A nurse is caring for a client in an outpatient clinic.

Exhibits

Select the 2 findings the nurse should identify as factors that may interfere with the client's sleep.

Caffeine use

Evening meal

Use of electronic devices

Exercise schedule

Bedtime Medications

Answer and Explanation

Correct Answer : A,C

A.   Caffeine is a stimulant and can interfere with sleep, especially if consumed in the afternoon or evening. It can lead to difficulty falling asleep and disrupt the sleep cycle.
B.   While heavy meals close to bedtime can cause discomfort or indigestion, a light evening meal generally does not significantly interfere with sleep for most individuals.
C.   The use of electronic devices, particularly before bedtime, can interfere with sleep due to the blue light emitted by screens. This light can suppress the production of melatonin, a hormone that helps regulate sleep.
D.   Regular exercise generally promotes better sleep. However, vigorous exercise close to bedtime may interfere with sleep due to the increase in adrenaline, but this is not always the case.
E.   The medications taken by the individual do not interfere with sleep.

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Correct Answer is C

Explanation

A. Hypotension is a concern but may occur for various reasons and is not as immediately life-threatening as dyspnea.

B. Tachycardia can indicate a problem but is less urgent than respiratory distress.

C. Dyspnea is the priority as it may indicate a recurrence of pulmonary embolism or another life-threatening respiratory issue.

D. A dry cough is a less urgent symptom and does not require immediate reporting.

A. Place the client in an upright position leaning over a bedside table. B. Inform the client they will be sedated for the procedure. C. Obtain informed consent from the client. D. Explain that a needle will be inserted in the pleural space to withdraw fluid. E. Administer a cough suppressant to the client prior to the procedure. F. Inform the client that they will need to fast 4 hr prior to the procedure.

Correct Answer is ["A","C","D","E"]

Explanation

A. Place the client in an upright position leaning over a bedside table – This position allows for optimal access to the pleural space and facilitates gravity-assisted drainage of pleural fluid.

B. Inform the client they will be sedated for the procedure – Thoracentesis is typically performed under local anesthesia, not sedation, unless the client has specific complications or needs.

C. Obtain informed consent from the client – Thoracentesis is an invasive procedure, and informed consent is required to ensure the client understands the risks, benefits, and alternatives.

D. Explain that a needle will be inserted in the pleural space to withdraw fluid – Providing a clear explanation of the procedure helps reduce anxiety and ensures the client understands what to expect.

E. Administer a cough suppressant to the client prior to the procedure – A cough suppressant can help prevent the client from coughing during the procedure, reducing the risk of complications such as needle displacement or injury.

F. Inform the client that they will need to fast 4 hr prior to the procedure – Fasting is not required for a thoracentesis. This procedure is usually performed with the client awake and does not involve general anesthesia.

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A nurse is caring for a client in an outpatient clinic. Exhibits Select the 2 findings the nurse should identify as factors that may interfere with the client's sleep.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who is postoperative and has a history of pulmonary embolism. Which of the following findings is the priority for the nurse to report to the provider?

Correct Answer is C

Explanation

A nurse working in the emergency department (ED) is admitting a client. Exhibits The nurse is preparing the client for a thoracentesis. Select the 4 actions that the nurse should take.

Correct Answer is ["A","C","D","E"]

Explanation

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A nurse is caring for a client in an outpatient clinic.

Exhibits

Select the 2 findings the nurse should identify as factors that may interfere with the client's sleep.