HESI RN MED SURG NEXT GEN QUESTIONS&ANSWERS THIS DOCUMENT CONTAINS NEXT GEN QUESTIONS WITH CASE STUDIES 2023

HESI RN MED SURG NG QUESTIONS&ANSWERS THIS DOCUMENT CONTAINS NEXT GEN QUESTIONS WITH CASE STUDIES 2023 1. A 72-year-old woman is admitted with shortness of breath and difficulty breathing. The client’s vital signs are as follows: Temp: 37 C (98.6 F), BP 162/94, pulse 92, and respiratory rate 26 and shallow. Oxygen saturation is 90% on room air. Client states she has been sleeping in a recliner chair for the past three nights because of difficulty breathing. She also states she has lower back pain with a pain level of “5” on a 0-10 pain scale. Upon assessment, the client states, “I am having difficulty breathing. I can’t catch my breath when I walk a few feet.” Client is oriented to person, place, and time. She has a productive cough. Crackles and wheezing heard upon auscultation, diminished breath sounds at bases; capillary refill is four seconds, and slight clubbing of fingers is noted. Ankles and feet are swollen, 2+ pitting edema noted. The client has no known drug allergies. Medical history reveals hypertension, hyperlipidemia, and chronic obstructive pulmonary disease (emphysema). The client takes the following medications: Furosemide 20 mg po daily Metoprolol 50 mg po daily Amlodipine besylate 5 mg po daily Atorvastatin calcium 10 mg po daily Albuterol 2 inhalations every 4-6 hours prn The client is placed on 2 liters of oxygen via nasal cannula. Arterial blood gases (ABGs) are drawn. The client is started on intravenous (IV) fluids and is given acetaminophen 650 mg by mouth for her pain level of “5”. A. How should the nurse position this client and why? Position the client to maximize ventilation (high fowlers 90). Encourage effective coughing or suction to remove secretions. B. List four signs and symptoms of respiratory distress the nurse may observe in a client with COPD. Dyspnea upon exertion. Productive cough that is most severe upon rising in the morning. Hypoxemia, rapid, shallow respirations. Crackles and wheezes, use of accessory muscles. C. The client wants her nasal oxygen turned up because she is experiencing increased difficulty breathing. What should the nurse say to the client? Clients who have chronically increase PaCO2 levels usually require 1-2L/min of oxygen via nasal cannula. It is important to recognize in COPD that low arterial level of oxygen serve as the primary drive for breathing. D. Why is it important to address the client’s pain level? It is important to control pain for COPD client in order to aid in the reduction of anxiety and stress. E. List three non-pharmacologic interventions that the nurse could implement to help decrease the client’s difficulty breathing. Abdominal breathing. Pursed lip breathing. Incentive Spirometry. F. What are the normal ranges for each of the ABG components in an adult: pH, partial pressure of carbon dioxide (PaCO2), bicarbonate (HCO3), partial pressure of oxygen (PaO2) and oxygen saturation (SaO2)? pH 7.35 – 7.45 PaO2 80 – 100 mm Hg PaCO2 35 – 45 mm Hg HCO3 21 – 28 mEq/L Sa O2 95-100% G. What ABG results would the nurse expect in a client with COPD? Hypoxemia with PO2 less than 80 mm Hg. Hypercarbia which is PCO2 of greater than 45 mm Hg. Respiratory acidosis with metabolic alkalosis compensation. H. Analyze each set of ABG results: 1. pH=7.32 PaCO2=58 mmHg HCO3=32 mEq/L PaO2=60 mmHg respiratory acidosis with metabolic alkalosis compensation 2. pH=7.22 PaCO2=35 mmHg HCO3=20 mEq/L PaO2=80 mmHg metabolic acidosis 3. pH=7.52 pCO2=28 mmHg HCO3=24 mEq/L PaO2=70 mmHg hypoxemia I. List two nursing diagnoses for this client? Ineffective airway clearance relates to bronchoconstriction, increased mucous production, ineffective cough, and other complications. Ineffective breathing pattern related to shortness of breath, mucous, bronchoconstriction, and airway irritants. 2. An adult client is diagnosed with restless leg syndrome and is referred to the sleep clinic. The healthcare provider prescribes ferrous sulfate 325 mg pO daily. Which laboratory values should the nurse monitor? a. Serum iron and ferritin 3. The nurse is caring for a client who is newly diagnosed with adrenocortical insufficiency. The client is experiencing chronic fatigue and weakness. Which intervention should the nurse implement? b. Explain that the hormone therapy will be needed for a time until adrenal glands are stimulated 4. To ensure the correct amount of oxygen delivery for a patient receiving 35% oxygen via a Venturi mask, it is most important that the nurse A. keep the air-entrainment ports clean and unobstructed. 5. While caring for a patient with respiratory disease, a nurse observes that the oxygen saturation dropsfrom 94% to 85% when the patient ambulates. The nurse should determine that A. supplemental oxygen should be used when the patient exercises. 