A nurse is caring for a client who reports difficulty falling asleep at night. Which of the following actions should the nurse take?

Encourage the client to ambulate in the hallway 1 hr before bedtime.

Tell the client to avoid drinking fluids 1 hr before bedtime.

Schedule routine care tasks during hours when the client is awake.

Advise the client to leave the television in the room on when trying to fall asleep.

Answer and Explanation

The Correct Answer is C

A. Encourage the client to ambulate in the hallway 1 hr before bedtime: Physical activity too close to bedtime can increase heart rate and body temperature, making it more difficult for the client to fall asleep. While ambulation is beneficial for overall health, it should be scheduled earlier in the day to promote sleep rather than interfere with it.

B. Tell the client to avoid drinking fluids 1 hr before bedtime: Limiting fluids before bed may reduce nighttime awakenings due to urination, but it does not directly address the client’s difficulty falling asleep. This intervention can support sleep quality but is secondary to scheduling care and reducing disturbances.

C. Schedule routine care tasks during hours when the client is awake: Performing nursing care while the client is awake minimizes nighttime interruptions and allows for uninterrupted rest. Prioritizing sleep hygiene by aligning care with the client’s natural sleep-wake cycle is an effective strategy to improve sleep onset and overall sleep quality.

D. Advise the client to leave the television in the room on when trying to fall asleep: Leaving the television on provides light and auditory stimulation, which can interfere with melatonin release and delay sleep onset. This practice is counterproductive and can worsen difficulty falling asleep.

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Correct Answer is B

Explanation

A. Urine specific gravity of 1.028 (1.005 to 1.03): A urine specific gravity in this range is within normal limits, indicating concentrated urine. In diabetes insipidus, urine is typically very dilute with a specific gravity below 1.005, reflecting excessive water loss, so this finding does not indicate DI.

B. Urine output of 250 mL/hr: Excessive urine output is a hallmark of diabetes insipidus, especially in the context of a recent head injury. High-volume, dilute urine (polyuria) occurs due to a deficiency of antidiuretic hormone or kidney insensitivity to it. This finding alerts the nurse to the early development of DI and the need for intervention.

C. Serum sodium of 115 mEq/L (136 mEq/L to 145 mEq/L): Low sodium indicates hyponatremia, which is not typical of DI. In fact, DI usually causes hypernatremia due to free water loss, making this finding inconsistent with the expected laboratory changes in DI.

D. Blood glucose of 198 mg/dL (less than 200 mg/dL): Mildly elevated blood glucose may indicate stress hyperglycemia but is unrelated to the pathophysiology of diabetes insipidus. Glucose levels do not provide a reliable indication of DI development.

A. Ground beef B. Peanut butter C. Kale D. Canoes

Correct Answer is C

Explanation

A. Ground beef: Ground beef provides protein and iron but contains very little calcium, which is the primary nutrient of concern when dairy products are removed from the diet. Eliminating dairy increases the risk of inadequate calcium intake, and ground beef does not help replace this deficit. It does not address the nutritional gap caused by lactose intolerance.

B. Peanut butter: Peanut butter offers healthy fats and some protein but is not a meaningful source of calcium. While it can contribute to overall calorie and nutrient intake, it does not compensate for the loss of dairy-derived calcium. Relying on peanut butter alone would leave the client at risk for long-term bone health issues.

C. Kale: Kale is rich in calcium and is easily absorbed by the body, making it an ideal substitute when dairy intake is restricted. Including kale regularly helps maintain adequate calcium levels to support bone strength and neuromuscular function. It offers a plant-based solution that aligns well with the dietary needs of someone with lactose intolerance.

D. Canoes: Canoes are not a known food source and provide no nutritional relevance in replacing nutrients lost from eliminating dairy. They do not offer calcium or other minerals commonly supplied by milk or dairy products. This option does not support dietary adjustments needed to prevent nutrient deficiencies.

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A nurse is caring for a client who reports difficulty falling asleep at night. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is at high risk for developing diabetes insipidus (DI) following a severe head injury. Which assessment finding indicates to the nurse that the client is developing DI?

Correct Answer is B

Explanation

A nurse is caring for a client who has lactose intolerance and eliminated dairy products from their diet. The nurse should instruct the client to increase consumption of which of the following foods?

Correct Answer is C

Explanation

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