The home health nurse is visiting an older adult client whose caregiver reports that the client has been anxious and disoriented in the morning. The caregiver also informs the nurse that the client gets up frequently to use the bathroom during the night. The client's current medications include hydralazine 75 mg by mouth daily, furosemide 40 mg by mouth daily, and potassium chloride 20 mEq by mouth daily. Which recommendation will the nurse provide the caregiver to decrease the disruption of sleep?

Offer the client iced tea before bed.

Suggest the client sleep without socks.

Have the client take a diuretic in the morning.

Encourage the client to take frequent naps during the day

Answer and Explanation

The Correct Answer is C

A. Offering iced tea before bed is not appropriate because tea contains caffeine, which can further disrupt sleep.
B. Sleeping without socks has no relevance to sleep disruption related to nocturia (frequent urination at night).
C. Having the client take a diuretic (furosemide) in the morning is the most appropriate intervention. Diuretics increase urine output, and taking them later in the day can lead to nocturia, which disrupts sleep and may contribute to confusion or disorientation in older adults.
D. Encouraging frequent naps during the day can interfere with the client’s nighttime sleep pattern, potentially worsening insomnia or nighttime disorientation.

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Correct Answer is B

Explanation

A. While loneliness can contribute to distress, the specific behaviors observed (excessive religious reading, crying, and poor sleep) suggest something deeper than just social isolation.
B. These behaviors are signs of spiritual distress, which may occur when a person is facing a serious illness or surgery and is struggling with questions of meaning, faith, or fear. Spiritual distress can manifest emotionally and behaviorally, as seen here.
C. While some anxiety is expected before major surgery, persistent emotional signs like excessive crying and poor sleep, along with intense religious focus, indicate more than normal preoperative nerves.
D. Labeling the client as “naturally emotional” is an assumption and dismisses the need for assessment and appropriate support.

A. Continue changing the dressing B. Open a new sterile dressing kit C. Wash the client's hands D. Restrain the client's hands

Correct Answer is B

Explanation

A. Continuing risks contamination and infection.
B. Opening a new sterile dressing kit is necessary because the sterility of the current kit has been compromised by the client's touch.
C. Washing the client’s hands is important but doesn’t restore sterility to the dressing kit.
D. Restraining without assessing safety or other options is not appropriate immediately.

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Naxlex Comprehensive Predictor Exams

client scheduled for complex heart surgery has been reading their religious text for hours each day, cries often, and is not sleeping well. What might these observations cue the nurse about the client?

Correct Answer is B

Explanation

The nurse is completing a sterile dressing change on a confused client. During the procedure, the client reaches down and touches the contents of the open dressing kit. What is the nurse's next action?

Correct Answer is B

Explanation

The nurse is creating a plan of care for an older adult client at risk for constipation. Which intervention by the nurse will decrease this risk?

The nurse determines that the student who has been instructed about lung function and smoking requires additional teaching when the student says

The nurse is disposing of an old dressing that is saturated with a client's blood. How should the nurse dispose of the dressing?

Which factor is the most important to consider when caring for clients with limited income?

A nurse is providing ongoing postoperative care to a client who has had knee surgery. The nurse assesses the dressing and finds it saturated with blood. The client is restless and has a rapid pulse. What should the nurse do next?

A new nursing graduate has made an error in documentation that led to an unexpected client outcome. When aiming to avoid future errors, which action should the nurse prioritize?

Although all of the following are factors that affect grief, which one is most likely to influence a person's expression of grief?