6. The nurse is caring for a 73-year-old patient who underwent a left total knee arthroplasty. On the third postoperative day, the patient complains of shortness of breath, slight chest pain, and that "something is wrong." Temperature is 98.4o F, blood pressure 130/88, respirations 36, and oxygen saturation 91% on room air. Which of the following should the nurse first suspect as the etiology of this episode? B. Pulmonary embolus from deep vein thrombosis 7. A nurse is preparing a client who has supraventricular tachycardia for elective cardioversion. Which of the following prescribed medications should the nurse instruct the client to withhold for 48 hr prior to cardioversion? Digoxin 8. Maria Perez, a 53 year old patient, is day 1 after a gastric bypass. She complains of shortness of breath; her respiration rate is 30 breaths/min, heart rate is 110 bpm, pulse oximetry 89% on room air, temperature is 100 F, and her blood pressure is 90/50 mmHg. She complains of feeling anxious and having stabbing chest pain which gets worse with inspiration. She complains that she feels like she is going to pass out or possibly die. A. What could possibly be going on with the patient and what measures should the nurse provide immediately? Priority interventions go in ABCDS order. Call rapid response team...get help Airway.. HOB to high Fowlers Breathing.. Administer O2 Auscultate BS Asses pulse Ox Circulation.. Assure IV access Prepare to Administer IV fluids to treat hypotension, if not effective start vasopressor therapy as prescribed. Prepare to administer pain medication She has SOB so she is not consuming enough oxygen to the body which in turn causes her to be feeling anxious. Administer oxygen. Administer oxygen via nasal cannula. she is tachypnea due to her respiratory rate being 30 breaths/min Her heart rate is 110 beat per minute so she is tachycardia. maintain adequate oxygen saturation She has a slight fever due to being 100 degrees F. give any analgesics prescribed by the physician he is experiencing chest pains which have a feel of a stabbing sensation - as a nurse administer oxygen therapy and Ms Marie Perez could be battling with pulmonary embolism. Apply antiembolism stockings or intermittent sequential compression devices as indicated. Administer IV fluids to treat hypotension, if not effective start vasopressor therapy as prescribed. Administer small doses of IV morphine to relieve discomfort or anxiety. B. What risk factors does the patient have for a pulmonary embolus? Over 50 years of age Postoperative status Immobility C. What measures are appropriate to manage a pulmonary embolism? Incentive spirometer and deep breathe to be tolerated. prevention not treatment of an active PE Administer analgesic as prescribed Administer anticoagulant therapy as prescribed What diagnostic test come before this? Assess the result of partial thromboplastin time (PTT) before administering anticoagulant. ● On continuous oxygen therapy ● Perform assessment always ● Trans-venous catheter for embolectomy ● Indwelling urinary catheter to monitor output when the client is hypotensive. ● Monitor ECG for right ventricular failure and dysrhythmias D. What measures are appropriate to help the patient in this case study prevent the reoccurrence of a pulmonary embolism? D/C teaching ...not all apply Obtain blood specimens for coagulation testing to evaluate anticoagulation therapy Initiate and maintain patent I.V. access if infusion is ordered; prepare to adjust the dosage based on the results of partial thromboplastin time. Provide I.V. site care according to your facility's policy. To apply anti-embolism stocks Early ambulation Prevent cross leg while sitting Prevent leaving IV catheter in place for a long time. Reposition Passive and active range of motion (legs) to avoid venous stasis. 9. A nurse is assessing a client who has graves’ disease. Which of the following images should indicate to the nurse that the client has exophthalmos? The nurse should identify an outward protrusion of the eyes as exophthalmos, a common finding of graves’ disease. An overproduction of the thyroid hormone causes edema of the extra ocular muscle and increases fatty tissue behind the eye, which results in the eyes protruding outward. Exophthalmos can cause the client to experience problems with vision, including focusing on objects, as well as pressure on the optic nerve. 