The older adult who experiences the stress of a job loss is at risk for a shingles outbreak, which is caused when the varicella-zoster virus, which causes chickenpox, is reactivated in the dorsal nerve root ganglia. Diagnosis is made based on symptoms and visual assessment which reveals vesicular blisters that follow the nerve dermatome. Although the childhood infectious disease history may reveal the history of chickenpox, this is unreliable and not diagnostic. A Tzanck smear is used to confirm the presence of herpesvirus; however, it is unnecessary and not an appropriate use of resources. A urinalysis and urine culture would be used to diagnose the cause of deep, not superficial, flank pain.