselves into their personal realities (options 2, 3 and 4 incorrect). Read p. 153 and p. 227
in your prescribed book for more information.

QUESTION 3

During the counselling session, your client discloses to you that he/she is HIV positive and
explains that the reason for not telling you before was because he/she was afraid of your
response. According to Egan, in which one of the following responses listed below would
you, as the counsellor, demonstrate basic empathy?

(1) You felt afraid to tell me that you are HIV positive, because you feared that I would
reject you.
(2) I know how you feel!
(3) Do I understand you correctly if I say that you are HIV positive and that you did not
want to tell me because you were afraid of my response?
(4) When did you find out that you were HIV positive?

Feedback on Question 3
The correct answer is 1. Basic empathy is to listen, understand and communicate in such a
way that the client understands himself/herself better and be able to act on it. Therefore, you
will demonstrate empathy by restating or rephrasing what the client tried to say to you as a
counsellor. Option 2 is incorrect as the counsellor demonstrates experiencing the same
emotions (sympathy). Option 3 is incorrect as it is a form of clarification. Option 4 is incorrect
as it does not focus on the message the client tried to convey. Read pp. 250-254 in your
prescribed book for more information.

QUESTION 4

When and how should referral of clients take place within the Aids context?

(a) Referral should be arranged in such a way that the client does not feel rejected.
(b) In cases of psychopathology or severe depression, it may be necessary to refer the
client to a clinical psychologist.
(c) Referral should be arranged if a counsellor no longer wants to be responsible for the
client.
(d) Referral should be arranged if the client needs additional helpers (e.g. spiritual or
financial).

The correct answer is:

(1) (b) and (c)

(2) (b) and (d)
(3) (a) and (c)
(4) (a), (b) and (d)

Feedback on Question 4
The correct answer is 4. The referral should be done when specialised or additional help is
required (option b and d correct) and with great sensitivity to prevent feelings of rejection
(option a correct). Referral should not be seen as the counsellor getting rid of the client
(option c incorrect). Read p. 258 in your prescribed book for more information.

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QUESTION 5

A counsellor who works at a health clinic for sex workers shows her clients unconditional
positive regard when she

(1) respects and accepts her clients as they are, irrespective of their values, work and
sexual preferences.
(2) accepts her clients' uniqueness as human beings but judges them for the work they do
in order to help them to change their ways.
(3) respects and accepts her clients as they are by putting aside her own Christian values
and beliefs.
(4) is ‘there for her clients’ by always taking their side and acting as their advocate.

Feedback on Question 5
The correct answer is 1. The counsellor demonstrates unconditional positive regard when
she accepts the client irrespective of his/her values or behaviour. If she judges her client she
does not show unconditional positive regard (option 2 incorrect). However, this does not
mean that she may not have her own values (option 3 incorrect). Unconditional positive
regard is about acceptance on not about side taking or acting as an advocate (option 4
incorrect). Read p. 236 in your prescribed book for more information.

QUESTION 6

One of the differences between a Western counsellor and a traditional African healer is that
the traditional healer (a) ____, while the Western counsellor (b) ____.

(1) (a) bases his help on common sense, scientific evidence and logic; (b) uses intuition
and symbols in her counselling
(2) (a) is mainly directive in his approach and gives his clients advice on what to do; (b) is
non-directive and expects her clients to take responsibility for their own decisions
(3) (a) makes his clients feel good about themselves by placing emphasis on individuality
and self concept; (b) emphasises the unity between her, her parents and her
community
(4) (a) gives attention to his clients’ feelings and thoughts through introspection; (b) follows
a more holistic approach and emphasises the unity of the body and mind

Feedback on Question 6
The correct answer is 2. Option 1 is not correct because Western counselling is based on
scientific and logical principles, while traditional African healing uses symbols and intuition.
Options 3 and 4 are incorrect as Western counselling emphasises individuality and the self,
and concentrates on feelings, insight and reality while traditional African healing values unity
of the person and the community. Read p. 260 in your prescribed book for more information.

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QUESTION 7

Maria’s HIV test results turned out to be positive. She felt a sense of relief when the
counsellor shared the news with her during a post-test counselling session. Which one of the
following statements best explains Maria’s reaction?