10. A nurse is caring for a client who has a stage 111 pressure injury. Which of the following findings contributes to delayed wound healing? Urine output 25 mL/hr 11. A nurse is providing teaching to a client who is receiving chemotherapy and has a new prescription for epoetin alfa. Which of the following client statements indicates an understanding of the teaching? “ I will monitor my blood pressure while taking this medication 12. A nurse is providing discharge instructions to a client following an upper gastrointestinal series with barium contrast. Which of the following information should the nurse provide? Increase fluid intake 13. A nurse is assessing a client who has acute cholecystitis. Which of the following findings is the nurse’s priority? Tachycardia 14. A nurse is teaching a client who has a family history of colorectal cancer. To help migrate this risk, which of the following dietary alterations should the nurse recommend? Add Cabbage to the diet 15. A nurse is caring for a client who has emphysema and is receiving mechanical ventilation. The client appears anxious and restless, and the high-pressure alarm is sounding. Which of the following actions should the nurse take first? Instruct the client to allow the machine to breathe for them. 16. A nurse is caring for a client 1 hr following a cardiac catheterization. The nurse notes the formation of a hematoma at the insertion site and a decreased pulse rate in the affected extremity. Which of the following interventions is the nurse’s priority? Apply firm pressure to the insertion site 17 . Harry Smith, 70 years of age, is a male patient who is admitted to the medical-surgical unit with acute community-acquired pneumonia. He was diagnosed with paraseptal emphysema 3 years ago. The patient smoked cigarettes one pack per day for 55 years and quit 3 years ago. The patient has a history of hypertension, and diabetes controlled with oral diabetic agents. The patient presents with confusion as to time and place. The family stated that this is a new change for the patient. The admission vital signs are as follows: blood pressure 90/50 mm Hg, heart rate 101 bpm, respiratory rate 28 breaths/min, and temperature 101.5°F. The pulse oximeter on room air is 85%. The CBC is as follows: WBC 12,500, platelets 350,000, HCT 30%, and Hgb 10 g/dL. ABGs on room air are pH 7.30, PaO2 55, PaCO2 50, HCO3 25. Chest x-ray results reveal right lower lobe consolidation, presence of apical bullae, flattened diaphragm, and a small pleural effusion in the right lower lobe. Lung auscultation reveals severely diminished breath sounds in the right lower lobe and absence of breath sounds at the base. The breath sounds in the rest of the lungs are slightly decreased. The patient complains of fatigue and shortness of breath and cannot finish a short sentence before the respiratory rate increases above the baseline and his nail beds and lips turn a bluish tinge and the pulse oximetry decreases to 82%. The patient is diaphoretic and is using accessory muscles. The patient coughs weakly, but he does not raise any sputum. A. What nursing assessment findings support the diagnoses of Pneumonia? fever ● Shortness of breath, ● low oxygen, observed in old age altered mental status , ● fatigue, and ● tachypneic, ● Tachycardia and active presence of atelectasis are all noted in a client with pneumonia infection. ● Unable to complete a short sentence. ● Lung auscultation reveals severely diminished breath sounds in the right lower lobe and absence of breath sounds at the base. The breath sounds in the rest of the lungs are slightly decreased. ● using accessory muscles. The patient coughs weakly, but he does not raise any sputum. B. What diagnostic findings support the diagnosis of Pneumonia? ● Elevation of white blood cells, ● Flattened diaphragm, ● Respiratory acidosis, ● hypoxia C. what NANDA nursing diagnoses should the nurse formulate for the patient? … Mr. Smith has more real and potential problems… review the NANDA list see which more you can apply to this pt. ● Respiratory failure, Not a NANDA nursing diagnosis Shock, Not a NANDA nursing diagnosis Impaired gas exchange related to pulmonary vasoconstriction and obstruction Anxiety related to feeling of impending doom Ineffective Peripheral Tissue Perfusion related to thrombus formation or embolization Ineffective airway clearance related to weak, ineffective cough to raise sputum and presence of decreased to absent breath sounds in the right lower lobe. Ineffective breathing pattern related to pneumonia and COPD manifested by tachypnea, and use of accessory muscles, and complaint of shortness of breath. Impaired gas exchange related to pneumonia, pleural effusion and COPD as evidenced by hypoxemia and respiratory acidosis, pulse oximetry of 85% on room air. ● Activity intolerance related to impaired respiratory function as evidenced by inability to complete a short sentence before respiratory status declines. Acute confusion related to hypoxemia manifested by disorientation to place and time. Risk for deficient fluid volume related to fever, tachypnea, and diaphoresis. Risk for imbalanced nutrition: less than body requirements related to work or breathing reducing the ability to eat. Potential complication: respiratory