A nurse is assisting with teaching a client about the sleep-wake cycle. The nurse should include that which of the following factors can interfere with the sleep-wake cycle?

Choice A reason : Continue to talk to the client as if they are awake.Even when a client is unresponsive, they may still be able to hear and benefit from hearing a familiar voice. Continuing to talk to the client can provide comfort and reassurance during the end-of-life stage⁷.

Choice B reason : Whisper when talking in the client's room.Whispering can create a sense of secrecy and exclusion. It is important to communicate in a normal tone, respecting the client's presence and dignity⁷.

Choice C reason : Limit the client's visitors to one at a time.Limiting visitors can be appropriate in certain situations to maintain a calm environment; however, it should be based on the client's wishes and needs, not as a general practice⁷.

Choice D reason : Avoid touching the client.Appropriate touch can be comforting to an unresponsive client, conveying care and presence. It should not be avoided unless there is a specific reason to do so, such as pain or discomfort⁷.

Choice A reason : Identity refers to how individuals perceive themselves, including their beliefs, qualities, and expressions. It is the understanding of oneself as a distinct individual. In the context of the client's situation, while stress can impact one's sense of identity, the primary issue described does not directly relate to the client's identity but rather to their ability to fulfill expected roles.

Choice B reason : Role performance stressors arise when individuals feel they cannot meet the expectations associated with their social or work roles. In this case, the client is stressed due to the difficulty in balancing work responsibilities with the demands of caring for an ill family member. This indicates a conflict in role performance, as the client struggles to adequately fulfill the roles of both employee and caregiver.

Choice C reason : Body image pertains to one's perception of the physical self and the feelings associated with this perception. It includes how individuals view their own body and how they believe others perceive it. The client's stress does not stem from concerns about body image but from the pressures of their responsibilities.

Choice D reason : Self-esteem is the value one places on oneself, encompassing feelings of worthiness or unworthiness. It is influenced by various factors, including personal achievements and recognition from others. Although self-esteem can be affected by stress, the scenario provided specifically highlights the client's stress related to role fulfillment, not their self-worth.