(1) Maria’s reaction is abnormal and she is definitely in denial and not ready to accept her
HIV positive status.
(2) Maria is displaying quite a normal reaction to her test results - perhaps this puts into
perspective some of the unexplained symptoms that she often gets; also, now she
does not have to live with the uncertainty any longer.
(3) Maria’s reaction is very abnormal - no one has ever reacted this way to an HIV positive
test result.
(4) Maria’s reaction is not unusual for a person suffering from post-traumatic stress
syndrome.

Feedback on Question 7
The correct answer is 2. Maria is now aware of her HIV status which could have reduced the
stress associated with uncertainty. Responses to positive test results vary from person to
person (options 1 and 3 incorrect) and being relieved does not portray denial of the results
(option 1 incorrect). There is no indication that Maria is suffering from post-traumatic stress
syndrome (PTSD) and it is too soon after the results for PTSD to develop. Neither is her
reaction indicative of PTSD. Read pp.272 and 276 in your prescribed book for more
information.

QUESTION 8

If a parent has to tell a child that the child is HIV positive, which of the following principles
apply?

(1) Disclosure is an ongoing process that may last for years, and the parent does not have
to tell the child everything at once.
(2) To withhold information from the child will later be experienced by the child as lying. It is
therefore better to give the child all the information about the condition at once.
(3) If a child is still very young (e.g. pre-school) and asks difficult questions, it is better to lie
to the child about certain issues than to confuse the child with complex answers.
(4) Parents experience so much fear and guilt about their child’s HIV positive status, that a
parent is not the ideal person to disclose the child’s status to the child.

Feedback on Question 8
The correct answer is 1. Disclosure to a child is an ongoing process (and not an event) and
may last for years. Therefore the parent does not have to tell the child everything at ones
(option 2 incorrect). Always tell the truth to keep the child’s trust and give enough information
to facilitate understanding (option 3 incorrect). A parent, who is ready to do so, is the best
person to tell the child about his/her infection (option 4 incorrect). Read p. 302 in your
prescribed book for more information.

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QUESTION 9

The symptoms of depression can be categorised as affective, physiological, cognitive and

behavioural. Physiological symptoms of depression include (a)___, while behavioural
symptoms of depression include (b)___.

(1) (a) pessimistic beliefs about the future, suicidal thoughts, negative thinking and
concentration problems; (b) sadness, unhappiness, worthlessness, anxiety and apathy
(2) (a) neglect of personal appearance, crying, social withdrawal and slow or reduced
speech; (b) pessimistic beliefs about the future, suicidal thoughts, negative thinking and
concentration problems
(3) (a) loss of appetite and weight, sleep disturbance, loss of libido, disrupted menstrual
cycle in women and constipation; (b) neglect of personal appearance, crying, social
withdrawal and slow or reduced speech
(4) (a) sadness, unhappiness, worthlessness, anxiety and apathy; (b) pessimistic beliefs
about the future, suicidal thoughts, negative thinking and concentration problems

Feedback on Question 9
The correct answer is 3. Option 1 is incorrect as it refers to cognitive and affective
symptoms. Option 2 is incorrect as it refers to behavioural and cognitive symptoms. Option 4
is incorrect as it refers to affective and cognitive symptoms. Read p. 293 in your prescribed
book for more information.

QUESTION 10

Which one of the following recommendations would most effectively help the bereaved
person to cope with his/her loss?

(1) Counsellors should be more direct with their bereaved clients and provide them with
solutions to their problems, so that they do not get stuck in the grief process.
(2) Clients should be encouraged to make a major-life change during the grief process, like
moving to another town or changing their jobs, since this will help them to reinvest their
emotional energy.
(3) While cautioning clients against the ‘rebound’ effect, counsellors should encourage
their clients to relocate emotionally by making new friends and even finding new
partners with time.
(4) Clients should not be encouraged to mark the anniversaries of their loved ones’ deaths,
because this will slow the rate at which they are successfully able to work through the
mourning process.

Feedback on Question 10
The correct answer is 3. Withdrawing emotional energy and reinvesting it is an important
bereavement task. Option 1 is incorrect as the counsellor should encourage the client to
work out his/her own solutions to problems. Option 2 is incorrect as the client’s judgement
may be affected and he/she should postpone important decisions. Option 4 is incorrect as
anniversaries form part of the bereavement process and both the counsellor and the client
should ensure that the client has sufficient support during those times. Read p. 321-324 in
your prescribed book for more information.

