A client complains of an inability to sleep through the night since admission three days ago. Which of the following factors is most likely to negatively affect the patient's sleep patterns?

Moderate fatigue

Ability to talk about day's events

Presence of pain

Absence of unfamiliar stimuli

Answer and Explanation

The Correct Answer is C

Choice A reason: Moderate fatigue typically encourages sleep as the body naturally seeks rest to recover. However, if fatigue is excessive, it might lead to an overtired state where the patient finds it difficult to relax and fall asleep. Normal ranges of physical activity and resulting fatigue can actually promote better sleep patterns by helping to regulate the body's natural sleep-wake cycle.

Choice B reason: The ability to talk about the day's events can be therapeutic and help in reducing stress levels. It allows the patient to process emotions and experiences, potentially leading to a calmer state of mind which is conducive to sleep. This is particularly true if the conversation is positive or neutral rather than rehashing stressful or traumatic events.

Choice C reason: The presence of pain is a significant factor that can disrupt sleep. Pain can make it difficult for a person to find a comfortable position for sleep, and it can cause frequent awakenings or prevent the patient from falling asleep altogether. Pain management should be a priority in patient care, especially at night, to facilitate better sleep. For instance, arthritis pain can be particularly disruptive due to joint discomfort, and addressing this with appropriate pain relief can greatly improve sleep quality.

Choice D reason: While unfamiliar stimuli can disrupt sleep, their absence is not typically a factor that would negatively affect sleep patterns. In fact, a lack of unfamiliar stimuli, meaning a quiet and consistent environment, is generally beneficial for sleep as it reduces the chances of disturbances.

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Correct Answer is C

Explanation

Choice A reason: Regular morning exercise can actually promote better sleep. It helps to regulate the body's clock and can lead to deeper, more restful sleep. However, exercising too close to bedtime may have the opposite effect.

Choice B reason: Going to bed at the same time every evening can help establish a consistent sleep-wake cycle, which is beneficial for people who have insomnia. This regularity can make it easier to fall asleep and wake up naturally.

Choice C reason: Alcohol consumption before bedtime can disrupt sleep patterns. While it may initially help someone fall asleep, it often leads to poorer quality of sleep and can cause awakenings throughout the night.

Choice D reason: If unable to sleep, getting out of bed can be a good strategy. It's part of stimulus control therapy for insomnia, which advises leaving the bed if you can't sleep, so you don't associate the bed with wakefulness

A. Initiate humidification therapy. B. Encourage the client to cough and deep breathe. C. Increase the client's oral fluid intake. D. Raise the head of the bed.

Correct Answer is D

Explanation

Choice A reason: Initiating humidification therapy can be beneficial for a client with pneumonia. Humidified air can help loosen respiratory secretions, making them easier to expectorate. However, while this intervention is helpful, it is not typically the first action a nurse should take. The priority is to address the client's immediate need for adequate oxygenation and ventilation.

Choice B reason: Encouraging the client to cough and perform deep breathing exercises is an essential part of care for patients with pneumonia. These actions help to clear mucus from the lungs and improve ventilation. Deep breathing helps to fully expand the alveoli, which can be compromised in pneumonia, and coughing helps to expel secretions that may be blocking the airways. However, this is not the most immediate action when the oxygen saturation is borderline normal.

Choice C reason: Increasing the client's oral fluid intake is important in the management of pneumonia. Adequate hydration thins respiratory secretions, making them easier to clear. It also supports overall bodily functions, which can be taxed during illness. Nonetheless, this intervention is not the most critical initial step in managing a client's immediate respiratory needs.

Choice D reason: Raising the head of the bed is the correct and immediate action to take for a client with pneumonia and an oxygen saturation of 88%. This position helps to improve chest expansion, promotes better lung aeration, and facilitates easier breathing. It also reduces the risk of aspiration, which is particularly important in clients with pneumonia. Elevating the head of the bed is a simple yet effective way to enhance oxygenation and should be the first step taken.

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A client complains of an inability to sleep through the night since admission three days ago. Which of the following factors is most likely to negatively affect the patient's sleep patterns?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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