Solutions - Chapter 45 - Kozier Erb's Fundamentals Nursing - 10 Ed

 

10TYK. During admission to a hospital unit, the client tells the nurse that her sleep tends to be very light and that it is difficult for her to get back to sleep if she’s awakened at night. Which interventions should the nurse implement? Select all that apply.
1.  Remind colleagues to keep their conversation to a minimum at night.
2.  Encourage the client’s family members to bring in a radio to play soft music at night.
3.  Deliver necessary medications and procedures at 1.5-or 3-hour intervals between 11 pm and 6 am.
4.  Encourage the client to ask family members to bring in a fan to provide white noise.
5.  Increase the temperature in the room.
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1ACT. What further information would be helpful to obtain from Mr. Harrison about his sleep problem?
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1TYK. A client is admitted for a sleep disorder. The nurse knows that the reticular activating system (RAS) is involved in the sleep/ wake cycle. In the accompanying illustration, which letter indicates the location of the RAS?
1.  A
2.  B
3.  C
4.  D
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2ACT. What suggestions can you make that may help him develop better sleep habits?
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2TYK. A client has a history of sleep apnea. Which is the most appropriate question for the nurse to ask?
1.  Do you have a history of cardiac irregularities?
2.  Do you have a history of any kind of nasal obstruction?
3.  Have you had chest pain with or without activity?
4.  Do you have difficulty with daytime sleepiness?
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3ACT. What are the most common problems that interfere with clients' ability to sleep?
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3TYK. Because of significant concerns about financial problems, a middle-aged client complains of difficulty sleeping. Which outcome would be the most appropriate for the nursing care plan? “By day 5, the client will:
1.  Sleep 8 to 10 hours per day.”
2.  Report falling asleep within 20 to 30 minutes.”
3.  Have a plan to pay all the bills.”
4.  Decrease worrying about financial problems and will keep busy until bedtime.”
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4TYK. A client reports to the nurse that she has been taking barbiturate sleeping pills every night for several months and now wishes to stop taking them. Which statement is the most appropriate advice for the nurse to provide the client?
1.  Take the last pill on a Friday night so disrupted sleep can be compensated on the weekend.
2.  Continue to take the pills since sleeping without them after such a long time will be difficult and perhaps impossible.
3.  Discontinue taking the pills.
4.  Continue taking the pills and discuss tapering the dose with the primary care provider.
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5TYK. During a well-child visit, a mother tells the nurse that her 4-year-old daughter typically goes to bed at 10:30 pm and awakens each morning at 7 am. She does not take a nap in the afternoon. Which is the best response by the nurse?
1.  Encourage the mother to consider putting her daughter to bed between 8 and 9 pm.
2.  Reassure the mother that it is normal for 4-year-olds to resist napping, but encourage her to insist that she rest quietly each afternoon.
3.  Recommend that her daughter be allowed to sleep later in the morning.
4.  Reassure her that her daughter’s sleep pattern is normal and that she has outgrown her need for an afternoon nap.
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6TYK. A college student was referred to the campus health service because of difficulty staying awake in class. What should be included in the nurse’s assessment? Select all that apply.
1.  Amount of sleep he usually obtains during the week and on weekends
2.  How much alcohol he usually consumes
3.  Onset and duration of symptoms
4.  Whether or not his classes are boring
5.  What medications, including herbal remedies, he is taking
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7TYK. During a yearly physical, a 52-year-old male client mentions that his wife frequently complains about his snoring. During the physical exam, the nurse notes that his neck size is 18 inches, his soft palate and uvula are reddened and swollen, and he is overweight. What is the most appropriate nursing intervention for the nurse to recommend to this client?
1.  Recommend that he and his wife sleep in separate bedrooms so that his snoring does not disturb his wife.
2.  Refer him to a dietician for a weight loss program.
3.  Caution him not to drink or take sleeping pills since they may make his snoring worse.
4.  Refer him to a sleep disorders center for evaluation and treatment of his symptoms.
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8TYK. A new nursing graduate’s first job requires 12-hour night shifts. Which strategy will make it easier for the graduate to sleep during the day and remain awake at night?
1.  Wear dark wrap-around sunglasses when driving home in the morning, and sleep in a darkened bedroom.
2.  Exercise on the way home to avoid having to stand around waiting for equipment at the gym.
3.  Drink several cups of strong coffee or 16 oz of caffeinated soda when beginning the shift.
4.  Try to stay in a brightly lit area when working at night.
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9TYK. The nurse is answering questions after a presentation on at a local senior citizens center. A woman in her late 70s asks for an opinion about the advisability of allowing her husbandS nap for 15 to 20 minutes each afternoon. Which is the nurse’s best response?
1.  “Taking an afternoon nap will interfere with his being able to sleep at night. If he’s tired in the afternoon, see if you can interest him in some type of stimulating activity to keep him, awake.”
2.  “He shouldn’t need to take an afternoon nap if he’s getting enough sleep at night.”
3.  “Unless your husband has trouble falling asleep at night a brief afternoon nap is fine.”
4.  “Encourage him to consume coffee or some other caffeinated beverage at lunch to prevent drowsiness in the afternoon.”
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