The nurse is assessing a client's sleep patterns. Which statement made by the client would require additional questioning by the nurse? "My partner tells me that:

I snore so loudly that I wake her up several times a night."

neither of us sleeps well after we have a big fight."

I sleep so soundly it's like waking the dead to get me up."

she's heard me tell jokes in my sleep."

Answer and Explanation

The Correct Answer is A

A. This statement suggests that the client may have sleep-disordered breathing, such as obstructive sleep apnea, which can disrupt the client's sleep patterns and affect their overall sleep quality. The nurse may want to inquire further about the frequency and severity of the snoring, as well as any associated symptoms such as daytime fatigue or observed pauses in breathing during sleep.
B. This statement indicates that emotional stressors, such as arguments or conflicts, may impact the client's sleep patterns. The nurse may want to explore how often these conflicts occur and how they affect the client's ability to fall asleep or stay asleep. Additionally, the nurse may inquire about coping strategies or interventions that the client and their partner use to address conflicts and minimize their impact on sleep.
C. This statement suggests that the client experiences deep or heavy sleep, which may or may not be problematic depending on the context. While deep sleep can be indicative of good sleep quality, it may also raise concerns about the client's ability to awaken in the event of an emergency or the presence of a sleep disorder such as hypersomnia. The nurse may want to inquire further about the client's overall sleep duration, sleep latency, and any difficulties with waking up in the morning.
D. This statement suggests that the client may experience sleep talking, which is a common sleep phenomenon. While sleep talking itself is typically benign, it may indicate underlying sleep disturbances such as sleep fragmentation or abnormal sleep cycles. The nurse may want to ask additional questions to assess the frequency and content of the sleep talking, as well as any potential impacts on the client's sleep quality or daytime functioning.

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Correct Answer is B

Explanation

B. This statement aligns with the concept of allostatic load, which refers to the cumulative physiological toll that chronic stress places on the body over time. Initially, the body's stress response system (the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system) is designed to help individuals cope with acute stressors. However, when stress becomes chronic, these physiological responses can become dysregulated and maladaptive, leading to negative health outcomes such as cardiovascular disease, immune dysfunction, and mental health disorders.
A. Chronic stress has been associated with various changes in gene expression and epigenetic modifications. However, these changes typically occur over longer periods and are not the primary mechanism by which chronic stress leads to illness in most cases.
C. Chronic stress can lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system, which are responsible for producing and regulating corticosteroids (such as cortisol) and catecholamines (such as adrenaline and noradrenaline). While acute stress typically results in increased production of these stress hormones, chronic stress can lead to desensitization and dysregulation of these systems, resulting in alterations in hormone levels and potential deficits in the availability of these stress mediators. However, deficits in corticosteroids and catecholamines are not the sole mechanism by which chronic stress leads to illness.
D. While chronic stress can certainly contribute to psychological fatigue and depletion of energy reserves, this is not the primary mechanism by which chronic stress leads to illness. The physiological responses to chronic stress, such as dysregulation of stress hormones, inflammation, and oxidative stress, are more directly linked to the development of various illnesses.

A. crush each tablet and mix with 20-30 mL of water or saline. B. use liquid medications when available. C. mix all medications, dilute with water and give them together. D. flush tube before beginning medication administration with 20-30 mL of water or saline. E. add medications directly to the tube feeding formula.

Correct Answer is ["B","D"]

Explanation

B. Liquid medications are generally preferred for administration through a feeding tube, as they do not require crushing or dissolving and can be easily administered. Using liquid medications reduces the risk of tube occlusion and ensures accurate dosing. Therefore, this procedure is appropriate for medications available in liquid form.

D. Flushing the tube before medication administration helps ensure patency and clears any residual feeding formula or medication from the tube. This step is essential to prevent clogging of the tube and ensure that the medication reaches the stomach or intestines. Therefore, flushing the tube with water or saline before medication administration is a standard procedure.
A. Crushing tablets and mixing them with water or saline can help ensure that the medication is in a form that can be administered through the gastrostomy tube. However, not all tablets are suitable for crushing, as some medications may have special formulations or coatings that should not be crushed.
Therefore, this procedure is appropriate for medications that are safe to crush and administer via a feeding tube.
C. Mixing medications can potentially alter their effectiveness or stability, so it is essential to follow guidelines and recommendations for medication administration through feeding tubes.
E. Adding medications directly to the tube feeding formula may be appropriate for certain medications that are compatible with the formula and do not require separate administration. However, not all medications can be safely mixed with feeding formula, as some medications may interact with the formula components or become less effective.

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The nurse is assessing a client's sleep patterns. Which statement made by the client would require additional questioning by the nurse? "My partner tells me that:

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Explanation

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Correct Answer is ["B","D"]

Explanation

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