failure. Potential complication: shock D. What goals should the nurse develop for the patient? You do not have any nursing diagnosis for these goals. ● Improved airway patency ● Improved breathing pattern ● Improved gas exchange4 ● Rest to conserve energy ● Maintenance of adequate nutrition ● Maintenance of adequate fluid balance ● Absence of complications E. What overall interventions should the nurse provide? Learn to put these in priority order as a test taking tip. Underdeveloped… Positioning Assessments O2 Medications Hydration Nutrition Activity restrictions ADLs infection control Education Assess the skin color, nail beds, and mucous membranes for color changes Monitor for any changes in vital signs Assess for signs and symptoms of hypoxia (such as confusion, headache, diaphoresis, restlessness, tachycardia, and pale skin) Auscultate lung sounds, noting areas of decreased ventilation and the presence of adventitious sounds. Position the client properly to facilitate ventilation-perfusion matching Assess for signs and symptoms of pulmonary infarction (such as fever, cough, bronchial breathing, hemoptysis, pleuritic pain, pleural friction rub, and consolidation) Assess for calf tenderness, redness, swelling, and hardened areas Monitor for any changes in the ABGs Monitor oxygen saturation as indicated Maintain client on bed rest. May resume activity gradually as tolerated Administer oxygen as indicated Anticipate the need to start anticoagulant therapy and, if there is massive thromboembolism, the use of thrombolytic therapy ● Obtain blood and sputum cultures as ordered before initiating antibiotics ● Head of bed elevated 45 degrees to increase oxygenation ● Report abnormal labs, physical findings and diagnostics test results to the MD. ● Monitor the sputum for color, amount, consistency and odor. ● Monitor intake and output. ● Providing patient /family education was to decrease risk for pneumonia such as proper nutrition, hand wash, annual influenza immunization, pneumococcal immunization, and avoid persons with upper respiratory infection or crowds in the winter months. 18. While caring for a client with a full-thickness burn covering 40% of the body, the nurse observes purulent drainage at the wound. Before reporting this finding to the healthcare provide, the nurse should review which of the client's laboratory values? A. White blood cell count 19- The home health nurse is evaluating a male client who manages his asthma and measures his peak expiratory flow rate (PEFR). Today he is experiencing an acute exacerbation and tells the nurse his PEFR is 60% of his personal-best reading. He is experiencing expiratory and inspiratory wheezes and has a RR of 24 breaths/minute, and oxygen saturation rate of 94% on room air. Which PRN medication should the nurse instruct the client to use? A. Albuterol 2.5 to 5 mg per nebulization 20- Which food is most important for the nurse to encourage a client with osteomalacia to include in a daily diet? A. Fortified milk and cereals 21. After three days of persistent epigastric pain, a female presents to the clinic, she has been taking oral antacids without relief. Her vital signs are heart rate 122 beats/minute, respirations 16 breaths/minute, oxygen saturation 96% and blood pressure 116/70 mmHG. The nurse obtains a 12-lead electrocardiogram (ECG). Which assessment finding is most critical? c. ST elevation in three leads 22. An adult client is diagnosed with restless leg syndrome and is referred to the sleep clinic. The healthcare provider prescribes ferrous sulfate 325 mg pO daily. Which laboratory values should the nurse monitor? a. Serum iron and ferritin 23. The nurse is caring for a client who is newly diagnosed with adrenocortical insufficiency. The client is experiencing chronic fatigue and weakness. Which intervention should the nurse implement? b. Explain that the hormone therapy will be needed for a time until adrenal glands are stimulated 24. the nurse is caring for an immobile client after spinal surgery. Which action is most important for the nurse to take to prevent postoperative complications? c. Apply intermittent pneumatic compression devices 25. An adult client is admitted with flank pain and is diagnosed with acute pyelonephritis. What is the priority nursing action? a. Encourage turning and deep breathing 26. The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi? c. Jogs more frequently than usual daily routine 27. A client with orthopnea expresses concern about the ability to “get enough air” during a scheduled thoracentesis. On which information should the nurse’s response be based on? c. The procedure is performed with the client in an upright position 28. Melinda Woods, a 14-year-old girl, was on a hiking trip with her family. Melinda slipped on a wet rock and fell on her right arm. She immediately