The practical nurse (PN) is caring for a client admitted with a diagnosis of herpes zoster. The client has draining lesions and reports that the affected area is painful. Which action should the PN take first?

Choice A reason: Demonstrating the use of an incentive spirometer is a valuable intervention for encouraging deep breathing and preventing atelectasis. However, in the context of a client with absent breath sounds on one side, the priority is to monitor for signs of respiratory distress or complications such as a pneumothorax. While using an incentive spirometer may be beneficial in other scenarios, it is not the immediate priority in this case.
Choice B reason: Monitoring the client for increasing respiratory distress is the most critical action to take. The absence of breath sounds on the left side could indicate a serious complication such as a pneumothorax, hemothorax, or other issues that can compromise respiratory function. By closely monitoring the client, the practical nurse can detect signs of worsening condition, such as increased work of breathing, cyanosis, or changes in vital signs, and provide timely intervention or support while awaiting the healthcare provider's arrival.
Choice C reason: Administering a PRN dose of a diuretic medication is not appropriate in this context. Diuretics are used to manage fluid balance and treat conditions such as heart failure or hypertension but are not relevant for addressing the immediate concern of absent breath sounds and potential respiratory distress. The focus should remain on monitoring the client's respiratory status and ensuring appropriate interventions are available if needed.
Choice D reason: Encouraging the client to use pursed-lip breathing can be beneficial for clients experiencing shortness of breath or for managing chronic obstructive pulmonary disease (COPD). However, in the case of absent breath sounds on one side, it is more important to monitor for signs of respiratory compromise and ensure the client receives prompt medical evaluation and intervention. Pursed-lip breathing is not the immediate priority in this scenario.

Choice A reason: A sore throat is a common and expected concern after an endoscopy. During the procedure, an endoscope is passed through the mouth and down the throat to examine the upper gastrointestinal tract, which can cause irritation and discomfort in the throat. This is typically temporary and can be managed with soothing remedies such as warm saltwater gargles or throat lozenges. The practical nurse should reassure the client that a sore throat is a normal side effect and provide appropriate comfort measures.
Choice B reason: Clay-colored stools are not typically associated with an endoscopy. This finding is more indicative of a problem with bile flow, possibly related to liver or gallbladder conditions. The presence of clay-colored stools suggests that bile is not reaching the intestines, which can occur in conditions such as biliary obstruction. While it is an important symptom to report, it is not directly related to the endoscopic procedure.
Choice C reason: Pain in the mid-abdominal area is not a common post-endoscopy concern. While some mild discomfort or bloating can occur due to the air introduced into the stomach during the procedure, severe or persistent mid-abdominal pain is not expected and should be evaluated further. This symptom could indicate a complication such as perforation, which is rare but serious.
Choice D reason: White, chalky emesis is not a typical concern after an endoscopy. This type of emesis may be related to the ingestion of barium, a contrast material used in certain radiologic studies, but it is not associated with an endoscopic examination. If a client experiences white, chalky emesis, further investigation is needed to determine the cause, but it is not a normal post-endoscopy symptom.