A nurse is caring for a client in an outpatient clinic
Select the 2 findings the nurse should identify as factors that may interfere with the client's sleep
Bedtime
Use of chronic devices
Evening meal
Medication
Caffeine use
Exercise schedule
Correct Answer : C,F
A. Bedtime: The client’s bedtime of 2330 has remained unchanged despite the shift in work hours, providing some stability to the circadian rhythm. A consistent bedtime typically supports sleep regulation rather than disrupting it. Although the new routine may affect sleep pressure, the bedtime is not the primary contributor to the new difficulties falling asleep.
B. Use of chronic devices: The client turns off their phone at 2230, limiting blue-light exposure well before bedtime. There is no indication of prolonged screen use or other electronic stimulation that would interfere with melatonin release. With the device turned off an hour before bed, this factor is unlikely to be influencing the client’s disrupted sleep.
C. Evening meal: The client now eats dinner late in the evening after a 1200–2000 work shift, placing the meal close to their 2330 bedtime. Eating late can increase gastrointestinal activity and delay the body’s transition into restful sleep, contributing to both difficulty falling asleep and nighttime awakenings.
D. Medication: The client’s medications ethinyl estradiol/desogestrel and ferrous sulphate have remained consistent for months without changes in timing or dosage. These medications are not known to disrupt sleep when taken as prescribed and do not coincide with the recent onset of nighttime symptoms.
E. Caffeine use: Although the client now drinks 2 to 3 cups of coffee, it is consumed early in the morning and remains outside the usual window in which caffeine impacts nighttime sleep. Morning intake allows adequate time for caffeine metabolism before bedtime. The timing makes it a less significant factor in the client’s difficulties initiating and maintaining sleep.
F. Exercise schedule: The client exercises immediately after a shift that ends at 2000, pushing vigorous activity close to bedtime. Late-evening exercise can increase sympathetic activity and core body temperature, which can interfere with the body’s ability to relax and initiate sleep.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Treat mild to moderate depression: Chondroitin and glucosamine do not have antidepressant properties and are not indicated for the treatment of mood disorders. Their mechanism of action is focused on cartilage support, not neurotransmitter modulation or mood regulation.
B. Enhance the immune system: While some supplements may influence immune function, chondroitin and glucosamine are not used for immunomodulation. Their primary role is in musculoskeletal health rather than preventing infections or altering immune responses.
C. Prevent and treat prostate enlargement: These supplements have no effect on prostate tissue or hormonal pathways related to benign prostatic hyperplasia. They are not indicated for urinary or prostate health and do not prevent prostate enlargement.
D. Improve joint functioning: Chondroitin and glucosamine are commonly used to support cartilage structure, reduce joint pain, and improve mobility in conditions such as osteoarthritis. They help maintain joint integrity and may decrease symptoms associated with cartilage degeneration, promoting better overall joint function.
Correct Answer is D
Explanation
A. Blood pressure 94/68 mm Hg: While slightly on the lower end for a 7-year-old, mild hypotension may not yet be present in severe dehydration because children often maintain blood pressure until significant fluid loss occurs. Blood pressure alone is not the earliest or most sensitive indicator of severe dehydration.
B. Urinary output 30 mL/hr: Normal urinary output for a child is approximately 1 mL/kg/hr. A child with severe dehydration typically has markedly reduced urine output (oliguria), so 30 mL/hr is still be within a low-normal range depending on the child’s weight
C. Respiratory rate 24/mn: This respiratory rate is within normal limits for a 7-year-old (approximately 18–25 breaths/min). It does not reflect compensation for dehydration or hypovolemia and is not a reliable indicator of severe fluid loss.
D. Heart rate 152/min: Tachycardia is an early and sensitive sign of hypovolemia in children. A heart rate of 152/min is significantly elevated for a 7-year-old, indicating compensatory mechanisms to maintain perfusion in response to severe dehydration.
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