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 B

Explanation

A. If the apical impulse is more vigorous than expected, it may indicate an abnormal finding, such as hyperdynamic circulation or heart failure. The nurse should not simply record this without further investigation.
B. It is important to investigate whether the client has a history of heart disease, as conditions like left ventricular hypertrophy, heart failure, or valvular heart disease could cause changes in the apical impulse. This provides context for understanding the findings.
C. Obtaining the client’s blood pressure is important in assessing cardiovascular health, but the most immediate response to a more vigorous apical impulse would be to explore the potential cause, including heart disease, rather than simply measuring blood pressure.
D. Comparing the apical pulse to the carotid pulse may help assess if the increased pulse force is generalized or localized, and whether it might be a sign of circulatory changes. This would help clarify whether the finding is normal or indicative of pathology.

A. "Refrain from eating or drinking for at least thirty minutes." B. "Lie in a prone position with slightly flexed knees." C. "Exhale slowly through your mouth then hold your breath." D. "Empty your bladder just prior to the examination."

Correct Answer is D

Explanation

A. The client should refrain from eating or drinking for other procedures but not specifically for an abdominal examination unless indicated for tests like ultrasounds.
B. A prone position is not necessary for an abdominal exam; lying on the back is preferred.
C. The client should not hold their breath during the abdominal exam unless asked to assist with specific maneuvers.
D. Having the bladder empty before the examination reduces discomfort and allows for better visualization of the abdominal organs.

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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

During the precordium assessment, the nurse palpates the apical impulse of a client on the 5th intercostal space left mid-clavicular line. The pulse is more vigorous than expected. Which action should the nurse take in response to this finding?

Correct Answer is B

Explanation

When preparing a female client for an abdominal examination, the nurse should provide her with which instruction?

Correct Answer is D

Explanation

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