A patient has been diagnosed has having 'long QT syndrome.' The patient is experiencing significant pain following a bout with shingles. What would be an appropriate drug for his pain?

Correct Answer: D

Rationale: Long QT syndrome predisposes patients to torsades de pointes, so pain management must avoid QT-prolonging drugs. Amitriptyline, a TCA, extends QT via sodium channel blockade, risking arrhythmias. Fentanyl, an opioid, has minimal QT impact and relieves severe pain but carries respiratory depression risks, less ideal for shingles' neuropathic pain. Acyclovir treats shingles' viral cause, not pain directly. Diazepam addresses anxiety, not pain. Gabapentin, an anticonvulsant, targets neuropathic pain (common in postherpetic neuralgia) by modulating calcium channels, with no significant QT prolongation, making it safe and effective here. Its efficacy in nerve pain, lack of cardiac risk, and suitability for chronic management post-shingles distinguish it as the best option.

Correct Answer: A

Rationale: Herpes simplex virus requires antiviral therapy, and acyclovir inhibits viral DNA replication, reducing symptom duration and severity, making it the standard treatment. Zidovudine targets HIV, not HSV. Nystatin is antifungal, ineffective against viruses. Metronidazole treats bacterial/protozoal infections. Acyclovir's specificity for HSV, backed by clinical guidelines, ensures targeted therapy, making A the most likely drug ordered for effective management.

Correct Answer: C

Rationale: Gentamicin, an aminoglycoside, treats severe infections but is ototoxic, risking hearing loss via cochlear damage, a serious, potentially irreversible effect. The nurse must monitor closely (e.g., assess for tinnitus, vertigo) to catch it early, prompting discontinuation. Rash suggests allergy but is less frequent and manageable. Nausea and diarrhea occur but are transient and less critical than auditory damage. Gentamicin's narrow therapeutic index and accumulation in inner ear tissues make ototoxicity the priority, especially with IV dosing where levels peak. Early detection prevents permanent disability, aligning with vigilant nursing care for nephrotoxic and ototoxic drugs, making C the adverse effect to watch most closely.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.