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QUESTION 11

Juan recently found out that he is HIV positive. He also realised that he has done a lot of
wrong things in his life. He promised God that he will never have sex again and go to church
and charity events if God will cure him from HIV. In which of the Kübler-Ross stages of
bereavement is Juan?

(1) Denial
(2) Bargaining and guilt
(3) Sadness and depression
(4) Resolution and acceptance

Feedback on Question 11
The correct answer is 2. Juan is feeling guilty about the wrong things he did and is
bargaining with God. This gives Juan the sense that he is still in control of what is happening
to him. Denial refers to disbelief (option 1 incorrect), sadness and depression refer to
symptoms such a withdrawal, depressed mood and tearfulness (option 3 incorrect) while
resolution and acceptance refer to coming to terms with loss (option 4 incorrect). Read p.
315-316 in your prescribed book for more information.

QUESTION 12

An example of a body fluid that requires universal precautions, is (a)___, while (b)___
do/does not require any special precautions.

(1) (a) blood; (b) cerebrospinal fluid (CSF)

(2) (a) vomit containing visible blood; (b) faeces and urine
(3) (a) nasal secretions; (b) saliva and tears
(4) (a) wound secretions; (b) amniotic fluid

Feedback on Question
The correct answer is 2. Blood and body fluids requiring universal precautions include blood,
CSF, vomiting containing visible blood, wound secretions, and amniotic fluid. Body fluids not
requiring universal precautions include faeces, urine, nasal secretions, saliva, and tears.
Read p. 368 in your prescribed book for more information.

QUESTION 13

Which one of the following steps may help Andrew to manage his stress and burnout?

(1) He should re-evaluate his belief in his own abilities, strive to achieve his performance
goals even if they are unrealistically high, and he must lower his standards.
(2) He should learn to trust and accept the knowledge he already has, rather than further
pressurise himself to attend the additional refresher and training courses.
(3) He must learn how to draw firm boundaries between himself and his clients so that he
can remain unaffected should one of them die.
(4) He should be encouraged to nurture himself as much as possible by ensuring that he
gets enough exercise and rest and takes time to do things that he really enjoys.

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Feedback on Question 13
The correct answer is 4. Self-care is an important part of managing stress and burnout.
Option 1 is incorrect as he should think about what he can realistically expect from himself,
and re-evaluate his performance goals. Option 2 is incorrect as his employer should offer
refresher courses as it assists in managing stress and burnout. Option 3 is incorrect as self-
care involves allowing himself to mourn the deaths of his clients. Read pp. 429-432, as well
as p. 436, in your prescribed book for more information.

QUESTION 14

Dudu felt sick, and visited her local clinic. On the clinic’s wall was a written notice stating that
all patients coming for treatment were expected to give their consent for an HIV test. This
practice is

(1) illegal, because not all people can read.

(2) legal, because it is the patients’ responsibility to ensure that they take notice of all
written notices in hospitals and clinics.
(3) illegal, because although the hospital ensured Nomsa’s informed consent through the
notice, they did not ask her to sign a consent form.
(4) legal, because the patients are formally informed about the tests by the notice.

Feedback on Question 14
The correct answer is 1. Used on its own this notice is illegal as not all people can read
(options 2 and 4 incorrect). This notice cannot be regarded as an informed consent as it
does not provide any more information than the hospitals expectations, and pre-test
counselling should form part of the informed consent (option 3 incorrect). One can also
argue that the word ‘expect’ could create the impression that the person does not have the
right to decline. Patients should rather be encouraged to test. Read p. 442-445 in your
prescribed book for more information.

QUESTION 15

According to the Sterilisation Act of 1998, a woman of (a)_____ years or older can consent
to sterilisation and the husband’s consent is (b)_____.

(1) (a) 18 (b) required

(2) (a) 18 (b) not required
(3) (a) 21 (b) required
(4) (a) 21 (b) not required

Feedback on Question 15
The correct answer is 2. According to sterilisation Act of 1998, a woman of 18 years or older
can give consent to sterilisation. A woman under 18 years of age must have the consent of a
parent or her legal guardian as this is a medical operation. The consent of the husband is not
a requirement. Read p. 459 in your prescribed book for more information.

