The nurse is caring for a patient with the following vital signs:
Temperature: 98.9°F
Pulse: 94
Respirations: 20
Blood pressure: 144/94
Pulse oximetry: 94%
What is the priority action of the nurse?

Choice A reason: This is an incorrect choice because "When did you first seek health care for your symptoms?" is not an example of back-channeling. Back-channeling is a communication technique that involves using verbal or non-verbal cues to indicate that the listener is paying attention and encouraging the speaker to continue. This statement is an example of an open-ended question, which is another communication technique that involves asking questions that require more than a yes or no answer and elicit more information from the speaker.

Choice B reason: This is an incorrect choice because "I am sure the doctor will answer all of your questions shortly." is not an example of back-channeling. Back-channeling is a communication technique that involves using verbal or non-verbal cues to indicate that the listener is paying attention and encouraging the speaker to continue. This statement is an example of a reassurance, which is another communication technique that involves expressing confidence or support to the speaker and alleviating their anxiety or fear.

Choice C reason: This is the correct choice because "I completely understand. Can you tell me more?" is an example of back-channeling. Back-channeling is a communication technique that involves using verbal or non-verbal cues to indicate that the listener is paying attention and encouraging the speaker to continue. This statement is an example of a verbal cue, which involves using words or phrases that show empathy, interest, or agreement, and invite the speaker to elaborate or clarify their message.

Choice D reason: This is an incorrect choice because "Try not to worry. I'm sure that you will be just fine." is not an example of back-channeling. Back-channeling is a communication technique that involves using verbal or non-verbal cues to indicate that the listener is paying attention and encouraging the speaker to continue. This statement is an example of a false reassurance, which is a communication barrier that involves making unrealistic or unfounded promises or predictions to the speaker and dismissing their concerns or feelings.

Choice A reason: This is an incorrect choice because the patient follows an organic, low-carbohydrate diet is not an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. A low-carbohydrate diet may have some benefits for weight loss, blood sugar control, and cardiovascular health, but it does not have a direct impact on the sleep quality or quantity of the patient.

Choice B reason: This is the correct choice because the patient now works in Alaska with extended daylight hours is an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. Extended daylight hours can disrupt the circadian rhythm, which is the natural cycle of sleeping and waking that follows a 24-hour pattern. The circadian rhythm is influenced by the exposure to light and dark, and it regulates the production of melatonin, a hormone that promotes sleep. When the daylight hours are longer, the melatonin levels may be lower, and the patient may have trouble falling asleep or staying asleep.

Choice C reason: This is an incorrect choice because the patient’s job includes many hours of hard labor each day is not an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. Hard labor may have some effects on the physical and mental health of the patient, but it does not necessarily cause insomnia or poor sleep. In fact, hard labor may increase the need for sleep and rest, and the patient may sleep better after a long day of work.

Choice D reason: This is an incorrect choice because the patient enjoys doing crossword puzzles and reading is not an assessment finding that indicates to the nurse why the patient is having difficulty sleeping at night. Crossword puzzles and reading are hobbies that may stimulate the brain and enhance the cognitive function of the patient, but they do not have a negative effect on the sleep quality or quantity of the patient. However, the nurse should advise the patient to avoid doing these activities close to bedtime, especially if they involve bright screens or lights, as they may interfere with the melatonin production and the sleep onset.