Nokea
The nurse is caring for a client with obstructive sleep apnea. The nurse should recognize that the client is at greater risk for the development of which complication?
- A. Fibromyalgia
- B. Peptic ulcer disease.
- C. Hypertension
- D. Hypothyroidism.
Correct Answer: C
Rationale: OSA increases blood pressure via hypoxia.
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A family member is demonstrating wound care using sterile technique. Which action indicates to the nurse that additional teaching is needed?
- A. Uses normal saline to irrigate the wound.
- B. Cleans from less soiled to more soiled areas.
- C. Opens a sterile package towards the body.
- D. Places soiled dressing in a plastic bag.
Correct Answer: C
Rationale: Opening towards body risks contamination.
History and Physical
2/15/2021
The patient is a 36-year-old female who is in the clinic today for insomnia. She reports that she started having trouble sleeping over a year ago after her father’s death. She has no medical problems and has never had surgery. She takes an oral contraceptive and a multivitamin daily. She does not smoke but drinks one to two glasses of wine every evening.
Nurse’s Notes
2/15/2021
Vital Signs:
• Temperature: 97°F (36.1°C) orally
• Heart rate: 59 beats/minute
• Respiratory rate: 16 breaths/minute
• Blood pressure: 116/72 mm Hg
Educated the patient on sleep hygiene techniques, such as avoiding exercise and caffeine right before bed.
3/2/2021
The patient is in the clinic following up after her sleep study, which showed no signs of sleep apnea. The patient continues to have poor sleep even with eliminating caffeine and doing a relaxing activity before bed, such as yoga. The patient will keep a sleep journal to document her sleep for the next 2 weeks.
3/16/2021
The patient completed a 2-week sleep journal. The patient falls asleep 1 to 2 hours after going to bed and wakes up 2 to 3 times per night. She does not have to use the restroom during the night. She experiences daytime drowsiness and headaches nowadays.
Orders
2/15/2021
Sleep study for 1 night.
What other recommendations could the nurse give to help the patient have better sleep? Select all that apply.
- A. Exercise in the evening
- B. Watch television in bed to fall asleep.
- C. Take an analgesic before bed.
- D. Avoid alcohol in the evening.
- E. Try to go to bed and awaken at the same time every day.
- F. Avoid naps.
- G. Eat a heavy meal before bed.
Correct Answer: D,E,F
Rationale: Choice A reason:
Exercising in the evening can actually be counterproductive for some people when it comes to sleep. While regular exercise is beneficial for overall health and can contribute to better sleep, doing it too close to bedtime can stimulate the body, making it harder to relax and fall asleep.
Choice B reason:
Watching television in bed is generally not recommended as part of good sleep hygiene. The light from the screen can interfere with the body's production of melatonin, the hormone that signals it's time to sleep, and engaging content can keep the brain alert rather than allowing it to wind down.
Choice C reason:
Taking an analgesic before bed is not a general recommendation for better sleep unless pain is a specific issue that is preventing sleep. It's important to address the root cause of insomnia rather than masking symptoms with medication.
Choice D reason:
Avoiding alcohol in the evening is a good practice for better sleep. Alcohol can disrupt the sleep cycle and lead to fragmented sleep, even though it may initially seem to help with falling asleep.
Choice E reason:
Going to bed and waking up at the same time every day helps to regulate the body's internal clock, or circadian rhythm, which can improve sleep quality. Consistency is key for this practice to be effective.
Choice F reason:
Avoiding naps, especially in the late afternoon or evening, can help ensure that you are sufficiently tired at bedtime. Napping can interfere with nighttime sleep if done too late in the day or for too long.
Choice G reason:
Eating a heavy meal before bed can lead to discomfort and indigestion, which can make it harder to fall asleep. It's best to have a light snack if needed and avoid large meals close to bedtime.
The nurse is reviewing the signed operative consent with a client who is admitted for the removal of a lipoma on the left leg. The client reports the permit should include another lipoma on the right leg. Which action should the nurse implement?
- A. Have the client sign a new surgical permit.
- B. Inform the surgeon about the client's concern.
- C. Add the additional information to the permit.
- D. Notify the surgical staff of the client's confusion.
Correct Answer: B
Rationale: Surgeon must evaluate and amend consent.
The healthcare provider prescribes magnesium hydroxide 4,800 mg PO at bedtime for a patient with constipation. The bottle is labeled, 'Magnesium Hydroxide Saline Laxative, USP 400 mg per 5 mL'. How many ounces should the nurse instruct the patient to take with each dose? (Enter numerical value only.)
Correct Answer: 2
Rationale: 4,800 mg ÷ (400 mg/5 mL) = 60 mL = 2 oz.
The nurse is teaching a spouse how to care for a client who recently had a stroke and has residual weakness on the right side. Which style of shoes should the nurse recommend the client wear when ambulating with the spouse's assistance?
- A. Slip-on rubber shower shoes
- B. Tennis shoes with Velcro
- C. Leather-soled loafers
- D. Rubber-soled slippers
Correct Answer: B
Rationale: Velcro shoes provide support and ease of use.