A client reports to the nurse of recently visiting someone who has a shingles infection. The client believes that having had chickenpox as a child will be protective against shingles. How should the nurse respond? Select all that apply.

Distinguish the difference between herpes varicella and herpes zoster.

Explain that the risk of developing shingles decreases with age.

Affirm that a person with shingles has a history of chickenpox infection.

Ask the client to describe the type of shingles that her brother has.

Instruct client to report the development of fatigue and low-grade fever.

Answer and Explanation

Correct Answer : A,C,E

Choice A reason: Distinguishing the difference between herpes varicella and herpes zoster is important for client education. Herpes varicella (chickenpox) and herpes zoster (shingles) are caused by the same virus, the varicella-zoster virus (VZV). After a person recovers from chickenpox, the virus remains dormant in the nerve tissues and can reactivate years later as shingles. Educating the client about the relationship between these two conditions helps in understanding the risk and nature of shingles.

Choice B reason: Explaining that the risk of developing shingles decreases with age is incorrect. In fact, the risk of developing shingles increases with age, especially in individuals over 50. The immune system's ability to keep the varicella-zoster virus dormant decreases with age, leading to a higher likelihood of reactivation as shingles. Therefore, this choice is not appropriate for client education.

Choice C reason: Affirming that a person with shingles has a history of chickenpox infection is accurate. Shingles occurs when the dormant varicella-zoster virus reactivates in someone who has previously had chickenpox. This information helps the client understand the connection between past chickenpox infection and the potential for developing shingles.

Choice D reason: Asking the client to describe the type of shingles that her brother has is not relevant to the client's own risk or education about shingles. The focus should be on providing accurate information about shingles and its relation to chickenpox, not on the details of another person's condition.

Choice E reason: Instructing the client to report the development of fatigue and low-grade fever is important because these can be early symptoms of shingles. Early identification and treatment of shingles can help manage symptoms and reduce complications. Educating the client on what to watch for and when to seek medical attention is crucial for effective management.

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Correct Answer is B

Explanation

Choice A reason: Placing the chin down and tilting the head for dysphagia (difficulty swallowing) during meals is not directly related to managing mucositis. While it may help with swallowing difficulties, it does not address the inflammation and pain caused by mucositis.

Choice B reason: Normal saline mouth rinses as swish and spit after meals and bedtime is an effective intervention for managing mucositis. Rinsing with saline helps to keep the mouth clean, reduce bacterial load, and soothe inflamed tissues. It can also help to remove food particles and debris, reducing the risk of infection and promoting healing. Saline rinses are gentle and do not contain irritating ingredients, making them ideal for sensitive oral tissues affected by mucositis.

Choice C reason: Eating high caloric meals to prevent weight loss is important for overall nutrition, especially for clients undergoing cancer treatment. However, it does not specifically address the management of mucositis. High caloric meals alone will not alleviate the pain, inflammation, and ulceration associated with mucositis. Clients with mucositis often have difficulty eating due to pain, so focusing on soothing and healing the oral tissues is a priority before addressing caloric intake.

Choice D reason: Using a commercial mouthwash for xerostomia (dry mouth) is not recommended for managing mucositis. Many commercial mouthwashes contain alcohol and other harsh ingredients that can further irritate the already inflamed mucous membranes. It is better to use a gentle and soothing rinse, such as saline, to manage mucositis symptoms and promote healing of the oral tissues.

A. Jugular vein distension B. Lower extremity edema C. Hepatomegaly D. Fatigue

Correct Answer is D

Explanation

Left-sided heart failure involves the failure of the left ventricle to pump blood efficiently into systemic circulation. Knowledge of hemodynamics must be applied to differentiate between backward failure, causing pulmonary congestion, and forward failure, which results in decreased cardiac output and systemic tissue hypoperfusion.

Choice A rationale: Jugular vein distension is a clinical hallmark of right-sided heart failure. It occurs when the right ventricle fails to pump blood into the lungs, causing increased pressure to back up into the superior vena cava and the systemic venous circulation.

Choice B rationale: Lower extremity edema, specifically dependent pitting edema, is characteristic of right ventricular dysfunction. When the right heart fails, systemic venous pressure rises, forcing fluid into the interstitial spaces of the ankles and feet due to increased hydrostatic pressure in the peripheral veins.

Choice C rationale: Hepatomegaly, or liver enlargement, results from systemic venous congestion associated with right-sided heart failure. Increased pressure in the hepatic veins causes the liver to become engorged with blood, a condition often accompanied by right upper quadrant abdominal discomfort and splenomegaly.

Choice D rationale: Fatigue is a primary symptom of left ventricular dysfunction caused by decreased cardiac output. As the left ventricle fails to eject sufficient oxygenated blood to meet metabolic demands, skeletal muscles and vital organs receive inadequate perfusion, leading to profound physical exhaustion.

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A client reports to the nurse of recently visiting someone who has a shingles infection. The client believes that having had chickenpox as a child will be protective against shingles. How should the nurse respond? Select all that apply.

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Naxlex Comprehensive Predictor Exams

A client with oral cancer is receiving radiotherapy (RT) prior to surgery. Which intervention should the nurse teach the client to implement in managing mucositis related to RT?

Correct Answer is B

Explanation

An adult client newly diagnosed with left ventricular dysfunction is admitted to the hospital with fine rales and wheezing. When assessing this client, which additional finding is the nurse likely to obtain?

Correct Answer is D

Explanation

A client is recovering from an episode of urinary tract calculi. During discharge teaching, the client asks about dietary restrictions. In discussing fluid intake, the nurse should include which type of fluid limitation?

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After teaching a client newly diagnosed with cholecystitis about recommended diet changes, the nurse evaluates the client's learning. Which food choices eliminated by the client indicate to the nurse that teaching has been successful?

A nurse is caring for a client with diabetes insipidus (DI). Which data warrants the most immediate intervention by the nurse?Reference Range: Sodium 136 to 145 mEq/L (136 to 145 mmol/L)

A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?

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