A nurse is assisting with teaching a class about vulnerable populations that are at risk for health disparities. The nurse should include that a client who lives in a crowded apartment building is at risk for which of the following conditions?

Choice A reason : Administering an opioid narcotic can be an effective measure for managing dyspnea in end-of-life care. Opioids, such as morphine, can reduce the sensation of breathlessness and improve comfort without significantly affecting oxygen saturation levels. The use of opioids is a well-established practice in palliative care for the relief of dyspnea, particularly when other causes of dyspnea have been addressed and managed appropriately.

Choice B reason : Increasing the heat in the client's room is not a recommended action for managing dyspnea and may actually worsen the client's comfort. Patients experiencing dyspnea often feel better in a cooler environment, as warm temperatures can make breathing feel more labored⁴.

Choice C reason : Placing the head of the client's bed flat is not advisable for managing dyspnea. Elevating the head of the bed can help ease breathing by reducing pressure on the diaphragm and allowing for better lung expansion. A semi-upright position, such as Fowler's or semi-Fowler's position, is typically recommended for patients experiencing dyspnea.

Choice D reason : Nasotracheal suctioning is a procedure used to clear secretions from the airway. While it may be necessary in some cases, it is not a standard action for managing dyspnea in end-of-life care unless there is a specific indication, such as excessive secretions that the patient cannot clear on their own. It can be uncomfortable and distressing for the patient and should be used judiciously⁵.

Choice A reason : Going to bed at the same time every night, even when not feeling tired, can help regulate the body's clock and aid in falling asleep at a regular time. However, lying in bed awake can lead to frustration and should be avoided. If sleep does not come within 20 minutes, it's recommended to get up and do something relaxing until feeling sleepy.

Choice B reason : Exercising can increase alertness and endorphin levels which can make it difficult to fall asleep if done too close to bedtime. Stopping exercise at least 2 hours before bedtime allows the body to wind down and prepare for sleep, making this statement correct and indicative of an understanding of good sleep hygiene practices.

Choice C reason : Watching television or engaging in other stimulating activities in the bedroom can associate the space with wakefulness rather than sleep. The light from screens can also suppress melatonin production, making it harder to fall asleep. Therefore, this statement does not reflect an understanding of the teaching on good sleep practices.

Choice D reason : Taking long naps, especially in the late afternoon or evening, can interfere with nighttime sleep. If naps are necessary, they should be limited to 20-30 minutes and taken earlier in the day. This statement suggests a misunderstanding of the impact of napping on sleep quality at night.