A nurse on a medical-surgical unit is caring for a postoperative client who reports difficulty sleeping due to noise. Which of the following interventions is appropriate for the nurse to implement?

Avoid entering the client's room unless requested during the night.

Turn off alarms on bedside monitoring equipment.

Conduct staff communications away from the client's room.

Turn on the client's TV to distract from hallway noise.

Answer and Explanation

The Correct Answer is C

Choice A Reason:

Avoid entering the client's room unless requested during the night is inappropriate. While minimizing entries can reduce disruptions, it's important for the nurse to perform necessary checks and care interventions. Avoiding the room completely might compromise the client's safety or care.

Choice B Reason:

Turn off alarms on bedside monitoring equipment is inappropriate. Disabling alarms can jeopardize patient safety as these alarms often indicate critical changes in the client's condition. Adjusting alarm settings or investigating if noise levels can be reduced without compromising safety would be more appropriate.

Choice C Reason:

Conduct staff communications away from the client's room is appropriate. This intervention helps minimize noise levels near the client's room, creating a quieter environment conducive to sleep. Staff conducting communications away from the room reduces unnecessary disturbances that might affect the client's rest.

Choice D Reason:

Turn on the client's TV to distract from hallway noise is inappropriate. Introducing more noise, such as from a TV, might not effectively address the issue of sleep disturbance due to external noise. Additionally, it's essential to respect the client's preferences, and some may prefer a quiet environment for sleep rather than additional noise from a TV.

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Correct Answer is D

Explanation

A. Devout practitioners of Buddhism prefer a ritual bath prior to burial.
Explanation: In Buddhism, the funeral customs can vary widely depending on the cultural and regional practices. Some Buddhists may prefer cremation, while others may choose burial. There isn't a strict requirement for a ritual bath, and practices can differ.

B. Devout practitioners of Judaism prefer to be buried 5 days after death.
Explanation: In Judaism, there is a tradition of burying the deceased as soon as possible, ideally within 24 hours. Waiting for 5 days is not consistent with Jewish burial practices.

C. Devout practitioners of Hinduism prefer to be buried after death and not cremated.
Explanation: In Hinduism, cremation is a common practice. Hindus believe in the cycle of reincarnation, and cremation is seen as a way to release the soul from the body. Burial is not a typical practice in Hinduism.

D. Devout practitioners of Islam prefer to have their heads turned toward Mecca at death.
Explanation: In Islam, it is a common practice to bury the deceased with their right side facing the Qiblah, which is the direction of the Kaaba in Mecca. This is part of the Islamic funeral rites.

A. Place the drainage system below the client's chest level. B. Loop excess tubing next to the client's side. C. Clamp the tubing when ambulating the client. D. Milk the client's tubing every shift.

Correct Answer is A

Explanation

Choice A Reason:

Placing the drainage system below the client's chest level is appropriate. This positioning allows for proper drainage and prevents the backflow of fluid or air into the chest. Maintaining the drainage system below the chest level helps ensure effective evacuation of air or fluid from the pleural space.

Choice B Reason:

Looping excess tubing next to the client's side is inappropriate. Looping excess tubing can create dependent loops, potentially causing fluid to accumulate in these areas and compromising the drainage system's effectiveness.

Choice C Reason:

Clamping the tubing when ambulating the client is inappropriate. Chest tube drainage systems should not be routinely clamped during ambulation. Clamping can lead to increased pleural pressure, potentially causing tension pneumothorax or other complications.

Choice D Reason:

Milking the client's tubing every shift is inappropriate. Milking or stripping the tubing is not recommended, as it can create a pressure gradient that may damage the lung tissue or disrupt the chest tube's seal. Passive drainage is preferred to maintain the negative pressure in the system.

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A nurse on a medical-surgical unit is caring for a postoperative client who reports difficulty sleeping due to noise. Which of the following interventions is appropriate for the nurse to implement?

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