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.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

A. Limited transportation is a barrier but secondary to more urgent needs.
B. Decreased access to healthcare is important but often results from unmet basic needs.
C. Basic human needs going unmet (such as food, shelter, and safety) is the most critical factor affecting overall health and well-being.
D. Increased disease risk is a consequence of unmet needs, making it less immediate than addressing basic needs first.

A. "Our personal beliefs and values have no effect on how we care for people." B. "It is important to see how any biases might impact our feelings about others." C. "Even if a treatment goes against the client's values, they have to have it." D. "Folk healers really can be a deterrent to a client's care."

Correct Answer is B

Explanation

A. Personal beliefs and values do affect how nurses provide care and must be acknowledged to provide culturally competent care.
B. Recognizing how personal biases can influence feelings and care is essential for developing cultural competence and providing respectful, individualized care.
C. Forcing treatments that conflict with a client’s values violates client autonomy and cultural respect.
D. Folk healers should be understood as part of a client’s cultural practice, not viewed as deterrents; respecting these practices supports holistic care.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is C

Explanation

A nurse manager is conducting an in-service education program for a group of staff nurses on developing cultural competence. The nurse manager determines that the educational program was successful based on which statement by the group?

Correct Answer is B

Explanation

A client asks a nurse to explain a living will. What is the nurse's best Answer?

A client verbalizes to a mental health counselor, "My life is meaningless since my spouse divorced me and that I no longer want to live." What nursing concern, resulting from the client's spiritual distress, is appropriate for care planning?

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?

A client returning to the floor after orthopedic surgery is reporting nausea. The nurse is aware that an appropriate intervention is to:

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 client has been prescribed a clear liquid diet. Which food or fluids should the nurse serve the client?

Which client is most at risk for foot difficulties?