The nurse is assessing a client who has herpes zoster. Which question will allow the nurse to gather further information about this condition?

Has everyone at home already had varicella?

Have the antifungal creams been effective?

Do you have any dry patches on your feet and hands?

Do your family members share combs and brushes?

Answer and Explanation

The Correct Answer is A

Choice A reason: Varicella is another name for chickenpox, which is caused by the varicella-zoster virus. Herpes zoster, also known as shingles, is a reactivation of the same virus that causes a painful rash along a nerve pathway. People who have had chickenpox are at risk of developing shingles later in life, especially if their immune system is weakened. Asking the client if everyone at home has already had varicella can help the nurse determine the risk of transmission and the need for isolation precautions.

Choice B reason: Antifungal creams are not effective for herpes zoster, which is caused by a virus, not a fungus. Antifungal creams are used to treat fungal infections, such as athlete's foot, ringworm, or candidiasis. Asking the client if the antifungal creams have been effective is not relevant to the condition and can indicate a lack of knowledge or a misdiagnosis.

Choice C reason: Dry patches on the feet and hands are not typical signs of herpes zoster, which usually causes a blistering rash along a nerve pathway. Dry patches on the feet and hands can be caused by other conditions, such as eczema, psoriasis, or diabetes. Asking the client if they have any dry patches on their feet and hands is not helpful to assess the condition and can divert the attention from the main problem.

Choice D reason: Sharing combs and brushes is not a common mode of transmission for herpes zoster, which is spread by direct contact with the fluid from the blisters. Sharing combs and brushes can transmit other infections, such as lice, scabies, or impetigo. Asking the client if their family members share combs and brushes is not pertinent to the condition and can imply a poor hygiene or a stigma.

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Correct Answer is B

Explanation

Choice A reason: Using incentive spirometer is not a relevant instruction for a client with BPH who underwent TUNA. Incentive spirometer is a device that helps improve lung function and prevent respiratory complications after surgery or prolonged bed rest. TUNA is a minimally invasive procedure that uses radiofrequency energy to shrink the prostate tissue and relieve the urinary obstruction. TUNA does not affect the respiratory system or require general anesthesia.

Choice B reason: Monitoring urinary stream for decrease in output is an important instruction for a client with BPH who underwent TUNA. Urinary output can reflect the kidney function and the effectiveness of the procedure. A decrease in urinary output can indicate urinary retention, infection, or bleeding, which are potential complications of TUNA. The client should report any changes in the urinary stream, such as difficulty, pain, frequency, urgency, or hesitancy, to the health care provider.

Choice C reason: Reporting when hematuria becomes pink tinged is not a necessary instruction for a client with BPH who underwent TUNA. Hematuria is the presence of blood in the urine, which is a common and expected finding after TUNA. Hematuria usually resolves within a few days and does not require intervention, unless it is excessive or persistent. The client should drink plenty of fluids to flush out the blood and prevent clot formation. The client should report any signs of infection, such as fever, chills, or foul-smelling urine, to the health care provider.

Choice D reason: Restricting physical activities is a correct instruction for a client with BPH who underwent TUNA. Physical activities can increase the blood pressure and the risk of bleeding or injury to the prostate. The client should avoid strenuous activities, such as lifting, running, or biking, for at least two weeks after the procedure. The client should also avoid sexual intercourse, driving, or sitting for long periods until the symptoms subside. The client should follow the health care provider's advice on when to resume normal activities.

A. Apical heart rate of 100 to 110 beats/minute. B. Redness and edema noted at the incision site. C. High-pitched sound heard upon inspiration. D. Pain rating of 8 on a scale of 1 to 10.

Correct Answer is C

Explanation

Choice A reason: An apical heart rate of 100 to 110 beats/minute is not unusual after surgery, as the client may be experiencing stress, pain, or anxiety. This finding does not require immediate action by the nurse, but should be monitored and reported if it persists or worsens.

Choice B reason: Redness and edema at the incision site are expected signs of inflammation and healing after surgery. This finding does not require immediate action by the nurse, but should be assessed for signs of infection, such as pus, warmth, or foul odor.

Choice C reason: A high-pitched sound heard upon inspiration, also known as stridor, is a sign of upper airway obstruction, which can be life-threatening. This finding requires immediate action by the nurse, such as administering oxygen, suctioning, or calling for help.

Choice D reason: A pain rating of 8 on a scale of 1 to 10 indicates severe pain, which can affect the client's recovery and comfort. This finding requires prompt action by the nurse, such as administering analgesics, repositioning, or providing non-pharmacological interventions. However, this is not as urgent as choice C, which involves the client's airway.

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The nurse is assessing a client who has herpes zoster. Which question will allow the nurse to gather further information about this condition?

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