A nurse is caring for a hospitalized pre-operative client experiencing insomnia in the hospital at 3:00 am (0300).
Which nursing intervention is the most appropriate for this client?

Encourage a warm shower.

Offer a glass of warm milk.

Notify the health care provider.

Encourage the client to watch television.

Answer and Explanation

The Correct Answer is D

Offer a glass of warm milk. According to some studies, warm milk may have a relaxing effect on the body and help induce sleep. It also contains tryptophan, an amino acid that is converted to serotonin and melatonin, which are neurotransmitters that regulate sleep cycles.

Choice A is wrong because a warm shower may increase the body temperature and make it harder to fall asleep.

Choice C is wrong because notifying the healthcare provider is not necessary for a client with insomnia unless there are other signs of distress or complications.

Choice D is wrong because watching television may stimulate the brain and interfere with the production of melatonin, a hormone that promotes sleep.

Some other nursing interventions for insomnia are:

Educate the patient on the proper food and fluid intake such as avoiding heavy meals, alcohol, caffeine, or smoking before bedtime.
Evaluate the patient’s sleep hygiene such as having a regular bedtime and wake-up time, avoiding naps during the day, and limiting exposure to light at night.
Provide a conducive environment for sleep such as reducing noise, adjusting temperature and lighting, and using comfortable bedding.
Help the patient develop a sleeping plan such as engaging in relaxing activities before bed, avoiding checking the clock, and getting out of bed if unable to sleep after 20 minutes.
Understand the proper use of sleep aids or other medications such as following the prescription, avoiding over-the-counter drugs without consulting the provider, and being aware of the side effects and interactions.

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Correct Answer is A

Explanation

Rhonchi. Rhonchi are low-pitched, rattling sounds that indicate mucus in the larger airways. They are most evident on expiration and may decrease after coughing.

Choice B is wrong because wheezes are high-pitched, squeaking sounds that indicate narrowed small air passages. They are usually heard on both inspiration and expiration.

Choice C is wrong because crackles are short, high-pitched popping sounds that indicate fluid or inflammation in the alveoli. They are usually heard on inspiration.

Choice D is wrong because pleural friction rubs are creaking or grating sounds that indicate inflammation of the pleura. They are usually heard on both inspiration and expiration and do not change with coughing.

A. High self-esteem. B. Antisocial personality traits. C. Good communication skills. D. Aggressive behaviors.

Correct Answer is B

Explanation

According to the Addiction Nursing Competencies, antisocial personality traits are one of the risk factors for developing addictive behaviors.

Antisocial personality disorder is characterized by a disregard for the rights and feelings of others, impulsivity, deceitfulness, and lack of remorse.

Choice A is wrong because high self-esteem is not associated with addictive behaviors. On the contrary, low self-esteem, passivity, and inability to relax or defer gratification are some of the personality factors that can predispose a person to substance use disorders.

Choice C is wrong because good communication skills are not related to addictive

behaviors. In fact, poor communication skills, social isolation, and lack of support are some of the psychosocial factors that can contribute to substance use disorders.

Choice D is wrong because aggressive behaviors are not a specific indicator of addictive behaviors.

Aggression can be a result of various factors, such as frustration, anger, stress, or mental illness. Aggression can also be influenced by the type and amount of substance used.

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A nurse is caring for a hospitalized pre-operative client experiencing insomnia in the hospital at 3:00 am (0300). Which nursing intervention is the most appropriate for this client?

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Correct Answer is B

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A nurse is caring for a hospitalized pre-operative client experiencing insomnia in the hospital at 3:00 am (0300).
Which nursing intervention is the most appropriate for this client?