A nurse is caring for a client who has a history of hypertension. Which of the following findings should the nurse recognize is indicative of transient ischemic attacks?

Choice A reason: Turning on overhead lights disrupts sleep by stimulating retinal photoreceptors, raising alertness via melatonin suppression. Scientifically, dim or red light preserves rest, making this contrary to reducing environmental stressors for sleep optimization in acute care settings.

Choice B reason: Rubber-soled shoes reduce noise from footsteps, minimizing auditory disturbances to sleep. Scientifically, quiet environments lower cortisol and enhance sleep quality, aligning with evidence-based stressor reduction strategies to promote rest in hospital clients effectively.

Choice C reason: Opening curtains increases light and noise exposure, disrupting sleep cycles via circadian misalignment. Scientifically, darkness supports melatonin production, so this heightens stressors, opposing the goal of improving rest in shared hospital rooms per sleep science.

Choice D reason: Shift reports near rooms raise noise levels, activating the hypothalamic-pituitary axis, disturbing sleep. Scientifically, quiet zones reduce awakenings, making this detrimental to stressor reduction, as it elevates auditory interference contrary to sleep promotion goals.

Choice A reason: Music therapy reduces pain perception but doesn’t eliminate breakthrough pain needs. Scientifically, it’s an adjunct, not a replacement, for analgesics, as severe pain signals persist despite auditory distraction, indicating misunderstanding of its supplementary role in hospice care.

Choice B reason: Discontinuing music when unresponsive overlooks its passive benefits, like comfort, even in unconscious states. Scientifically, auditory stimuli can soothe, suggesting continued use, not cessation, misaligning with hospice goals for holistic pain management.

Choice C reason: Increasing alertness contradicts music therapy’s calming effect in hospice, aimed at relaxation, not stimulation. Scientifically, it lowers arousal to ease pain perception, not heighten awareness, showing a misgrasp of its palliative intent.

Choice D reason: Music distracts from pain by engaging the brain’s auditory cortex, reducing focus on nociceptive signals. Scientifically, this aligns with gate control theory, where non-painful stimuli mitigate pain perception, reflecting accurate understanding of its role in hospice care.