Which nursing interventions are appropriate to include in a plan of care to promote sleep for patients who are hospitalized? (Select all that apply)

Instruct them to take a long walk an hour before bedtime

Arrange with laboratory to draw blood outside of sleep hours

Encourage patients to fall asleep while watching television

Close the door to patients’ rooms at bedtime

Provide a warm green tea or coffee with evening meal

Answer and Explanation

Correct Answer : B,D

Choice A reason: A long walk an hour before bedtime may stimulate the body, increasing heart rate and alertness, which can delay sleep onset. Physical activity is beneficial earlier in the day to promote sleep, but close to bedtime, it may disrupt the body’s wind-down process, reducing sleep quality in hospitalized patients.

Choice B reason: Arranging blood draws outside sleep hours minimizes nighttime disruptions, which are critical for restorative sleep. Hospital environments often interrupt sleep with procedures, increasing stress and fatigue. This intervention supports the sleep-wake cycle by ensuring uninterrupted rest, promoting better recovery and reducing physiological stress in patients.

Choice C reason: Watching television before sleep exposes patients to blue light, which suppresses melatonin production, a hormone essential for sleep. This can delay sleep onset and reduce sleep quality. Hospitalized patients need a calm, low-stimulation environment to promote rest, making television an inappropriate intervention for sleep promotion.

Choice D reason: Closing the door at bedtime reduces noise and light from hospital corridors, creating a quieter, darker environment conducive to sleep. This minimizes disruptions, supporting the body’s circadian rhythm and melatonin production. A calm environment is essential for hospitalized patients, who often face sleep challenges due to hospital activity.

Choice E reason: Green tea or coffee contains caffeine, a stimulant that inhibits sleep by blocking adenosine receptors, increasing alertness. Consuming these near bedtime can delay sleep onset and reduce sleep quality. Hospitalized patients require interventions that promote relaxation, not stimulation, making this an inappropriate choice for sleep promotion.

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Correct Answer is A

Explanation

Choice A reason: Hypomagnesemia, low magnesium (normal 1.7–2.2 mg/dL), is indicated by the 0.8 mEq/L value. Magnesium is vital for muscle, nerve, and cardiac function. Low levels can cause tremors, seizures, and arrhythmias. The other values (sodium, chloride, potassium) are within normal ranges, making hypomagnesemia the primary imbalance.

Choice B reason: Hyponatremia, low sodium (normal 135–145 mEq/L), is not indicated, as the sodium level is 140 mEq/L, within normal limits. Hyponatremia can cause neurological symptoms like confusion, but the lab values do not support this diagnosis, and magnesium imbalance is the clear abnormality.

Choice C reason: Hyperchloremia, high chloride (normal 98–106 mEq/L), is not present, as the chloride level is 107 mEq/L, just above normal and not clinically significant. Elevated chloride may occur in dehydration or renal issues, but the primary concern here is the significantly low magnesium level.

Choice D reason: Hypokalemia, low potassium (normal 3.5–5.0 mEq/L), is not indicated, as the potassium level is 3.6 mEq/L, within normal range. Hypokalemia causes muscle weakness and arrhythmias, but the lab values point to hypomagnesemia as the primary electrolyte imbalance in this case.

A. Hypernatremia B. Hyperkalemia C. Hyponatremia D. Hypokalemia

Correct Answer is A

Explanation

Choice A reason: Hypernatremia, high blood sodium (normal 135–145 mEq/L), is indicated by the 158 mEq/L level. It results from water loss, causing dehydration (dry mucous membranes, low urine output) and neurological symptoms like confusion due to brain cell shrinkage. The symptoms and lab values align with hypernatremia in this elderly client.

Choice B reason: Hyperkalemia, high potassium (normal 3.5–5.0 mEq/L), is not indicated, as the potassium level is 4.8 mEq/L, within normal range. Hyperkalemia causes arrhythmias and muscle weakness, not confusion or dehydration signs. The primary issue is high sodium, pointing to hypernatremia, not potassium imbalance.

Choice C reason: Hyponatremia, low sodium, causes swelling and neurological symptoms like seizures. The client’s sodium of 158 mEq/L indicates hypernatremia, not hyponatremia. Dry mucous membranes and low urine output suggest water loss, not sodium dilution, making hyponatremia inconsistent with the clinical and lab findings.

Choice D reason: Hypokalemia, low potassium, causes muscle weakness and arrhythmias. The client’s potassium of 4.8 mEq/L is normal, and symptoms like confusion and dehydration point to hypernatremia, not potassium deficiency. The high sodium level and clinical presentation make hypokalemia an unlikely diagnosis in this case.

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Which nursing interventions are appropriate to include in a plan of care to promote sleep for patients who are hospitalized? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

As the nurse assesses a client’s laboratory values, the following are noted: Sodium 140 mEq/L, Magnesium 0.8 mEq/L, Chloride 107 mEq/L, Potassium 3.6 mEq/L. What electrolyte imbalance is indicated?

Correct Answer is A

Explanation

A 73-year-old hospitalized client demonstrates the following symptoms: dry mucous membranes, decreased urine output, confusion, a serum sodium of 158 mEq/L, a potassium of 4.8 mEq/L. The nurse recognizes that these symptoms are indicative of?

Correct Answer is A

Explanation

indicate the nurse is addressing the affective domain of learning?

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