The nurse is having difficulty hearing his patient’s apical pulse with his stethoscope. Which action will help the nurse hear the heartbeat more clearly?

Choice A reason: This is a correct choice because careful delegation is a leadership skill that involves assigning tasks to the appropriate staff members based on their scope of practice, competence, and availability. Careful delegation ensures that the nursing student can focus on the most important aspects of patient care while supervising and supporting the delegated staff¹.

Choice B reason: This is a correct choice because team communication is a leadership skill that involves exchanging information, ideas, and feedback with other members of the health care team in a clear, respectful, and timely manner. Team communication facilitates collaboration, coordination, and continuity of care for the patients².

Choice C reason: This is a correct choice because case management is a leadership skill that involves planning, organizing, and evaluating the care of a specific group of patients across the continuum of care. Case management ensures that the patients receive the best quality of care while optimizing the use of resources and reducing costs³.

Choice D reason: This is a correct choice because time management is a leadership skill that involves prioritizing, scheduling, and completing tasks within the available time. Time management helps the nursing student to balance the demands of patient care, education, and personal life while avoiding stress and burnout.

Choice E reason: This is a correct choice because priority setting is a leadership skill that involves identifying the most urgent and important tasks and goals and allocating the appropriate time and resources to them. Priority setting helps the nursing student to provide safe and effective care for the patients while meeting their needs and expectations.

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.