A nurse is caring for a client who states, "I have been having trouble sleeping for the last several months." Which of the following responses should the nurse make?

"You should take a 2-hour nap during the afternoon."

"You should relax by watching a television show in bed before going to sleep."

"You should avoid stressful activities prior to going to sleep."

"You should plan to exercise 2 hours before going to sleep."

Answer and Explanation

The Correct Answer is C

Choice A reason:
The statement "You should take a 2-hour nap during the afternoon" is not advisable. While short naps can be beneficial, long naps, especially those taken late in the day, can interfere with nighttime sleep by reducing sleep drive. It is generally recommended to limit naps to 20-30 minutes and to avoid napping late in the afternoon.

Choice B reason:
The statement "You should relax by watching a television show in bed before going to sleep" is not recommended. Watching television or using other electronic devices before bed can negatively impact sleep quality. The blue light emitted from screens can suppress melatonin production, making it harder to fall asleep. It is better to engage in relaxing activities that do not involve screens, such as reading a book or listening to calming music.

Choice C reason:
The statement "You should avoid stressful activities prior to going to sleep" is the correct response. Engaging in stressful activities before bed can increase anxiety and make it difficult to fall asleep. It is important to establish a relaxing bedtime routine that includes activities such as deep breathing exercises, meditation, or gentle stretching to promote better sleep.

Choice D reason:
The statement "You should plan to exercise 2 hours before going to sleep" is partially correct but not ideal. While regular exercise can improve sleep quality, exercising too close to bedtime can have the opposite effect for some people. It is generally recommended to finish exercising at least 3-4 hours before bedtime to allow the body to wind down.

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Correct Answer is ["B","D"]

Explanation

Choice A reason:
The statement "Speak to the client in a loud voice" is not appropriate. Speaking loudly can escalate the client's agitation and increase their distress. It is important to use a calm, gentle tone to help de-escalate the situation.

Choice B reason:
The statement "Identify the client's stressors" is the correct response. Understanding what is causing the client's agitation can help in addressing the root cause and calming the client. Identifying stressors is a key step in managing agitation effectively.

Choice C reason:
The statement "Stand directly in front of the client" is not advisable. Standing directly in front of an agitated client can be perceived as confrontational and may increase their agitation. It is better to stand at an angle or to the side to avoid appearing threatening.

Choice D reason:
The statement "Talk to the client using short, simple sentences" is the correct response. Using clear, concise language helps the client understand instructions and reduces confusion, which can help in calming them down.

Choice E reason:
The statement "Request that security guards restrain the client" is not appropriate as a first response. Restraints should only be used as a last resort when the client poses an immediate danger to themselves or others and when less restrictive measures have failed.

A. "Until your medication has reached therapeutic levels, you will need constant observation." B. "Since you are trying to follow the treatment plan, we can submit your request to the provider." C. "If you complete a contract that states you will not harm yourself, you can be alone." D. "We are concerned about you and need to keep you safe."

Correct Answer is D

Explanation

Choice A Reason:
Stating that the client needs constant observation until their medication reaches therapeutic levels is factual but may not address the client's immediate emotional needs. While it is important to monitor the client closely, this statement does not convey empathy or concern for the client's well-being. It is crucial to balance safety measures with compassionate communication to build trust and support the client.

Choice B Reason:
Submitting the client's request to the provider because they are trying to follow the treatment plan might give the client false hope that their request for privacy will be granted. This approach does not prioritize the client's safety, which is paramount when dealing with suicidal ideations. The nurse must ensure that the client is safe and supported, rather than focusing on procedural aspects.

Choice C Reason:
Allowing the client to be alone if they complete a contract stating they will not harm themselves is not a reliable safety measure. Contracts for safety, also known as no-harm contracts, have been shown to be ineffective in preventing suicide. The nurse should instead focus on continuous observation and support to ensure the client's safety.

Choice D Reason:
Expressing concern and the need to keep the client safe is the most appropriate response. This statement acknowledges the client's feelings and emphasizes the nurse's role in ensuring their safety. It conveys empathy and support, which are essential in building a therapeutic relationship and providing effective care for clients with suicidal ideations.

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A nurse is caring for a client who states, "I have been having trouble sleeping for the last several months." Which of the following responses should the nurse make?

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