A nurse is contributing to the plan of care for a client who reports insomnia due to increased stress.
Which of the following interventions is the nurse's priority?

Inquire about the client's bedtime routine.

Recommend that the client go for a walk every morning.

Instruct the client to turn off the television before bedtime.

Encourage the client to listen to soft music at the onset of stress.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Inquiring about the client's bedtime routine is the nurse's priority because it directly addresses the client's reported problem of insomnia due to increased stress. Understanding the client's routine can help identify factors contributing to sleep difficulties and guide the development of an appropriate plan of care.

Choice B rationale:

Recommending that the client go for a walk every morning may be a helpful intervention, but it does not directly address the client's immediate concern of insomnia. It's important to first assess the client's current situation and then provide tailored interventions.

Choice C rationale:

Instructing the client to turn off the television before bedtime is a good sleep hygiene practice, but it may not be the priority when the client is experiencing acute insomnia due to increased stress. The nurse should first gather information about the client's specific situation.

Choice D rationale:

Encouraging the client to listen to soft music at the onset of stress is a useful relaxation technique, but it may not be the priority in this case. The nurse should focus on addressing the client's insomnia by identifying contributing factors and implementing appropriate interventions.

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Correct Answer is B

Explanation

Correct answer is: B. 16 lb.

Choice A rationale: 32 lb. is too much weight gain for a client whose prepregnancy BMI was 30.5. According to the Institute of Medicine (IOM) guidelines, obese women (BMI greater than or equal to 30) should only gain 11 to 20 lb.during pregnancy 1 2.Excessive weight gain can increase the risk of gestational diabetes, hypertension, cesarean delivery, and postpartum weight retention 1.

Choice B rationale: 16 lb. is an acceptable weight gain for a client whose prepregnancy BMI was 30.5. This is within the recommended range of 11 to 20 lb.for obese women (BMI greater than or equal to 30) by the IOM guidelines 1 2.Adequate weight gain can help ensure optimal fetal growth and development, as well as maternal health 1.

Choice C rationale: 24 lb. is too much weight gain for a client whose prepregnancy BMI was 30.5. This exceeds the recommended range of 11 to 20 lb.for obese women (BMI greater than or equal to 30) by the IOM guidelines 1 2.Excessive weight gain can increase the risk of gestational diabetes, hypertension, cesarean delivery, and postpartum weight retention 1.

A. "Let me show you how to swaddle and cuddle him, then you try.” B. "I'll take him back to the nursery, so you can get some rest.” C. "If I turn him on his side, maybe he'll go back to sleep.” D. "Babies need to cry soon after they are born to develop their lungs.”

Correct Answer is A

Explanation

Choice A rationale:

The nurse should respond by offering to show the client how to swaddle and cuddle the newborn and then encourage the client to try it herself. This response promotes bonding between the mother and newborn and empowers the client to care for her baby, building her confidence and self-esteem.

Choice B rationale:

Taking the newborn back to the nursery without involving the mother does not support maternal-infant bonding and does not address the client's feelings of inadequacy. It is essential to encourage maternal involvement in infant care.

Choice C rationale:

Turning the newborn on his side without addressing the client's concerns does not provide emotional support or guidance on infant care. It is important to respond to the client's emotional needs and offer assistance in caring for the baby.

Choice D rationale:

Telling the client that babies need to cry to develop their lungs is not an appropriate response to the client's distress. It does not address the client's concerns or provide helpful guidance on caring for the newborn.

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A nurse is contributing to the plan of care for a client who reports insomnia due to increased stress.Which of the following interventions is the nurse's priority?

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A nurse is contributing to the plan of care for a client who reports insomnia due to increased stress.
Which of the following interventions is the nurse's priority?