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SECTION B: GUIDANCE TRACK

QUESTION 16

Young children (grades 1 to 3) have an overwhelming fear of Aids, because

(1) they can already grasp the consequences of HIV infection and what the virus can do to
their bodies.
(2) although they can already comprehend that Aids is not a punishment for sin, they find it
difficult to understand how one can prevent infection.
(3) they have a good understanding of how sex and drug usage can cause Aids, but find it
difficult to deal with it emotionally.
(4) they see disease in rather vague, supernatural and imaginative terms due to the level
of their emotional development.

Feedback on Question 16
The correct answer is 4. Children in the foundation phase do not really understand what
illness is as they are unable to think operationally at this stage. Causes, symptoms and
consequences of illness do not make sense to them (options 1 and 3 incorrect). Option 2 is
relevant to children in the intermediate phase. Read p. 190-191 in your prescribed book for
more information.

QUESTION 17

Spiritual counsellors should consider a child’s development stage when talking to the child
about death. For example, when a young school child’s parent dies (early primary school),
the counsellor should

(1) explain to the child that it was God’s will to take the parent away and that the child
should accept this.
(2) explain religion to the child in terms of abstract forms to help the child not to feel guilty
about the parent’s death.
(3) explain to the child that the illness and death of the parent was not punishment for a
wrongdoing.
(4) use symbols to explain the death of the parent to the child because children of this age
respond better to concrete examples.

Feedback on Question 17
The correct answer is 3. Young school-age children see illness, and therefore also death, as
punishment. Therefore, the counsellor should explain to the child in concrete terms that the
illness and death of the parent was not punishment for wrongdoing. Option 1 is incorrect as
one should be careful to encourage acceptance without allowing for mourning. Option 2 is
incorrect as it is applicable to the adolescent years. Option 4 is incorrect as their
understanding of symbols is limited. Read p. 337 in your prescribed book for more
information.

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QUESTION 18

If you are a Christian counsellor, how would you counsel HIV positive clients from other
religions, such as Muslims or Buddhists?

(a) Stress the importance of and reverence for life.

(b) Encourage people to partake in purification rituals, to meditate and/or restructure their
lives.
(c) Urge them to convert to Christianity or be doomed.
(d) Explain to them that religion is not important and that they should rather concentrate on
medical and psychological aspects of the disease.

The correct answer is:

(1) (a) and (c)

(2) (a) and (b)
(3) (c)
(4) (b) and (d)

Feedback on Question 18
The correct answer is 2. Religious counsellors in the Aids field must be sensitive to the fact
that their clients will not necessarily all belong to the same religious framework, and the
spiritual and/or religious framework of the client will direct the session. All religions should be
treated with equal respect within the professional counselling environment (options a and b
correct). Denying the importance of religion or trying to convert your client to Christianity may
not help the client at all and you may end up never seeing your client again. Read p.331-333
in your prescribed book for more information.

QUESTION 19

A child’s fundamental need for transcendence is deprived due to HIV and Aids when the
child

(1) has no understanding of its place in the larger context of spirituality or religion.
(2) loses autonomy and control over its destiny and when he or she has no choice
regarding home, family structure or marital status.
(3) is deprived from school and when there is a loss of inquisitiveness and connection with
the wider world outside of the immediate culture.
(4) loses its family home and when there is a general decline into a state of physical
poverty.

Feedback on Question 19
The correct answer is 1. Transcendence is the belief that we are part of something bigger
than ourselves, and that the world is more than physical reality which links with spirituality
and religion. Option 2 refers to freedom, option 3 refers to participation and understanding,
and option 4 refers to subsistence. Read p. 358 in your prescribed book for more
information.

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QUESTION 20

The fundamental need for transcendence will be fulfilled by

(1) allowing children to experience and express their independence and to honour the
rights of children.
(2) providing the child unconditionally with a family home, adequate nutritious food,
clothing and primary health care.
(3) adults who provide life skills, insight and guidance to build a child’s knowledge of his or
her family and community.
(4) adults who inculcate in children a sense of wonder at the larger world and who
encourage cultural and religious practices.

Feedback on Question 20
The correct answer is 4. Please see the previous feedback. Read p.358 in your prescribed
book for more information.

SECTION C: CARE TRACK

QUESTION 16
It is very difficult to decide when to stop active treatment and to begin to prepare a patient
and his or her family for dying. When does palliative care usually begin?

(a) When medical treatment is no longer effective.

(b) When the patient with Aids does not want to continue with treatment.
(c) When the side-effects of treatment outweigh the benefits.
(d) When there is no reasonable chance of improvement.

