A nurse is caring for a client in an outpatient clinic.

Exhibits

Select the 2 findings the nurse should identify as factors that may interfere with the client's sleep.

Caffeine use

Evening meal

Use of electronic devices

Exercise schedule

Bedtime Medications

Answer and Explanation

Correct Answer : A,C

A.   Caffeine is a stimulant and can interfere with sleep, especially if consumed in the afternoon or evening. It can lead to difficulty falling asleep and disrupt the sleep cycle.
B.   While heavy meals close to bedtime can cause discomfort or indigestion, a light evening meal generally does not significantly interfere with sleep for most individuals.
C.   The use of electronic devices, particularly before bedtime, can interfere with sleep due to the blue light emitted by screens. This light can suppress the production of melatonin, a hormone that helps regulate sleep.
D.   Regular exercise generally promotes better sleep. However, vigorous exercise close to bedtime may interfere with sleep due to the increase in adrenaline, but this is not always the case.
E.   The medications taken by the individual do not interfere with sleep.

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Correct Answer is ["B","C","E","F","G"]

Explanation

A. Perform a vaginal examination every 12 hr. Routine vaginal examinations are not indicated at this stage of care, as there are no signs of labor or uterine contractions. Vaginal exams should only be performed if there are indications of preterm labor or changes in maternal symptoms.

B. Obtain a 24-hr urine specimen. Collecting a 24-hour urine specimen allows for accurate measurement of total protein excretion, which is critical for confirming the severity of preeclampsia. This diagnostic tool helps guide further management decisions.

C. Administer betamethasone. Betamethasone is given to promote fetal lung maturity in the event of a preterm delivery, which is a significant risk at 31 weeks of gestation in the presence of severe preeclampsia. It reduces neonatal morbidity and mortality.

D. Monitor intake and output hourly. While monitoring fluid status is essential, hourly monitoring is not typically required unless there are signs of worsening renal function, oliguria, or fluid imbalance. Regular but less frequent monitoring is sufficient for this client.

E. Give antihypertensive medication. The client's blood pressure readings of 162/112 mm Hg and 166/110 mm Hg require prompt antihypertensive treatment to reduce the risk of complications such as stroke, placental abruption, or eclampsia.

F. Provide a low-stimulation environment. A quiet, low-stimulation environment helps reduce the risk of seizures, which is a concern for clients with severe preeclampsia. This intervention supports neurological stability.

G. Maintain bed rest. Bed rest minimizes physical exertion, helping to lower blood pressure and improve placental perfusion, which is critical for fetal well-being in a client with severe preeclampsia.

A. "Make sure to use nearby furniture to support yourself when walking to the bathroom." B. "I will have the physical therapist ambulate you to the bathroom." C. "Tell me what concerns you have about using a bed pan." D. "You have to use the bed pan for your own safety."

Correct Answer is C

Explanation

A. Encouraging the client to use furniture for support is unsafe, especially for a client on complete bed rest.

B. Physical therapy is not typically called for immediate assistance to use the bathroom and is impractical for an end-of-life client.

C. Exploring the client’s concerns allows the nurse to understand and address the emotional or psychological distress associated with using a bed pan.

D. Simply instructing the client to use a bed pan without addressing their concerns may seem dismissive and fail to provide emotional support.

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A nurse is caring for a client in an outpatient clinic. Exhibits Select the 2 findings the nurse should identify as factors that may interfere with the client's sleep.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is continuing to care for the client. Exhibits The nurse is initiating the client's plan of care. Which of the following interventions should the nurse plan to implement? Select all that apply.

Correct Answer is ["B","C","E","F","G"]

Explanation

A nurse is caring for a client who is near the end of life and is on complete bed rest. The client states that he needs to have a bowel movement, and the nurse offers a bed pan. The client states, "I've always used the bathroom." Which of the following responses should the nurse make?

Correct Answer is C

Explanation

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A nurse is caring for a client in an outpatient clinic.

Exhibits

Select the 2 findings the nurse should identify as factors that may interfere with the client's sleep.