The nurse assesses a client being treated for Herpes zoster (shingles). Which assessment(s) should the nurse include when evaluating the effectiveness of treatment? Select all that apply.
Pain scale.
Skin integrity.
Bowel sounds.
Functional ability
Heart sounds.
Correct Answer : A,B,D
A. Pain scale: Pain is a key symptom of Herpes zoster (shingles), and the effectiveness of treatment is often measured by the relief of pain. The nurse should assess the pain level regularly using a pain scale to evaluate the effectiveness of pain management interventions.
B. Skin integrity: Herpes zoster causes a rash and blisters, and monitoring skin integrity is important to assess for signs of infection, healing, or any new areas of skin breakdown. The healing of the rash and blisters is a key indicator of treatment effectiveness.
C. Bowel sounds: Bowel sounds are not related to the treatment or condition of Herpes zoster. While important in other contexts, they are not a relevant assessment for evaluating the effectiveness of shingles treatment.
D. Functional ability: Functional ability, including the client’s ability to perform activities of daily living, can be impacted by the pain and discomfort associated with shingles. Assessing functional ability helps to gauge the overall impact of the condition and the effectiveness of treatment in improving quality of life.
E. Heart sounds: Heart sounds are not directly related to the treatment of Herpes zoster. This assessment is not necessary for evaluating the effectiveness of shingles treatment unless there are unrelated cardiovascular concerns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
A. Ask the client if she has any alcohol in the room at this time: This is an essential step in assessing for immediate safety and contraband that may impact her treatment plan, especially considering her symptoms and possible withdrawal risk.
B. Administer a PRN prescription for an antianxiety drug: This could mask symptoms of alcohol withdrawal or interact negatively with alcohol. Medication should be given only after thorough assessment and consultation.
C. Inform the family that they are enabling the client: While family education is important, using accusatory language like "enabling" can damage therapeutic relationships. A nonjudgmental, supportive approach is better.
D. Observe for signs to determine if client is inebriated: Monitoring for inebriation supports accurate clinical assessment and decisions about withdrawal protocols, safety, and medication timing.
E. Schedule a conference with the client and family members: A joint meeting allows open discussion, identifies care goals, and promotes understanding and support from all parties involved.
Correct Answer is A
Explanation
A. Provide a bedside commode for toileting: This intervention helps reduce the cardiac workload by minimizing the effort needed for the client to walk to the bathroom. It allows the client to conserve energy and reduce the strain on the heart.
B. Assist with ambulation in the hallway: While mobility is important, ambulating in the hallway can increase the heart’s workload, especially in a client with heart failure and pneumonia. It's best to minimize unnecessary physical exertion to prevent exacerbations.
C. Teach to sleep in a side-lying position: While side-lying can sometimes help with breathing, this position does not directly reduce the cardiac workload. The priority is ensuring the client has adequate rest and minimizing physical strain.
D. Encourage active range of motion exercises: While range of motion exercises are important for preventing complications like muscle atrophy, they may increase the cardiac workload. For a client with pneumonia and heart failure, the priority is to reduce exertion and conserve energy.
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