The correct answer is:

(1) (b) and (d)

(2) (a) and (c)
(3) (b), (c) and (d)
(4) (a), (b), (c) and (d)

Feedback on Question 16
The correct answer is 4. Read p. 416b in your prescribed book for more information.

QUESTION 17

Garth started to abuse alcohol and to smoke heavily when his doctor told him that he is HIV
positive. Is it necessary for him to stop the habit?

(1) Yes, it is necessary, because alcohol abuse and smoking mask the signs of
opportunistic infections, and might lead to a situation where his infections are not
diagnosed and treated in time.
(2) No, it is not necessary, because he is infected anyway and to stop his habits will cause
him too much stress, which is not good for his health.
(3) Yes, it is necessary, because alcohol and cigarettes have been linked to the
suppression of the immune system by lowering of the CD4+T cell count, as well as to
an increase in secondary infections and illnesses such as pneumonia.
(4) No, it is not necessary, because alcohol interacts very well with some of the
medications that the doctor will prescribe for him to decrease the spread of infection in
the body.

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Feedback on Question 17
The correct answer is 3. The HIV positive person is encouraged to avoid drugs and alcohol
abuse as well as smoking because it can suppress the immune system; lower CD 4 + T cell
counts and increase secondary infections and illnesses (options 3 and 4 incorrect).
Alternative 1 is not correct as these habits do not mask opportunistic infections. Read p. 388
in your prescribed book for more information.

QUESTION 18

Anne’s daughter, who is three years old, has a severe chronic illness and is bedridden as a
result. The health care professional who visits Anne and her daughter at home gives Anne
the following advice: 'A bedridden child should be held in someone’s lap as often as
possible.' Do you agree with this advice?

(1) Yes. It will help with the digestion of the child’s food and it will prevent constipation.
(2) Yes. It will improve the child’s circulation and give her the love and attention she needs.
(3) No. It will spoil her rotten and the last thing a mother needs is a spoiled, sick child.
(4) No. To be picked up all the time by other people will result in chronic pain.

Feedback on Question 18
The correct answer is 2. One of the factors which can cause circulatory impairment is
pressure on the body parts. Therefore, being held in someone’s lap will increase the child’s
blood circulation and avoid bedsores (option 1 incorrect). Being held also provides much
needed love and attention (option 3 incorrect). Bedsore and a lack of circulation may results
in pain (option 4 incorrect). ( Read p. 404 in your prescribed book for more information.

QUESTION 19

Some degree of mental confusion or dementia is common among people with Aids because
of the effect of the HI virus on the brain. How would you care for a patient who has problems
with memory loss, concentration, confusion and disorientation?

(1) Keep the patient’s room or home structured, avoid unnecessary changes, place familiar
things like photographs around the patient and keep a light on at night.
(2) Talk about the distant past, and when the patient is confused, or has the facts wrong,
argue with the patient until he or she has all the facts straight.
(3) Challenge the patient’s delusions with reality because if you play along or ignore the
delusions, the patient will become more confused and disorientated.
(4) Be very patient and talk to the person as though he or she is a child - that is the only
way that a confused person will feel cared for.

Feedback on Question 19
The correct answer is 1. The other options will be of no benefit to the patient and may rather
confuse him/her even more. It is also disrespectful. Read pp. 411-413 in your prescribed
book for more information.

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QUESTION 20

Diarrhoea is one of the most common problems in patients with HIV infection and Aids. The
difference between acute and chronic diarrhoea is that acute diarrhoea (a) ___, while chronic
diarrhoea (b) ___.

(1) (a) is when a person has three or more loose or watery stools per day; (b) is when a
person has six or more loose or watery stools per day
(2) (a) can be treated by prescribing a proper diet and a rehydration fluid; (b) has to be
treated with an appropriate antibiotic, loperamide or codeine
(3) (a) is seldom associated with nausea and vomiting; (b) is almost always associated
with nausea and vomiting
(4) (a) lasts for less than two weeks; (b) usually lasts for more than two weeks

Feedback on Question 20
The correct answer is 4. Read p. 395 in your prescribed book for more information.
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We hope that you have learned more than theory in this assignment and that you are
stimulated to read more about new developments in the HIV and Aids field. Best wishes with
all the work ahead, and make the best of it!

Your lecturers in HIV/Aids care and counselling.

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