During the first trimester of pregnancy, a client who was treated for genital herpes with acyclovir prior to this pregnancy tells the practical nurse (PN) that she is experiencing an episode of genital herpes.

Which nursing intervention has the highest priority?

Assess her feelings about therapeutic abortions in the event the infant has been affected

Identify current sexual partners so that they can be evaluated and treated for genital herpes if necessary.

Instruct her to avoid sexual intercourse while active, visible lesions are present.

Determine if the client has taken acyclovir for this outbreak of genital herpes.

Answer and Explanation

The Correct Answer is C

A.   Assess her feelings about therapeutic abortions in the event the infant has been affected. - While important to address concerns, the immediate priority is to manage the current outbreak and prevent transmission.
B.   Identify current sexual partners so that they can be evaluated and treated for genital herpes if necessary. - Contact tracing is important but not the highest priority in managing the current outbreak.
C.   Instruct her to avoid sexual intercourse while active, visible lesions are present. - This is crucial to prevent transmission of the herpes virus to the sexual partner and to reduce the risk of complications for the pregnancy.
D.   Determine if the client has taken acyclovir for this outbreak of genital herpes. - While important for understanding the treatment history, instructing the client on preventive measures has a higher priority.

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Correct Answer is D

Explanation

A. Ineffective pain management reported while using morphine PCA is concerning but may not be immediately life-threatening.
B. Inability to void after discontinuing an indwelling catheter should be addressed but might not require immediate attention.
C. Oral ice chips eaten after vomiting postoperatively might need monitoring, but it's not typically an urgent issue.
D. Coffee-ground secretions draining via nasogastric tube suction could indicate bleeding in the upper gastrointestinal tract, which requires immediate attention due to the potential for severe
bleeding.

A. "I understand this is a disease that occurs mostly in older men." B. "I have found the support I need from my faith and family." C. "I think I had this disease for a long time, but the doctor did not find it." D. "I do not have any use for those who say this disease is going to win."

Correct Answer is B

Explanation

This statement shows awareness but doesn't necessarily indicate acceptance of the prognosis. B. Acceptance is often linked with finding emotional support, and this statement implies the client has found solace and support from faith and family, reflecting a level of acceptance. C. This statement suggests a disbelief or denial of the diagnosis, which is not indicative of acceptance.
D. This statement reflects resistance and denial rather than acceptance of the prognosis. Acceptance usually involves acknowledgment and finding ways to cope positively, which is not shown in this statement.

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During the first trimester of pregnancy, a client who was treated for genital herpes with acyclovir prior to this pregnancy tells the practical nurse (PN) that she is experiencing an episode of genital herpes. Which nursing intervention has the highest priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which client finding should the practical nurse (PN) report to the registered nurse (RN) immediately?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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During the first trimester of pregnancy, a client who was treated for genital herpes with acyclovir prior to this pregnancy tells the practical nurse (PN) that she is experiencing an episode of genital herpes.

Which nursing intervention has the highest priority?