The nurse is caring for a patient in the sleep lab. Which assessment finding indicates to the nurse that the patient is in stage 4 NREM?

Choice A reason: Cheyne-Stokes breathing, alternating cycles of deep breathing and apnea, is a hallmark of impending death, often seen in the final hours. It reflects brainstem dysfunction as the body shuts down. This finding signals the nurse to prepare the family for imminent death, providing emotional support and guidance.

Choice B reason: Redness of skin may indicate pressure injuries or fever but is not a specific sign of imminent death. In the dying process, skin may become mottled or pale, not red. This finding does not prompt immediate preparation for death, making it an incorrect choice.

Choice C reason: Tense muscle tone is not typical in the last stages of dying, where muscles relax due to metabolic shutdown. Rigidity occurs post-mortem (rigor mortis). This finding does not indicate imminent death, so it does not require preparing the family, making it incorrect.

Choice D reason: Clear colored urine reflects hydration but is not a sign of impending death. In the dying process, urine output decreases, and color darkens due to reduced renal perfusion. This finding is irrelevant to preparing the family for death, as it does not signal the final stages.

Choice A reason: Non-Hispanic Blacks are projected to grow, but their growth rate is slower than Hispanics due to lower birth rates and immigration patterns. By 2060, they will remain a significant group, but demographic data indicate they will not outpace Hispanics, making this incorrect for the fastest-growing ethnic group.

Choice B reason: Multiracial individuals are increasing due to intermarriage, but their growth rate is lower than Hispanics. Projections show they will form a smaller population share by 2060 compared to Hispanics, driven by high birth rates and immigration. This choice is incorrect, as it underestimates Hispanic growth trends.

Choice C reason: Asians are a fast-growing group due to immigration, but their growth rate is surpassed by Hispanics, who benefit from both immigration and higher fertility rates. By 2060, Asians will increase significantly, but demographic forecasts confirm Hispanics as the fastest-growing group, making this choice incorrect.

Choice D reason: Hispanics are projected to be the fastest-growing racial/ethnic group by 2060, driven by high birth rates, immigration, and a younger population. Census projections estimate they will account for nearly 30% of the US population, surpassing other groups in growth rate due to demographic trends, making this the correct choice.