Which bedtime action by the nurse may make it more difficult for the patient to fall asleep?

Choice A reason: This is the correct choice because performing a focused patient assessment is the first action of the nurse when starting care for the patient at the beginning of the shift. A focused patient assessment involves collecting data about the patient's current condition, needs, and preferences. This data helps the nurse to identify any changes, problems, or risks that require immediate attention or intervention.

Choice B reason: This is an incorrect choice because conducting the patient’s health history is not the first action of the nurse when starting care for the patient at the beginning of the shift. A health history involves collecting data about the patient's past and present health status, medical history, family history, and social history. This data helps the nurse to understand the patient's background, risk factors, and health goals. A health history is usually conducted during the admission process or the initial assessment, not at the beginning of each shift.

Choice C reason: This is an incorrect choice because creating the nursing care plan for the patient is not the first action of the nurse when starting care for the patient at the beginning of the shift. A nursing care plan involves developing a set of interventions and outcomes based on the patient's assessment data, diagnosis, and goals. This plan guides the nurse to provide individualized and holistic care for the patient. A nursing care plan is usually created after the initial assessment and updated regularly throughout the care process, not at the beginning of each shift.

Choice D reason: This is an incorrect choice because administering prescribed medications is not the first action of the nurse when starting care for the patient at the beginning of the shift. Administering prescribed medications involves giving the patient the right drug, dose, route, time, and documentation according to the physician's order and the nursing standards. This action requires the nurse to check the patient's assessment data, allergies, vital signs, and laboratory results before giving the medication. Administering prescribed medications is usually done after performing a focused patient assessment, not before.

Choice A reason: This is an incorrect choice because professional shared governance is not a patient care action, but an organizational model that empowers nurses and other health care professionals to participate in decision making and policy development within their practice settings¹.

Choice B reason: This is an incorrect choice because nursing care delivery model is not a patient care action, but a framework that defines how nursing care is organized, coordinated, and delivered to the patients. Examples of nursing care delivery models include primary nursing, team nursing, and case management².

Choice C reason: This is the correct choice because interprofessional communication is a patient care action that involves exchanging information, ideas, and feedback among health care professionals from different disciplines who work together to provide comprehensive care for the patients. Interprofessional communication enhances collaboration, quality, and safety of care³.

Choice D reason: This is an incorrect choice because continuing staff education is not a patient care action, but a professional development activity that involves updating and enhancing the knowledge and skills of the health care staff through formal or informal learning opportunities. Continuing staff education improves the competence and performance of the staff.