A nurse is teaching a client about the sleep-wake cycle. The nurse should include that which of the following factors can interfere with the sleep-wake cycle? (Select All that Apply)

A bright light

Drinking caffeinated beverages in the evening

A 20 min nap during the day

Emotional stress

A regular bedtime schedule

Answer and Explanation

Correct Answer : A,B,C,D

A) Bright light: Exposure to bright light, especially in the evening or at night, can interfere with the body's production of melatonin, a hormone that regulates the sleep-wake cycle. Bright light exposure can disrupt circadian rhythms, making it more challenging to fall asleep and stay asleep.

B) Drinking caffeinated beverages in the evening: Caffeine is a stimulant that can interfere with sleep by blocking the effects of adenosine, a neurotransmitter that promotes sleepiness. Consuming caffeinated beverages in the evening can delay the onset of sleep and reduce overall sleep duration.

C) A 20-minute nap during the day: While short naps can be beneficial for some individuals, especially if they are sleep-deprived, napping for too long or too late in the day can disrupt the body's natural sleep-wake cycle. Short naps can be refreshing, but longer or late-day naps can make it harder to fall asleep at night.

D) Emotional stress: Stress and anxiety can trigger the body's "fight or flight" response, leading to increased alertness and difficulty relaxing or falling asleep. Chronic stress can disrupt the sleep-wake cycle, leading to difficulty initiating or maintaining sleep and resulting in poor sleep quality.

E) A regular bedtime schedule: Having a consistent bedtime schedule can actually help regulate the sleep-wake cycle by reinforcing the body's internal clock. Going to bed and waking up at the same time each day, even on weekends, can help improve sleep quality and make it easier to fall asleep and wake up naturally.

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Correct Answer is ["B","D","E"]

Explanation

A. Prime the blood tubing with dextrose 5% in water:
Priming the blood tubing with dextrose 5% in water is not appropriate for a blood transfusion. Blood tubing should be primed with normal saline, not dextrose solutions, to prevent hemolysis of the blood components.
B. Check vital signs before transfusion:
Before initiating a blood transfusion, it's essential to assess the client's vital signs, including temperature, pulse, respiratory rate, and blood pressure. Monitoring vital signs before, during, and after the transfusion helps identify any adverse reactions promptly.
C. Insert an IV with a 13-gauge needle:
Using a 13-gauge needle for IV insertion is not appropriate for a blood transfusion. Typically, a smaller gauge needle, such as 18 or 20 gauge, is used for venous access during a blood transfusion to minimize discomfort and reduce the risk of hemolysis.
D. Transfuse the blood product within 5 hr after removing it from refrigeration:
Blood products should be transfused within a specific timeframe after removal from refrigeration to minimize the risk of bacterial growth and subsequent infection. Typically, this timeframe is within 4 hours for packed red blood cells and within 24 hours for platelets. Adhering to the recommended timeframe ensures the safety and efficacy of the transfusion.
E. Check the expiration date of the blood product with a second nurse:
Verifying the expiration date of the blood product with a second nurse or healthcare provider is a crucial step to ensure patient safety and prevent the administration of expired blood products. This double-check process helps mitigate the risk of administering outdated or expired blood components.

A. A client who has had a cerebrovascular accident B. A client who has had radiation therapy for head and neck cancer C. A client who is 4 hr postoperative following a leg amputation with general anesthesia D. A client who has lactose intolerance E. A client who has had prolonged diarrhea

Correct Answer is ["A","B","C"]

Explanation

A) A client who has had a cerebrovascular accident:
Clients who have had a cerebrovascular accident (stroke) often suffer from dysphagia (difficulty swallowing) due to impaired muscle control or sensory deficits. This makes them more susceptible to aspiration, as food or liquid can enter the airway instead of the esophagus.

B) A client who has had radiation therapy for head and neck cancer:
Radiation therapy in the head and neck area can cause damage to tissues, leading to mucositis, fibrosis, and reduced salivary flow, all of which can impair swallowing function. This increases the risk of aspiration because the normal mechanisms that protect the airway during swallowing may be compromised.

C) A client who is 4 hr postoperative following a leg amputation with general anesthesia:
General anesthesia can depress the gag and cough reflexes and impair coordination of the muscles involved in swallowing, making it more difficult for the client to protect their airway. This increased risk of aspiration is particularly relevant in the immediate postoperative period when the effects of anesthesia may still be present.

D) A client who has lactose intolerance:
Lactose intolerance primarily affects the digestive system and does not directly impact the mechanics of swallowing or increase the risk of aspiration. This condition leads to gastrointestinal symptoms such as bloating, diarrhea, and abdominal pain when consuming lactose-containing foods, but it does not increase the risk of food or liquid entering the airway during eating.

E) A client who has had prolonged diarrhea:
Prolonged diarrhea can lead to dehydration and electrolyte imbalances, but it does not directly affect the swallowing mechanism or increase the risk of aspiration. The primary concern with prolonged diarrhea is fluid and electrolyte management rather than an increased risk of aspiration during eating.

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A nurse is teaching a client about the sleep-wake cycle. The nurse should include that which of the following factors can interfere with the sleep-wake cycle? (Select All that Apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning to perform a blood transfusion for a client. Which of the following actions should the nurse plan to take? (Select all that apply)

Correct Answer is ["B","D","E"]

Explanation

A nurse is caring for a group of clients. Which of the following clients should the nurse identify as having an increased risk of aspiration while eating? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

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A nurse is assessing a client who has diabetes mellitus and reports foot pain. The nurse should evaluate the client for which of the following alterations as Indications that the client has an infection? (Select all that apply)

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A nurse manager is observing an AP applying wrist restraints for a client. Which of the following actions should the nurse identify as an indication that the AP understands the procedure?

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