began crying with pain. The skin is intact, but there is an obvious deformity to the right lower arm. Her mother quickly transports her to the emergency room of the local hospital. (Learning Objective 3) a. What are the initial actions of the nurse? The initial action of the nurse should be neurovascular assessment of the right hand. The nurse then should immobilize the right lower arm. The arm should be elevated above the heart on a pillows and ice should be applied to decrease the swelling. b. The fracture is reduced and immobilized by a cast. What discharge instructions will the nurse provide to the patient? The nurse should provide the following discharge instructions: Reduce swelling by keeping the cast elevated on a pillows and applying ice to the cast. Instruct the patient and the parent on how to perform a neurovascular assessment and to report any abnormal assessment or increased pain not relieved by analgesic to the primary care provider promptly. Instruct the patient and the parent on the use of pain medication and NSAIDs to manage pain. Use of pain medications should decrease over the first week until they are no longer needed. Instruct patient and parent on activity level; such as frequently flexion and extension of fingers, ROM to right shoulder; avoid lifting and twisting or excessive use of the right arm. Instruct patient and parent on diet high in protein, vitamin C, and zinc to promote bone healing. Follow-up with primary care provider as instructed. Verify understanding by having the patient and patent repeat the instructions 29. Alan Dean, a 42-year-old patient, is admitted to the medical-surgical unit after a left below-the-knee amputation (BKA) for a traumatic injury at an industrial job. The patient has two Jackson Pratt drains, and a removable rigid dressing was placed over the soft dressing after surgery. There is a large tourniquet at the bedside. There are also ace wraps and bandaging supplies at the bedside. a. What is the rationale for the removable rigid dressing, and what is the role of the nurse when caring for the patient with this type of dressing? The rational for the removable rigid dressing placed over the soft dressing is to control swelling, to provide uniform compression to support the soft tissue, to control pain, to prevent joint flexion contracture, to help shape the residual limb, and to protect the limb from trauma when transferring the patient. The nurse will assess the patient’s vital signs, Jackson Pratt drains, and the femoral pulse of the left leg and compare the pulse with the right leg. The nurse will assess the wound in several days when the surgeon removes the removable rigid dressing, and the surgeon will replace the dressing if no complications are noted. b. On what areas should nursing care for the patient in this case study focus? Nursing care for this patient should focus on: Provide interventions to maintain adequate tissue perfusion to the residual limb. The residual limb should be gently handled. The residual limb should not be elevated because flexion contracture of the hip mayresult. Monitor fluid and electrolyte balance and provide ordered interventions to correct imbalances. Achieve adequate pain relief as reported by the patient. Phantom pain is a common occurrence. The patient should be medicated for phantom pain. Provide strict sterile asepsis when caring for the wound and report abnormal findings immediately. Instruct patient and family on care of the residual limb. Encourage patient to vent feelings about the change in body image, and encourage the patient to look at, feel, and participate in the care of the limb. Encourage patient to vent feelings and provide additional counseling via consults as needed to help resolve grief successfully. Instruct and promote achievement of independence in self-care. Reinforce rehabilitation to achieve physical mobility using prosthesis. 30. The nurse is instructing the client on insulin administration. The client is performing a return demonstration for preparing the insulin. The client's morning dose of insulin is 10 units of regular and 22 units of NPH. The nurse checks the dose accuracy with the client. The nurse determines that the client has prepared the correct dose when the syringe reads how many units? 32 units. 