An adult male client tells the nurse that he smokes approximately one pack of cigarettes daily. How can the nurse expect smoking to affect this client's sleep?

Decrease the need for rapid eye movement (REM) sleep.

He would sleep soundly during the first half of the night, with increased arousals during the second half.

Increase sleep latency, and reduce total sleep time.

He would have difficulty falling to sleep, and sleep very lightly with more frequent arousals.

Answer and Explanation

The Correct Answer is C

A.   Nicotine’s impact on REM sleep is not as direct as this option suggests. REM sleep can be reduced, but
it is not directly linked to a decreased need for REM sleep.
B.   This option may be true for some individuals, but smoking typically causes disruptions throughout the night, not just in the second half.
C.   Smoking has been shown to increase sleep latency (the time it takes to fall asleep) and reduce total sleep time due to nicotine’s stimulant effect and withdrawal symptoms during sleep.
D.   Difficulty falling asleep and light sleep with frequent arousals are common effects of smoking due to
nicotine’s stimulant properties and withdrawal during the night.

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Correct Answer is D

Explanation

A. Absent deep tendon reflexes are not typically associated with nailbed clubbing. While reflexes may be diminished in some conditions, they are not commonly related to the pathophysiology behind clubbing.
B. A capillary refill time of less than 3 seconds is a normal finding and does not align with clubbing, which often indicates chronic hypoxia or systemic conditions such as heart or lung disease.
C. Peripheral dependent edema refers to swelling in the lower extremities, which can be associated with circulatory problems, but it is not directly linked to nailbed clubbing. Edema is more common in conditions like heart failure or kidney disease.
D. A low oxygen saturation of 85% is consistent with conditions that cause chronic hypoxia, such as chronic lung disease or congenital heart disease. Chronic low oxygen levels can lead to nailbed clubbing as a compensatory response to inadequate oxygenation.

A. The right pupil constricts and the left consensually responds. B. Both pupils are equal in size and constrict readily to the light source. C. Bilateral pupil size changes as the distance of the light source varies. D. The left iris is "notched" and the pupil size changes minimally.

Correct Answer is D

Explanation

A. This is a normal finding where the right pupil constricts when the light is directed at it, and the left pupil constricts consensually as well. This suggests normal function of the pupillary light reflex pathway, and no further evaluation is needed.
B. This also indicates normal pupillary function. Equal pupil size and appropriate constriction to light are typical findings, suggesting no immediate issues with the nervous system.
C. Pupil size should not change in response to distance unless there is a near response (accommodation). If the pupil size changes to distance of the light source instead of light reflex, this suggests potential abnormality in the pupillary reflex response.
D. This is an abnormal finding. A "notched" iris suggests possible damage or congenital anomalies, and minimal change in pupil size may indicate impaired pupil reflexes, requiring further evaluation to rule out neurological or ophthalmologic issues.

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An adult male client tells the nurse that he smokes approximately one pack of cigarettes daily. How can the nurse expect smoking to affect this client's sleep?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse assesses that a client has nailbed clubbing. Which additional information is consistent with this finding?

Correct Answer is D

Explanation

While conducting a physical assessment, the nurse shines a pen light into a client's right eye and moves the light source to check the client's left eye. Which finding indicates the need for further evaluation?

Correct Answer is D

Explanation

The nurse is performing oral inspection of a client with dark pigmented skin. The nurse observes a patchy discoloration of the buccal mucosa. Which action should the nurse take?

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