Which patient has the highest risk of experiencing nocturia? The patient who:
Takes a sleeping pill at 9 pm.
Takes a diuretic at 7 pm.
Takes frequent naps during the day.
Takes a diuretic at 7 am. . .
The Correct Answer is B
Choice A rationale
Taking a sleeping pill at 9 pm might influence nighttime voiding indirectly by affecting sleep patterns or bladder awareness, but it doesn't directly increase urine production. Sleeping pills primarily work on the central nervous system to promote sleep and are not known to have a diuretic effect that would lead to increased nighttime urination.
Choice B rationale
Taking a diuretic at 7 pm significantly increases the risk of nocturia because diuretics promote fluid excretion by the kidneys. This increased urine production will likely occur during the night, after the medication has been absorbed and metabolized, leading to the need to wake up to urinate. The peak effect of many diuretics occurs within a few hours of administration.
Choice C rationale
Taking frequent naps during the day is unlikely to be a direct cause of nocturia. While changes in daytime activity and fluid intake patterns could indirectly influence nighttime voiding, napping itself does not have a physiological mechanism that directly increases urine production specifically at night.
Choice D rationale
Taking a diuretic at 7 am is less likely to cause nocturia compared to taking it in the evening. By 7 pm, the diuretic's effect of increased urine production will likely have subsided for most individuals, allowing for more normal bladder function during the night. The majority of the diuresis will occur during the daytime hours. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While reporting communicable diseases is a public health responsibility, it is typically mandated by law and health regulations, not specifically a requirement that nurses *always* report to the Board of Nursing in Texas. Reporting protocols usually involve health departments.
Choice B rationale
Parents declining treatment for a child can raise ethical and legal concerns, potentially involving child protective services or the legal system, but it is not always a direct reporting requirement to the Texas Board of Nursing unless it involves professional misconduct by a nurse.
Choice C rationale
A patient's decision to leave against medical advice is a matter of patient autonomy. While nurses document this and ensure the patient understands the risks, it is not typically a mandatory reporting situation to the Texas Board of Nursing unless there are specific concerns about the nurse's conduct related to the discharge.
Choice D rationale
Abuse of older adults by another nurse directly involves the professional conduct and potential harm caused by a licensed nurse. The Texas Board of Nursing is responsible for regulating nursing practice and ensuring patient safety, making it mandatory for nurses to report such instances of misconduct by a colleague.
Correct Answer is D
Explanation
Choice A rationale
While it might seem natural to inquire about prior discussions, this response could induce guilt or regret in the spouse and doesn't directly address the current emotional distress and uncertainty about the spouse's wishes as explicitly stated in the advance directive. It shifts the focus to the past rather than the present need for clarification regarding the existing directive.
Choice B rationale
Although the primary care provider may indeed have the client's best interests in mind, this statement dismisses the spouse's expressed uncertainty and relies on an assumption about the PCP's motivations. It doesn't help the spouse understand or feel confident about the content of the advance directive, which is the core of their concern.
Choice C rationale
This statement, while true, places the burden of decision-making solely on the spouse without acknowledging the existence of the advance directive, which is meant to guide such decisions. It overlooks the possibility that the directive already contains the spouse's wishes and could offer clarity, thereby increasing the spouse's anxiety.
Choice D rationale
This response directly addresses the spouse's statement by reminding them that their spouse's wishes are likely documented in the advance directive. It encourages the spouse to review the directive, which is the most direct way to understand what their spouse wanted regarding medical interventions like a PEG tube, thus providing immediate and relevant support.
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