A nurse is caring for a client who is being treated for posttraumatic stress disorder (PTSD). The client states, "I'm not able to fall asleep easily or stay asleep." Which of the following recommendations should the nurse make?

Catch up on lost sleep by napping during the daytime.

Avoid reading in the evenings prior to bedtime.

Dim the screen on your cellphone when using it in your bedroom.

Try meditation before you go to bed at night.

Answer and Explanation

The Correct Answer is D

Choice A reason: Napping during the daytime can interfere with nighttime sleep patterns and is generally not recommended for individuals with insomnia. It can create a cycle of fragmented sleep and may exacerbate difficulties in falling and staying asleep at night.

Choice B reason: While avoiding stimulating activities such as reading in the evening can be helpful for some individuals, it is not a universal recommendation. Reading can actually be a relaxing activity for many people and may help them wind down before bedtime.

Choice C reason: Dimming the screen on electronic devices can reduce exposure to blue light, which can interfere with the body's natural sleep-wake cycle. However, it is generally recommended to avoid the use of electronic devices altogether in the bedroom to promote better sleep hygiene.

Choice D reason: Meditation is a relaxation technique that can be beneficial for individuals with PTSD and sleep disturbances. It can help calm the mind, reduce stress, and prepare the body for sleep. Mindfulness meditation, in particular, has been shown to improve sleep quality and is a recommended practice for those experiencing insomnia.

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Correct Answer is A

Explanation

Choice A reason: Guided imagery is a relaxation technique that can help calm the mind and is beneficial for individuals with anxiety disorders. It involves envisioning a peaceful scene or series of experiences that can distract from anxious thoughts. This method can be particularly helpful before bedtime to ease the transition into sleep.

Choice B reason: Lying in bed and trying to force oneself to fall asleep can actually lead to increased frustration and anxiety, making it harder to fall asleep. It's recommended to leave the bed if unable to sleep and engage in a quiet activity until feeling sleepy.

Choice C reason: Eating a substantial meal before bed can lead to discomfort and disrupt sleep. It's better to have a light snack if needed and avoid heavy meals close to bedtime.

Choice D reason: Restricting sleep can exacerbate anxiety and is not recommended. It's important to maintain a regular sleep schedule and ensure adequate sleep to manage anxiety symptoms effectively.

A. Administer the medication to the client via IM injection. B. Offer the client the medication at the next scheduled dose time. C. Inform the client that they do not have the right to refuse the medication. D. Implement consequences until the client takes the medication.

Correct Answer is B

Explanation

Choice A reason: Administering the medication via IM injection against the client's will can be considered a violation of the client's rights, especially in the context of mental health care where consent and autonomy are highly valued. Involuntary treatment, including medication administration, should only be considered in situations where the client poses an immediate risk to themselves or others, which is not indicated in the scenario provided.

Choice B reason: Offering the medication at the next scheduled dose time respects the client's current decision to refuse the medication while also maintaining the prescribed treatment plan. It allows time for the client to reconsider their decision and provides an opportunity for the nurse to engage in further discussion about the benefits and importance of the medication, potentially addressing any concerns or fears the client may have.

Choice C reason: Informing the client that they do not have the right to refuse medication is incorrect and unethical. Patients have the right to informed consent, which includes the right to refuse treatment. This is particularly important in mental health care, where respecting the client's autonomy and rights is essential for building trust and promoting recovery.

Choice D reason: Implementing consequences for refusing medication is coercive and can damage the therapeutic relationship between the nurse and the client. It may also lead to increased resistance and distrust from the client, which can negatively impact their overall care and treatment outcomes.

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A nurse is caring for a client who is being treated for posttraumatic stress disorder (PTSD). The client states, "I'm not able to fall asleep easily or stay asleep." Which of the following recommendations should the nurse make?

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