Going to bed hungry or overly full does not interfere with sleep.

It helps the patient reach REM state of sleep faster.

The correct answer is D. "I will call for pain medication before the previous dose wears off."

Choice A rationale:

This statement indicates a misunderstanding of pain management. Avoiding medication to prevent addiction can lead to uncontrolled pain, which can hinder recovery and increase the risk of complications.

Choice B rationale:

While this statement shows the client is aware of their pain, waiting until it becomes intolerable can result in periods of severe discomfort and potential setbacks in recovery.

Choice C rationale:

Relying on a nurse to evaluate pain before requesting medication can delay pain relief, leading to unnecessary suffering and potential complications.

Choice D rationale:

This statement indicates an understanding of proactive pain management. By requesting medication before the previous dose wears off, the client helps maintain consistent pain control, which is crucial for recovery and preventing pain escalation.

Choice A rationale:

Taking a warm bath before trying to go back to sleep is a relaxation technique that may help with sleep but does not address the underlying causes of insomnia. It is more of a short-term coping strategy rather than a method for locating the reasons for the insomnia.

Choice B rationale:

Reviewing times in her life when she had no insomnia is not a practical approach to addressing the current issue of insomnia. It does not help in identifying the specific factors or triggers contributing to the patient's current sleep problems.

Choice C rationale:

Keeping a diary related to sleep and problems encountered is a practical and effective approach to identify the factors contributing to the patient's insomnia. This diary can help track patterns, such as bedtime routines, diet, stressors, and other variables that may be linked to the sleep problem. Identifying these factors can aid in developing a plan to address the specific causes of the insomnia.

Choice D rationale:

Discussing the problem with her friends may provide emotional support but is unlikely to help identify the root causes of the insomnia. Friends may offer advice or share their experiences, but a structured approach like keeping a sleep diary is more likely to yield valuable information.