A nurse is collecting data on a client who reports acute pain at a level of 7 on a scale of 0 to 10. Which of the following findings should the nurse expect?
Bradycardia.
Decreased respiratory rate.
Hypoglycemia.
Hypertension.
The Correct Answer is D
Choice A rationale:
Bradycardia, a slow heart rate, is not typically associated with acute pain. In response to pain, the body usually experiences increased heart rate (tachycardia) as part of the stress response.
Choice B rationale:
A decreased respiratory rate is not an expected finding in response to acute pain. Acute pain often leads to increased respiratory rate as the body attempts to manage the pain and stress.
Choice C rationale:
Hypoglycemia, a low blood sugar level, is not a typical physiological response to acute pain. Acute pain is more likely to induce a release of stress hormones, such as cortisol and adrenaline, which can lead to increased blood sugar levels.
Choice D rationale:
Hypertension, or elevated blood pressure, is an expected physiological response to acute pain. Pain activates the body's stress response, leading to increased sympathetic nervous system activity, which can cause vasoconstriction and increased blood pressure. This response helps prepare the body to cope with the pain and stress. Monitoring blood pressure in a client reporting acute pain is essential to assess the impact of pain and determine appropriate pain management strategies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
There are three types of sleep apnea: obstructive, central, and mixed complex. Obstructive apnea is the most common type. It is caused by the relaxation of the soft tissues, which allows partial to total obstruction of the airway. (True or False) = The correct answer is True.
Choice A rationale:
True. Obstructive sleep apnea is indeed the most common type. It occurs when the soft tissues in the throat and the muscles of the upper airway relax too much during sleep, leading to a partial or complete blockage of the airway. This obstruction results in the characteristic pauses in breathing that are a hallmark of obstructive sleep apnea.
Choice B rationale:
False. Obstructive sleep apnea is not caused by the need for hypnotics or sleep-inducing medications. It is a physiological condition related to airway obstruction during sleep and not a result of poor sleep hygiene or a lack of medication.
Choice C rationale:
False. While it's true that older adults may have changes in their sleep patterns, this doesn't mean they require 10 hours of sleep a day to prevent fatigue. Sleep needs can vary among individuals, and older adults often experience more fragmented sleep and may nap during the day, but the requirement for 10 hours of sleep a day is not a general rule.
Choice D rationale:
False. Older adults may nap more during the day due to changes in their sleep patterns, but it doesn't necessarily mean they need to nap less to sleep better at night. The sleep-wake cycle of older adults may be different from younger individuals, and it's not always necessary for them to reduce daytime napping to improve nighttime sleep.
Correct Answer is A
Explanation
Choice A rationale:
The nurse recommends that normal sleep and rest patterns can best be acquired by suggesting that the patient exercises in the mornings. Morning exercise can help regulate the circadian rhythm and improve sleep-wake patterns. It helps to reset the internal body clock, making it easier to fall asleep at night. However, exercise should not be too close to bedtime, as it may have a stimulating effect.
Choice B rationale:
Taking a nap during the day may provide a short-term boost in alertness but is not recommended as the primary method to acquire normal sleep and rest patterns. Daytime naps should be brief (20-30 minutes) and should not interfere with nighttime sleep. Excessive daytime napping can disrupt the regular sleep cycle.
Choice C rationale:
Drinking wine is not a recommended approach for acquiring normal sleep and rest patterns. Alcohol consumption, especially in the evening, can disrupt sleep cycles and negatively affect the quality of sleep. It may lead to frequent awakenings during the night and contribute to sleep disturbances.
Choice D rationale:
Smoking cigarettes is not a recommended approach for acquiring normal sleep and rest patterns. Nicotine is a stimulant that can interfere with sleep by increasing alertness and heart rate. Smoking can contribute to sleep difficulties and should be avoided, especially close to bedtime. .
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