A nurse is caring for a client who is receiving inpatient treatment for an eating disorder. The client states, "I just can't sleep soundly here because It's too noisy." Which of the following actions should the nurse take?

Recommend that the client try to sleep during the day when it is quieter.

Keep conversations and activities to a minimum during the nighttime.

Turn on the client's television at night to cover up environmental noises.

Tell the client that they will eventually get used to people talking at night.

Answer and Explanation

The Correct Answer is B

A.   Encouraging the client to sleep during the day disrupts the natural sleep-wake cycle and may not address the underlying issue of noise disturbances at night.

B.   Minimizing conversations and activities during the nighttime promotes a quieter environment conducive to sleep, addressing the client's concern directly.
C.   Using a television to cover up noise may not address the root cause of the client's sleep disturbance and could interfere with sleep hygiene.
D.   Dismissing the client's concern and suggesting they will eventually get used to the noise does not address the immediate issue or offer practical solutions.

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Correct Answer is D

Explanation

A. The provider must renew the prescription for restraints every 4 hours for adults, not every 8 hours.
B. A staff member should check on the client every 15 minutes, not every 30 minutes, to ensure safety.
C. The client should be assessed for toileting needs every 2 hours, not every 15 minutes.
D. Offering hydration and nutrition every 2 hours is appropriate to maintain the client’s basic needs while in restraints.

A. Report the information to local authorities. B. Avoid reporting the information provided by the client because it is confidential. C. Tell risk management about the client's plan to hurt their partner. D. Notify the provider that the client should stay longer at the facility to work on anger management.

Correct Answer is A

Explanation

A. Safety is paramount, and if a client expresses intent to harm someone, it must be taken seriously and reported to local authorities to prevent harm and ensure the safety of the potential victim.
B. Confidentiality is important, but when there is a threat to harm others, the duty to warn and protect overrides confidentiality.
C. While informing risk management may be appropriate in some situations, when there is an imminent threat of harm, immediate action is necessary, which includes reporting to local authorities.
D. Delaying discharge to work on anger management may not be sufficient to ensure the safety of the potential victim. Reporting the threat to local authorities is necessary to prevent harm.

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A nurse is caring for a client who is receiving inpatient treatment for an eating disorder. The client states, "I just can't sleep soundly here because It's too noisy." Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an adult client who has been placed in physical restraints due to aggressive behavior. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is caring for a client who has antisocial personality disorder and reports planning to hurt their partner upon discharge. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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