A nurse is teaching a class about sources of stress. Which of the following is an example of a physiological stressor?

Choice A reason: Nitroglycerin is a vasodilator used to relieve angina by dilating coronary arteries, improving blood flow to the myocardium. Standard protocol advises taking one sublingual tablet every 5 minutes for up to three doses. If pain persists after three tablets (15 minutes), it may indicate a myocardial infarction, requiring immediate emergency intervention. This choice reflects correct understanding of the timing and action needed for unresolved angina.

Choice B reason: Taking one nitroglycerin tablet and immediately calling 911 if pain persists is incorrect, as it does not follow the standard protocol of administering up to three tablets at 5-minute intervals. This approach risks delaying necessary treatment, as a single dose may not suffice to relieve angina, and premature emergency calls without completing the protocol could lead to unnecessary interventions.

Choice C reason: Taking four nitroglycerin tablets over 20 minutes deviates from the standard protocol, which recommends three tablets at 5-minute intervals (total 15 minutes). Extending the duration or number of doses without seeking emergency care could delay critical treatment for a potential myocardial infarction, as persistent pain beyond three doses indicates a serious condition requiring immediate medical attention.

Choice D reason: Calling 911 immediately upon experiencing angina before taking nitroglycerin tablets is incorrect. The standard protocol involves administering nitroglycerin first to attempt pain relief, as angina may resolve with vasodilation. Immediate emergency calls without attempting the prescribed treatment could lead to unnecessary hospitalizations and overlook the medication’s potential to alleviate symptoms effectively.

Choice A reason: Exercise stimulates the sympathetic nervous system, increasing heart rate and adrenaline, which can delay sleep onset if performed close to bedtime. However, stopping exercise 2-3 hours before sleep is recommended, as 30 minutes may be insufficient to allow physiological arousal to subside, potentially disrupting sleep initiation.

Choice B reason: Removing the television from the bedroom reduces exposure to blue light, which suppresses melatonin production in the pineal gland, disrupting circadian rhythms. It also minimizes cognitive stimulation from engaging content, promoting a calm environment conducive to sleep, aligning with sleep hygiene principles for insomnia management.

Choice C reason: A warm bedroom can disrupt sleep, as the body’s core temperature naturally drops to initiate sleep, regulated by the hypothalamus. A cooler room (60-67°F) supports this process, enhancing melatonin release and sleep quality, whereas warmth may increase wakefulness and reduce deep sleep stages.

Choice D reason: A 1-hour nap can disrupt the sleep-wake cycle, reducing sleep pressure at night. Long naps decrease adenosine buildup, a key driver of sleepiness, worsening insomnia. Short naps (20-30 minutes) may be beneficial, but extended naps interfere with nocturnal sleep consolidation, exacerbating insomnia symptoms.