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 C

Explanation

A. Trying not to listen to the conversation does not address the issue of confidentiality breach or protect the client's privacy.
B. Writing an incident report might be necessary, but the immediate action should be to stop the conversation to protect the client's confidentiality.
C. Approaching the individuals involved and asking them to stop is the most appropriate and immediate action to protect the client's privacy and confidentiality.
D. Telling the client about the UAP's concern might not be suitable without context or proper consent, and it might not address the confidentiality breach.

A. Tell the UAP to take the client back to his room. B. Instruct the UAP to walk on the client's affected side. C. Take over the ambulation and counsel the UAP later. D. Provide client an assistive device, such as a cane or walker.

Correct Answer is B

Explanation

A. Tell the UAP to take the client back to his room. - This action might not address the problem and may disrupt the ongoing activity without rectifying the situation.
B. Instruct the UAP to walk on the client's affected side. - When assisting a client with rightsided weakness, the caregiver should support the affected side, providing assistance and stability.
Instructing the UAP to walk on the client's affected side is the appropriate action.
C. Take over the ambulation and counsel the UAP later. - This might disrupt the ongoing care and might not rectify the situation immediately. Addressing it promptly is crucial.
D. Provide the client an assistive device, such as a cane or walker. - While assistive devices can be beneficial, in this scenario, the immediate concern is correcting the UAP's positioning

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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?

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Naxlex Comprehensive Predictor Exams

The practical nurse (PN) overhears a conversation between an unlicensed assistive personnel (UAP) and another staff member in the hospital cafeteria line concerning a client's reaction to being given a diagnosis of terminal cancer. What is the best nursing action?

Correct Answer is C

Explanation

The practical nurses (PN) notes that an unlicensed assistive personnel (UAP) is ambulating a male client who had a stroke and has right-sided weakness. The UAP is walking on the client's left side. Which action should the PN take?

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?