32. A nurse has two middle-aged clients who have a prescription to receive a blood transfusion of packed red blood cells at the same time. The first client's blood pressure dropped from the preoperative value of 120/80 mm Hg to a postoperative value of 100/50. The second client is hospitalized because he developed dehydration and anemia following pneumonia. After checking the patency of their IV lines and vital signs, what should the nurse do next? 2. Ask another nurse to verify the compatibility of both units at the same time 33. A nurse is reinforcing discharge teaching to a client following arthroscopic surgery. To prevent postoperative complications which of the following actions should be reinforced during the teaching? Administer an opioid analgesic to the client 30 min prior to initiating CPM exercises 34. A nurse is caring for a client who is postoperative following foot surgery and is not to bear weight on the operative foot. The nurse enters the room to discover the client hopped on one foot to the bathroom, using an IV pole for support. Which of the following actions should the nurse take? 1) Walk the client back to bed immediately and get the client a bedpan. 2) Tell the client to remain in the bathroom after toileting and obtain a wheelchair 35. Your patient takes regular insulin and NPH twice A-day for glucose control. What times should the patient be taught to be alert for signs of hypoglycemia? – Is late afternoon and early morning 36. What is a proton pump inhibitor, such as pantoprazole (protonix) used for? – Reduce gastric acid secretion 37. Your patient has a non productive cough and presence of secretions in his tracheostomy. Prior to sectioning the patient, what should you do 1st? – Hyperoxygenate patient 38. Dietary teaching for a patient with chronic renal failure should include choices that are: - Low potassium, low protein, moderate fat 39. Which of the following nursing diagnosis is most important for a patient with chronic obstructive pulmonary disease (COPD) – Impaired gas exchange 40. Your patient is admitted from the ED with failure to thrive and advanced dementia. You note he is extremely underweight, appears unbathed for some time, and has a stage 4 pressure injury to his coccyx. You were told in report that he lives at home with family members. What should you do? - Notify the charge nurse and social worker of your concerns. 41. You have a patient going for dialysis. There are medications include Lisinopril(prinivil), ondansetron (zofran), famotidine(pepcid) and atorvastatin(lipitor). Which medication would you possibly hold and seek clarification? – LISINOPRIL(PRINIVIL) 42. What is the best indication of an acute neurological problem? – Change in level of consciousness 43. Your patient is admitted with diverticulitis. What type of diet do you expect to be ordered for the patient? - Clear liquids 44. Your post op patient has a Jackson - Pratt drain in place. How do you ensure effective drain function? – Compress the drain, then plug the bulb to establish suction. 45. Is a patient with peritonitis Presents with tachycardia, hypotension, and dehydration. What other assessment finding would you anticipate as part of your physical assessment? – Severe abdominal pain or rebound tenderness 46. Your patient with a known history of diabetes is displaying symptoms of diaphoresis, Cool skin, lethargy, And shakiness. What is your 1st action? – Check the patient's blood glucose level 47. A patient on warfarin(Coumadin/jantoven) has an INR of 6. Which medication would you anticipate administering? – Vitamin K 48. A male client who reports feeling chronically fatigued has a hemoglobin of 11.0 grams/dl (110 mmol/L or SI), hematocrit of 34% and microcytic and hypochromic red blood cells. Based on the findings, which dinner selection should the nurse suggest for the patient? A. Beef steak with steam broccoli and orange slices 49- Two hours before a client's scheduled surgery, the nurse is completing the preoperative checklist. Which information requires the most immediate action by the nurse? B. Preoperative serum potassium level is 2.8 mEq/L (2.8mmol/L) 50. - The nurse is assessing a client's arteriovenous (AV) fistula. Which finding provides evidence of its normal function? B. Enlarged vein 51- Following a transurethral resection of the prostate (TURP), a client is discharged from the hospital with an indwelling urinary catheter. Which instruction is important for the nurse to include in the discharge teaching plan? B. Drink 3 liters of water each day 52- A client is receiving chemotherapy for treatment of metastatic carcinoma. When monitoring the client for systemic side effects, which assessment finding warrants intervention by the nurse? A. Leukopenia 53- A client with Cushing's syndrome is recovering from an elective laparoscopic procedure. Which assessment finding warrants immediate intervention by the nurse? A. Irregular apical pulse 54 A client who fractured the right femur from a fall at home is placed in a skeletal traction while awaiting surgery. When the client tells the nurse the need to urinate, which intervention should the nurse implement? D. Maintain traction while the client uses a female urinal 55 The nurse is assessing a client who has herpes zoster. Which question will allow the nurse to gather further information about this condition? A. Has everyone at home already had varicella?