The nurse is caring for a hospitalized patient who states, "I cannot sleep at night in this hospital and it's making me crazy." Which of the following should the nurse ask first?

"I can tell your family not to visit you close to bedtime."

"Would you like me to provide you with earplugs?"

"I can get you a mental health consult if you think that would help."

"Tell me why you think you may not be sleeping at night."

Answer and Explanation

The Correct Answer is D

A. "I can tell your family not to visit you close to bedtime." While this could be a consideration, it does not address the patient's immediate concerns and the possible causes of their sleep issues.

B. "Would you like me to provide you with earplugs?" This is a possible solution but does not investigate the underlying cause of the sleep issue.

C. "I can get you a mental health consult if you think that would help." A mental health consult may be helpful, but it is not the first step in understanding and addressing the immediate concern.

D. "Tell me why you think you may not be sleeping at night." This is the best initial response as it allows the nurse to understand the root cause of the patient's sleep disturbances and address specific issues, such as noise, light, or discomfort.

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Correct Answer is B

Explanation

A. “I drink one glass of wine before bed to help me sleep.” This statement indicates a potentially unhealthy coping strategy. Using alcohol as a sleep aid can lead to dependency and does not address the underlying grief. It is not considered an appropriate coping mechanism.

B. “I joined an art group that my partner attended at my church.” This statement indicates a healthy coping strategy. Joining an art group provides social support, a sense of community, and a constructive outlet for emotions. It also honors the memory of the partner in a positive way.

C. “I am leaving my partner’s belongings in the same place.”This statement may indicate difficulty in moving forward and could suggest that the client is struggling to accept the loss. While it is normal to keep some belongings for sentimental reasons, leaving everything unchanged might hinder the grieving process.

D. “I can make it through most of the day before I feel like crying.” While it's normal to experience a range of emotions during grief, excessive suppression of emotions can hinder the healing process. It's important for the client to allow themselves to grieve and express their emotions in healthy ways.

A. "Have you been trying to lose weight?" B. "You must take care of yourself or you will not be able to care for your partner." C. "What are some things you are doing to take care of yourself?" D. "It is often easy to lose weight when we become busy and distracted."

Correct Answer is C

Explanation

A. "Have you been trying to lose weight?" This response does not address the caregiver’s concern about losing weight due to lack of time and may seem to dismiss their situation.

B. "You must take care of yourself or you will not be able to care for your partner." While this statement is true, it may be perceived as accusatory and could lead to feelings of guilt or resentment.

C. "What are some things you are doing to take care of yourself?" This is a good response as it encourages the caregiver to think about their self-care practices and opens a dialogue about their well-being.

D. "It is often easy to lose weight when we become busy and distracted." This response might minimize the caregiver’s concern and does not provide practical support or solutions.

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The nurse is caring for a hospitalized patient who states, "I cannot sleep at night in this hospital and it's making me crazy." Which of the following should the nurse ask first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

Explanation

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