A client complains of an inability to sleep through the night since admission three days ago. Which of the following factors is most likely to negatively affect the patient's sleep patterns?

Moderate fatigue

Ability to talk about day's events

Presence of pain

Absence of unfamiliar stimuli

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is C

Explanation

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.

A. Droplet B. Airborne C. Contact D. Protective E. Protective

Correct Answer is B

Explanation

Choice A reason: Droplet precautions are used for diseases that are spread by large respiratory droplets produced by coughing, sneezing, or talking. Examples include influenza, pertussis, and mumps. However, tuberculosis is not spread through large droplets but through airborne particles that can remain suspended in the air for long periods.

Choice B reason: Airborne precautions are necessary for diseases that are transmitted by smaller droplets, which can be suspended in the air for extended periods and can be inhaled. Tuberculosis, particularly pulmonary or laryngeal tuberculosis with a productive cough, requires airborne precautions because the bacteria can be expelled into the air and inhaled by others. The nurse should initiate airborne precautions, which include placing the patient in a negative pressure room and using personal protective equipment such as N95 respirators.

Choice C reason: Contact precautions are used for infections that are spread by direct contact with the patient or the patient's environment. Examples include infections caused by multidrug-resistant organisms, scabies, and norovirus. Tuberculosis is not spread by direct contact, so contact precautions are not the primary method of prevention.

Choice D reason: Protective isolation, also known as neutropenic or reverse isolation, is used to protect immunocompromised patients from infections. It is not used for patients with tuberculosis, as the goal is to protect others from the tuberculosis bacteria, not to protect the patient from external infections.

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A client complains of an inability to sleep through the night since admission three days ago. Which of the following factors is most likely to negatively affect the patient's sleep patterns?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is B

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