An older adult client reports not being able to sleep due to a recent leg injury. Which factor(s) will the nurse assess as a source of the insomnia? (Select All that Apply.)

cultural factors

level of pain

eating habits

expectations for recovery

medications that could interfere with sleep

Answer and Explanation

Correct Answer : B,D,E

A. Cultural factors:

Cultural factors can influence sleep patterns and behaviors, such as bedtime routines, sleep hygiene practices, and beliefs about sleep. However, in this scenario where the client's reported sleep disturbance is directly linked to a recent leg injury, cultural factors might have less direct relevance compared to other factors like pain or medications.

B. Level of pain:

Pain is a common cause of insomnia, particularly in cases where there is a recent injury. Pain can make it difficult for individuals to find a comfortable sleeping position or to relax enough to fall asleep. Assessing the level and nature of pain is crucial in addressing sleep disturbances in this context.

C. Eating habits:

While eating habits can influence overall health and well-being, they might have less immediate impact on sleep disturbances related to a recent leg injury. However, certain dietary factors, such as consuming caffeine or heavy meals close to bedtime, could exacerbate insomnia. It's still important to consider eating habits as part of a comprehensive assessment, but they might not be the primary focus in this scenario.

D. Expectations for recovery:

The client's expectations for recovery can influence their emotional state and overall psychological well-being, which in turn can impact sleep patterns. Anxiety, uncertainty, or unrealistic expectations about recovery may lead to increased stress and difficulty sleeping. Assessing the client's expectations and addressing any concerns or misconceptions can be essential in managing insomnia related to a recent injury.

E. Medications that could interfere with sleep:

Certain medications, such as pain relievers, muscle relaxants, or steroids prescribed for managing the leg injury, may have side effects that interfere with sleep. It's important to review the client's medication regimen to identify any potential sleep-disrupting drugs and consider adjustments or alternative medications if appropriate.

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Correct Answer is C

Explanation

A. Ensure that medical treatments comply with cultural expectations:

- This choice suggests the importance of aligning medical treatments with the cultural expectations of patients. While it's crucial to consider cultural factors when providing healthcare, the primary goal is not just to comply with cultural expectations, but rather to ensure that care is effective, respectful, and aligned with the individual's values and preferences within their cultural context.

B. Increase compliance among minority clients:

- This choice implies a focus on increasing adherence or compliance with medical recommendations among minority clients. While improving compliance is an important aspect of healthcare delivery, it should not be the sole focus when considering cultural factors. Instead, understanding culture should aim to provide culturally competent care that respects the beliefs, values, and preferences of minority clients, thereby fostering trust, engagement, and better health outcomes.

C. Provide individualized and culturally sensitive care:

- This choice accurately reflects the essence of understanding culture in healthcare. Providing individualized and culturally sensitive care involves recognizing and respecting the unique cultural backgrounds, beliefs, values, and preferences of each patient. It emphasizes the importance of tailoring care to meet the specific needs and preferences of diverse older adults within their cultural context, thereby promoting effective communication, engagement, and trust in the healthcare provider.

D. Ensure that clients get the respect customary in their own ethnic group:

- While ensuring respect for clients is indeed important, focusing solely on the respect customary in their own ethnic group may overlook the diversity of cultural backgrounds and preferences within that group. Understanding culture in healthcare goes beyond adherence to specific customs or norms and involves recognizing and respecting the individuality and diversity of each patient's cultural background and preferences. Therefore, while respect is important, the broader goal is to provide individualized and culturally sensitive care that respects the unique cultural perspectives and preferences of each patient.

A. A 78-year-old client's stomach pH is increased. B. A 71-year-old client's echocardiogram reveals slight left ventricular hypertrophy. C. A 78-year-old client has recently developed urinary incontinence D. An 81-year-old client's glomerular filtration rate (GFR) is decreased.

Correct Answer is D

Explanation

A. A 78-year-old client's stomach pH is increased.

An increased stomach pH could indicate a disruption in gastric acidity levels, which may be associated with various gastrointestinal conditions or medications. While it could be a normal variation in some cases, especially considering age-related changes, an increased stomach pH might also suggest underlying issues such as hypochlorhydria or certain medications' effects. Further investigation may be warranted to determine the cause and potential implications of this finding, especially if it's persistent or associated with symptoms.

B. A 71-year-old client's echocardiogram reveals slight left ventricular hypertrophy.

Left ventricular hypertrophy (LVH) is a common finding, particularly in older adults with hypertension or other cardiovascular risk factors. While slight LVH might not always be clinically significant, it could indicate underlying cardiac abnormalities or increased cardiovascular risk. However, it's important to note that echocardiographic findings need to be interpreted in conjunction with the patient's clinical history and other cardiac assessments to determine the significance of the finding and the need for further investigation.

C. A 78-year-old client has recently developed urinary incontinence.

Urinary incontinence is a common problem in older adults and can have various causes, including urinary tract infections, neurological disorders, medication side effects, or pelvic floor dysfunction. While it is important to assess and address urinary incontinence, particularly considering its impact on quality of life, it may not always warrant immediate further investigation unless it's associated with other concerning symptoms or complications that require assessment or treatment.

D. An 81-year-old client's glomerular filtration rate (GFR) is decreased.

A decreased glomerular filtration rate (GFR) is indicative of impaired kidney function and may suggest underlying kidney disease or other systemic conditions affecting renal function. This finding warrants further investigation to determine the cause and severity of kidney dysfunction, assess for associated complications, and guide appropriate management. Further evaluation may include additional renal function tests, imaging studies, or referral to a nephrologist for specialized care.

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An older adult client reports not being able to sleep due to a recent leg injury. Which factor(s) will the nurse assess as a source of the insomnia? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A nurse is providing care to several clients. The nurse reviews each client's diagnostic and assessment findings. Which result would warrant the nurse to investigate further?

Correct Answer is D

Explanation

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