Five months following treatment for herpes zoster, an older adult client tells the home health nurse of continuing to experience pain where the rash occurred. Which action should the nurse implement?
Teach the client about phantom pain symptoms.
Perform a complete mental status exam.
Determine if the client has had a shingles vaccination.
Complete an assessment of the client's pain.
The Correct Answer is D
D. Persistent pain following the resolution of herpes zoster, known as postherpetic neuralgia (PHN), is a common complication, especially in older adults. PHN can cause significant discomfort and affect the client's quality of life. Therefore, it is essential for the nurse to conduct a comprehensive assessment of the client's pain to better understand its characteristics, severity, duration, aggravating or alleviating factors, and impact on daily activities.
A. Patient education should follow a complete assessment of the pain to ascertain the diagnosis.
B. Performing a complete mental status exam is not indicated solely based on the client's report of persistent pain from herpes zoster.
C. Determining if the client has had a shingles vaccination is important for preventive healthcare, but it is not the priority action in addressing the client's current pain concern related to PHN. The focus should be on assessing and managing the client's pain to improve their comfort and well-being.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This intervention is important for assessing the client's respiratory status during and after the seizure. Apnea can cause cardiac arrest and respiratory failure and hence a priority.
B. This intervention is crucial for assessing potential injury to the client's mouth or tongue, which can occur during a seizure due to involuntary muscle movements. However, before assessing for lacerations, the nurse should prioritize ensuring the client's safety.
C. Documenting details of the seizure activity is important for maintaining accurate medical records and providing information to the healthcare team. However, before documenting details of the seizure, the nurse should prioritize ensuring the client's safety and providing immediate assistance during the seizure. Therefore, while documentation is essential, it may not be the first intervention to implement.
D. While evaluating for incontinence is important for addressing the client's immediate needs and ensuring comfort, it may not be the first intervention to implement. The nurse should prioritize ensuring the client's safety and providing immediate assistance during the seizure.
Correct Answer is B
Explanation
B. Acute pancreatitis is inflammation of the pancreas that can cause severe upper abdominal pain, which may radiate to the back, fever, and vomiting. Elevated serum amylase and lipase levels are characteristic laboratory findings in acute pancreatitis, indicating pancreatic injury or inflammation. The client's symptoms and laboratory results are consistent with acute pancreatitis.
A. Hepatorenal failure, also known as hepatorenal syndrome, is a serious complication of advanced liver disease where there is progressive renal failure in the setting of liver dysfunction. While hepatorenal syndrome can present with symptoms such as abdominal pain, fever, and vomiting, it is not typically associated with significantly elevated serum amylase and lipase levels.
C. Biliary duct obstruction occurs when there is a blockage in the bile ducts, leading to impaired flow of bile from the liver to the small intestine. While biliary duct obstruction can cause symptoms such as upper abdominal pain and vomiting, it is not typically associated with significantly elevated serum amylase and lipase levels.
D. While surgical site infection is a potential complication following cholecystectomy (gallbladder removal surgery), it typically presents with symptoms such as wound redness, swelling, warmth, and purulent drainage from the incision site.
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