The nurse assesses a client with a sleep pattern disturbance. In developing a plan of care, what assessment data should the nurse obtain first?

History of seasonal allergies and nasal congestion.

Amount and type of caffeinated drinks before bedtime.

Urinary frequency and episodes of nocturia.

Usual bed time and time of awakenings.

Answer and Explanation

The Correct Answer is D

A.   A history of seasonal allergies and nasal congestion can affect sleep quality due to discomfort or breathing difficulties. While this information is relevant for identifying possible physical factors that might influence sleep, it is not the first piece of data to obtain when trying to understand the overall sleep pattern.
B.   The consumption of caffeinated drinks before bedtime can significantly impact sleep quality. Caffeine is a stimulant that can disrupt sleep patterns and contribute to difficulty falling asleep. This assessment is important, but it should follow an initial understanding of the client’s overall sleep schedule and habits to determine how much caffeine might be affecting their sleep.
C.   Urinary frequency and nocturia (waking up frequently to urinate during the night) can interfere with sleep and contribute to disturbances. This information is valuable for identifying potential causes of disrupted sleep but is typically assessed after understanding the client’s basic sleep patterns and schedule.
D.   Understanding the client’s usual bedtime and time of awakenings provides essential information about their sleep schedule and overall sleep patterns. This data is crucial as it establishes a baseline for assessing the client’s sleep routine and helps identify any deviations or irregularities in their sleep behavior.

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Correct Answer is A

Explanation

A. Intense physical exercise, particularly when combined with a low body mass index, can lead to
amenorrhea. This condition, often referred to as "athletic amenorrhea," occurs due to the body’s response to excessive physical stress and insufficient fat stores. A low BMI combined with high levels of physical activity can disrupt the hormonal balance necessary for regular menstrual cycles.
B. While certain types of IUDs (especially hormonal ones) can cause changes in menstrual patterns, they are not typically associated with the same degree of amenorrhea as seen with significant weight loss or low BMI. The timeline of one month after IUD insertion is relatively short for such significant changes to occur solely due to the device, making it a less likely cause of the client’s amenorrhea in this context.
C. Chronic UTIs generally do not affect menstrual cycles or cause amenorrhea. They are more likely to result in symptoms related to the urinary system rather than hormonal imbalances that influence menstrual cycles.
D. Increased calcium intake is generally associated with positive health benefits, including bone health, but it is not typically linked to amenorrhea. Calcium intake alone, especially if it is not accompanied by other significant dietary or lifestyle changes, is unlikely to be a contributing factor to amenorrhea.

Correct Answer is ["20"]

Explanation

The standard distance for a visual acuity test using the Snellen chart is 20 feet. This distance allows for an accurate assessment of how well a person can see the details of the letters on the chart, which is a common method used by eye doctors to measure visual acuity.

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The nurse assesses a client with a sleep pattern disturbance. In developing a plan of care, what assessment data should the nurse obtain first?

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Correct Answer is A

Explanation

The nurse is assessing the visual acuity of a client who reports changes in vision. How many feet away from the Snellen chart should the client stand? (Enter a whole number only.)

Correct Answer is ["20"]

Explanation

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