A client tells the nurse about beginning an exercise program a month ago to lose weight and improve sleep.

The client states that it still takes at least two hours to fall asleep at night.

Which action should the nurse implement?

Encourage the client to exercise every day to eliminate bedtime wakefulness.

Advise the client that lifestyle changes often take several weeks to be effective.

Ask the client for a description of the exercise schedule that is being followed.

Determine the amount of weight the client has lost since increasing activity.

Answer and Explanation

The Correct Answer is B

The correct answer is Choice B: Advise the client that lifestyle changes often take several weeks to be effective.

Choice B rationale: Exercise is known to improve sleep quality and reduce the time it takes to fall asleep; however, these benefits may not be immediate. Lifestyle modifications, such as incorporating regular physical activity, typically require several weeks before noticeable improvements in sleep patterns and overall health are observed. By informing the client about this expected timeframe, the nurse promotes realistic expectations and encourages adherence to the exercise program.

Choice A rationale: Encouraging daily exercise to eliminate bedtime wakefulness may be counterproductive, as overexertion can lead to increased arousal and impaired sleep quality. Additionally, daily exercise might be too rigorous or impractical for some individuals, potentially leading to burnout or injury. It is essential to tailor exercise recommendations to the client's fitness level, preferences, and goals.

Choice C rationale: While obtaining information about the client's exercise schedule is helpful in assessing their adherence and progress, it does not directly address the issue of sleep onset difficulties. The nurse should focus on providing education and guidance on the expected timeline for observing sleep improvements with exercise.

Choice D rationale: Weight loss is a potential outcome of increased physical activity but is not directly correlated with improvements in sleep onset latency. Focusing solely on weight loss may overlook other essential aspects of sleep hygiene and healthy lifestyle changes. The nurse should emphasize the broader benefits of exercise and provide a comprehensive approach to addressing the client's concerns.

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Correct Answer is C

Explanation

The correct answer is choice C: Increase rate of ventilation.

Choice A rationale:

Decreasing expiratory flow time would not directly address the elevated PaCO2 levels. This intervention is more related to managing expiratory phase issues rather than correcting respiratory acidosis.

Choice B rationale:

Decreasing expiratory pressure might help with certain ventilation issues, but it does not specifically target the elevated PaCO2 and resulting acidosis.

Choice C rationale:

Increasing the rate of ventilation helps to blow off more CO2, thereby reducing PaCO2 levels and correcting the respiratory acidosis indicated by the pH of 7.26 and PaCO2 of 68 mm Hg.

Choice D rationale:

Increasing the ventilator tidal volume could also help reduce PaCO2 by increasing the amount of air exchanged with each breath. However, increasing the rate of ventilation is generally a more immediate and effective intervention for acute respiratory acidosis.

A. Neurology unit supervisor. B. Adult nurse practitioner. C. Nurse case manager. D. Risk management nurse.

Correct Answer is C

Explanation

Choice A rationale:

The neurology unit supervisor is not the most appropriate nurse to coordinate the progression of care for a client with a spinal cord injury (SCI). While they may have expertise in neurology, the nurse case manager is specifically trained to coordinate and manage the care of patients with complex conditions, including SCI. They can facilitate communication between various healthcare providers and ensure that the client receives comprehensive care throughout their stay.

Choice B rationale:

An adult nurse practitioner may have specialized knowledge in the care of adults, but they may not have the specific skills and training required to coordinate the care of a client with a spinal cord injury in the ICU. Nurse case managers are better equipped to manage complex cases and ensure the continuity of care for the client.

Choice D rationale:

A risk management nurse focuses on minimizing healthcare-related risks and ensuring the safety of patients and staff. While their role is essential, it is not the primary responsibility to coordinate the progression of care for a client with a spinal cord injury. The nurse case manager is better suited for this role as they specialize in care coordination.

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A client tells the nurse about beginning an exercise program a month ago to lose weight and improve sleep. The client states that it still takes at least two hours to fall asleep at night. Which action should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client receiving mechanical ventilation has a pH of 7.26, PaCO2 of 68 mm Hg, and a PaO2 of 92 mm Hg. Which intervention should the nurse implement?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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A client tells the nurse about beginning an exercise program a month ago to lose weight and improve sleep.

The client states that it still takes at least two hours to fall asleep at night.

Which action should the nurse implement?