A nurse is caring for a client who is having difficulty falling asleep. Which of the following interventions should the nurse implement to promote sleep for the client?
Offer the client a caffeinated beverage 3 hr before their bedtime.
Turn on the client's television before they go to bed.
Warm the temperature of the client's room before they go to bed.
Dim the lights in the client's room at bedtime.
The Correct Answer is D
A. Caffeine is a central nervous system stimulant that blocks adenosine receptors, which promote sleepiness. Consuming caffeinated beverages within several hours of bedtime can significantly delay sleep onset, reduce total sleep time, and fragment sleep cycles. For clients who have trouble falling asleep, caffeine intake should be avoided at least 4–6 hours before bedtime to prevent interference with natural sleep patterns.
B. Television, smartphones, and other electronic devices emit blue light that suppresses melatonin secretion, which is necessary for initiating and maintaining sleep. Additionally, the content viewed can be stimulating or stressful, further delaying the onset of sleep. Nurses should encourage clients to minimize screen exposure before bedtime.
C. Excessively warming the room can be disruptive because the body naturally lowers its core temperature to initiate sleep. A cooler, comfortable room temperature (around 18–21°C or 65–70°F) supports the body’s thermoregulation during sleep and promotes deeper, more restorative sleep cycles.
D. Dimming the lights at bedtime signals the brain that it is time to prepare for sleep by increasing melatonin production. This nonpharmacologic intervention helps the client transition from wakefulness to sleep, reduces environmental stimuli, and promotes relaxation. Other complementary interventions may include creating a quiet environment, using calming scents or music, and encouraging a consistent bedtime routine to strengthen the circadian rhythm.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. This statement indicates that the client’s comfort needs are not being fully met. It reflects dissatisfaction and a desire for better communication or attention from the healthcare team. This is not an indicator of comfort.
B. This statement reflects anxiety or anticipatory stress, showing that the client still has unresolved concerns. Effective comfort measures would aim to reduce such worry, so this does not indicate comfort.
C. This reflects frustration with responsiveness and suggests that the client is experiencing some discomfort or unmet needs. It does not indicate that comfort measures have been effective.
D. Feeling safe and supported is a core component of client comfort. Comfort interventions often focus on emotional support, reassurance, and creating a sense of security, in addition to physical relief. This statement demonstrates that the client’s needs have been addressed, and comfort has been successfully promoted.
Correct Answer is A
Explanation
A. Shift work disrupts the normal circadian rhythm, leading to irregular sleep patterns, altered eating habits, and metabolic changes. These disruptions increase the risk for insulin resistance and impaired glucose metabolism, which can contribute to the development of type 2 diabetes mellitus. Multiple studies have shown a higher prevalence of diabetes in individuals who perform night shifts or rotating shifts compared to those with consistent daytime schedules.
B. Central sleep apnea is caused by a failure of the brain to send appropriate signals to the respiratory muscles, often associated with heart failure, stroke, or opioid use. It is not specifically linked to shift work or circadian rhythm disruption.
C. While shift workers may experience excessive daytime sleepiness due to sleep deprivation or circadian misalignment, hypersomnia is a sleep disorder characterized by excessive sleep despite adequate sleep opportunities and is not a direct consequence of shift work. Shift work primarily causes circadian rhythm–related sleep disturbances rather than intrinsic hypersomnia.
D. RLS is a neurological disorder characterized by uncomfortable sensations in the legs with an urge to move them, often worse at night. It is not caused by shift work, although sleep disruption may exacerbate symptoms in individuals with preexisting RLS.
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