For the client with obstructive sleep apnea (OSA), the nurse should expect the following findings:

Choice A reason: Moderate fatigue typically encourages sleep as the body naturally seeks rest to recover. However, if fatigue is excessive, it might lead to an overtired state where the patient finds it difficult to relax and fall asleep. Normal ranges of physical activity and resulting fatigue can actually promote better sleep patterns by helping to regulate the body's natural sleep-wake cycle.

Choice B reason: The ability to talk about the day's events can be therapeutic and help in reducing stress levels. It allows the patient to process emotions and experiences, potentially leading to a calmer state of mind which is conducive to sleep. This is particularly true if the conversation is positive or neutral rather than rehashing stressful or traumatic events.

Choice C reason: The presence of pain is a significant factor that can disrupt sleep. Pain can make it difficult for a person to find a comfortable position for sleep, and it can cause frequent awakenings or prevent the patient from falling asleep altogether. Pain management should be a priority in patient care, especially at night, to facilitate better sleep. For instance, arthritis pain can be particularly disruptive due to joint discomfort, and addressing this with appropriate pain relief can greatly improve sleep quality.

Choice D reason: While unfamiliar stimuli can disrupt sleep, their absence is not typically a factor that would negatively affect sleep patterns. In fact, a lack of unfamiliar stimuli, meaning a quiet and consistent environment, is generally beneficial for sleep as it reduces the chances of disturbances.

Choice A reason: Not wearing artificial nails during client care is a recommended practice to prevent the spread of infection, as artificial nails can harbor bacteria.

Choice B reason: Washing hands when they are visibly dirty is correct, but hand hygiene should also be performed at other times, such as before and after patient contact, regardless of the appearance of cleanliness.

Choice C reason: Changing gloves is not a substitute for hand washing. Hand hygiene is necessary before donning gloves and after removing them to prevent the transmission of pathogens.

Choice D reason: Using alcohol-based hand products is a standard practice in healthcare settings and is effective in killing most bacteria and viruses when the hands are not visibly soiled.