Nokea
A nurse is caring for a client who has insomnia. Which of the following actions should the nurse take?
- A. Use overhead lighting when checking equipment.
- B. Keep the door to the client's room closed.
- C. Provide the client with snug-fitting nightwear.
- D. Administer prescribed diuretics in the evening.
Correct Answer: B
Rationale: Closing the door reduces noise, promoting a sleep-conducive environment.
You may also like to solve these questions
A nurse is caring for a client who has dyspnea with an oxygen saturation of 88%. Which of the following indicates the type of face mask the nurse should use to deliver the client a 90% oxygen concentration?
- A. Simple face mask
- B. Nasal prongs
- C. Non-rebreather mask
- D. Nasal cannula
Correct Answer: C
Rationale: A non-rebreather mask delivers up to 90-100% oxygen, ideal for raising saturation.
A nurse is caring for a client who has a new prescription for a belt restraint. Which of the following actions should the nurse take?
- A. Apply the belt restraint over the client's gown.
- B. Make sure four fingers fit between the restraint and the client's body.
- C. Check the client's skin integrity every 4 hr.
- D. Tie the belt restraint to the side rail of the bed.
Correct Answer: A
Rationale: Applying restraints over clothing prevents skin irritation and adds comfort, reducing risks of abrasions and pressure sores.
A nurse on a medical-surgical unit is caring for a postoperative client who reports difficulty sleeping due to noise. Which of the following interventions is appropriate for the nurse to implement?
- A. Conduct staff communications away from the client's room.
- B. Avoid entering the client's room unless requested during the night.
- C. Turn on the client's TV to distract from hallway noise.
- D. Turn off alarms on bedside monitoring equipment.
Correct Answer: A
Rationale: Reducing noise near the client’s room promotes a sleep-friendly environment.
A nurse is caring for a client who requires a sterile dressing change. The nurse should recognize that the surgical field has been contaminated if which of the following actions occur?
- A. Unnecessary sterile items are placed on the field.
- B. The sterile solution is poured with the bottle held over the field.
- C. The handle of a pair of sterile scissors is resting 5 cm (2 in) from the field's edge.
- D. A pair of sterile forceps is allowed to rest in a container of sterile water on the field.
Correct Answer: B
Rationale: Pouring over the field risks contamination from the bottle, breaching sterility.
A nurse is planning to obtain a client's oxygen saturation. Which of the following might influence the result of this test?
- A. The client is wearing nail polish.
- B. The client has an elevated hemoglobin level.
- C. The client has a fever.
- D. The client is wearing a ring.
Correct Answer: A
Rationale: Nail polish can block light in pulse oximetry, leading to inaccurate low readings.