A nurse is caring for an adult client who reports having trouble getting to sleep at night. Which of the following recommendations should the nurse make?

"Remain in bed until you fall asleep."

"Sleep longer hours on the weekend."

"Keep the television volume low while you are trying to fall asleep."

"Establish a daily exercise routine."

Answer and Explanation

The Correct Answer is D

A.   Remaining in bed until falling asleep can worsen insomnia and create negative associations with the bed.
B.   While maintaining a consistent sleep schedule is important, sleeping longer on the weekends can disrupt the circadian rhythm.
C.   Keeping the television volume low can help with sleep, but it might not directly address the underlying issue of trouble falling asleep.
D.   Correct. Regular exercise, especially during the day, can help regulate sleep patterns and improve the ability to fall asleep at night.

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Correct Answer is C

Explanation

A. Instructing the client to hold the drainage bag at waist height when ambulating is incorrect because the drainage bag should always be kept below the level of the bladder to prevent urine from flowing back into the bladder, which could lead to a urinary tract infection (UTI).
B. Collecting a sterile specimen from the urinary drainage bag is incorrect because urine in the drainage bag is not considered sterile. If a sterile specimen is needed, it should be obtained by cleaning the catheter's sampling port with an antiseptic solution and withdrawing urine directly from the port using a sterile syringe.
C. Securing the tubing with adhesive tape to the lower abdomen is correct because it helps prevent accidental pulling or tugging on the catheter, which could cause discomfort or dislodgement. Properly securing the tubing also helps maintain a continuous flow of urine and reduces the risk of infection.
D. Coiling the tubing on the bed above the collection bag is incorrect because it can cause urine to flow back into the bladder, increasing the risk of infection and compromising the effectiveness of the drainage system. The tubing should be kept below the level of the bladder to ensure proper drainage.

A. Oxygen saturation level B. Tremors C. Current level of consciousness D. Heart rate E. Chronic health condition F. Respiratory rate

Correct Answer is ["A","B","F"]

Explanation

A. Oxygen saturation level: The client is restless, not following commands, and has labored respirations with crackles and wheezes in the breath sounds. Monitoring the oxygen saturation level is essential to assess the client's respiratory status and oxygenation.
B. Tremors: The client has tremors in their hands. Considering the client's history of Parkinson's disease, changes in tremors should be monitored and addressed promptly.
C. The immediate concern is addressing the respiratory distress.
D. Heart rate may also be monitored, but it's not as critical in this context.
E. Chronic health conditions are relevant for the overall care plan, but they do not require immediate intervention as compared to respiratory and tremor issues.
F. Respiratory rate: The client has labored respirations and abnormal breath sounds (crackles and wheezes). Monitoring the respiratory rate is important to evaluate the client's breathing pattern and respiratory distress.

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A nurse is caring for an adult client who reports having trouble getting to sleep at night. Which of the following recommendations should the nurse make?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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