RNSG1430 Exam 2: Comfort and Sleep - Flashcards

Q: A patient who takes low-dose aspirin to prevent cardiovascular events asks a health care professional about taking ibuprofen (Advil) to treat rheumatoid arthritis. The health care professional should respond with

\"Ibuprofen will reduce the anti platelet effects of low-dose aspirin\"

question

A patient who takes low-dose aspirin to prevent cardiovascular events asks a health care professional about taking ibuprofen (Advil) to treat rheumatoid arthritis. The health care professional should respond with

answer

"Ibuprofen will reduce the anti platelet effects of low-dose aspirin"

question

A patient is about to start taking aspirin to prevent cardiovascular events. You should instruct the patient to watch for and report which of the following adverse effects of aspirin?

answer

petechiae

question

Ibuprofen (Advil)

answer

a nonsteroidal anti-inflammatory drug (NSAID) reduces inflammation, relieves mild to moderate pain and reduces fever.

question

Morphine

answer

an opiod analgesic, relieves moderate and severe pain, reduces anxiety, and produces sedation.

question

Prednisone,

answer

a gluccorticoid, reduces inflammation and delays the pregression of various disorders. It also suppresses the immunne system to prevent organ rejection.

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Naloxone (Narcan)

answer

an opioid antagonist, reverses the effect of opioid analgesic

question

SELECT ALL THAT APPLY Patient is about to begin taking oral morphine to treat acute pain from an injury. Which of the following instructions should you include about morphine? A.) Take it with food B.) Rise slowly from sitting or reclining C.) Take it on a fixed schedule D.) Increase fluid and fiber intake E.) Do not take if before driving

answer

take it with food rise slowly from sitting or reclining increase fluid and fiber intake do not take it before driving

question

A presciber prescibes prednisone (Deltasone) for a pt who has type 1 diabetes mellitus. In relation to the side effects of prednisone, which of the following prescriptions should you epect the provider to include?

answer

Increase serum glucose monitoring

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A pt is about to start taking tramadol (Ultram) to treat moderate pain. Which of the following instructions should you include

answer

allow 1 hr for it to take effect

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A pt who is receiving chemo takes allopurinol (Zyloprim) prior to the chemo to reduce the risk for which ?

answer

Hyperuricemia

question

butorphanol

answer

anesthesia adjunct

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acetaminophen

answer

fever reduction

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prednisone

answer

prevention of organ rejection

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morphine

answer

sedation

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Butorphanol is an unsafe analgesic choice for patients who

answer

use a fentanyl (Sublimaze) patch for chronic pain

question

A patient arrives at the emergency room immediately following an acetaminophen (Tylenol) overdose. Which of the following drugs would you plan to administer? A.) Atropine B.) Naloxone C.) Acetylcysteine (Acetadote) D.) Flumazenil

answer

C.) Acetylcysteine (Acetadote)

question

A patient is about to begin celecoxib (Celebrex) therapy for osteoarthritis. You should instruct the patient to watch for and report which of the following possible indications of a serious reaction to this drug?

answer

Black, tarry stools

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case study 1 because the patient is taking celebrex for osteoarthritis , he knows to watch for and report which of the following possible indications of an adverse reaction to celecoxib?

answer

weight gain

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case study 1 in addition to celecoxib, the patient takes low dose aspirin daily for which of the following purposes?

answer

Reduces the risk of a cardiovascular event

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case study 1 Which of the following instructions should the health care provider give the patient regarding the use of aspirin prior to the surgery?

answer

Stop taking it 1 week before surgery.

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case study 2 The health care provider prepares to give the patient morphine IV for pain. Knowing the adverse effects of morphine, she should monitor the patient for which of the following?

answer

respiratory depression

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The health care provider prepares to give the patient morphine IV for pain. What drug does the nurse know would need to be administered in the event of respiratory depression?

answer

naloxone

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Use acetaminophen (Tylenol) to:

answer

-Relieve mild pain -Reduce fever

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a health care professional is caring for a patient who has osteoarthritis and is about to begin taking aspirin, patient should report the following possible indications of salicylism

answer

-Tinnitus - Diaphoresis (sweating and headache) -Dizziness

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a health care professional should question the use of acetaminophen for patients who have which of the following

answer

alcohol use disorder

question

which of the following can increase the risk of reye's syndrome in children

answer

aspirin

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a health care professional is caring for a patient who is taking naloxene to treat a morphine overdose. the health care professional should monitor for which of the following adverse effects?

answer

-Tachypenia -Increased pain (asses pain frequently) -Tachycardia -Hypertension (monitor BP)

question

a health care professional should advise a patient who has which of the following to stop taking ibuprofen to treat an occasional headache or muscle strain?

answer

peptic ulcer disease

question

A health care professional is caring for a patient who is opioid-dependent and is about to begin taking butorphanol (Stadol). The health care professional should recognize the patient is at risk for developing a syndrome that causes which of the following? (Select all that apply.) A) Bronchospasm B) Vomiting C) Peripheral edema D) Abdominal cramps E) Hypertension

answer

B) Vomiting D) Abdominal cramps E) Hypertension

question

A health care professional is caring for a patient who takes furosemide (Lasix) and is about to begin taking prednisone to treat inflammatory bowel disease. The health care professional should monitor the patient for which of the following results of concurrent use of the two drugs? A) Hypercalcemia B) Hypoglycemia C) Hypothermia D) Hypokalemia

answer

D) Hypokalemia

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A health care professional should understand that naloxone can reverse the effects of an excessive dosage of which of the following drugs?

answer

morphine

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A health care professional is caring for an older adult patient who is about to begin taking prednisone for long-term treatment of rheumatoid arthritis. The health care professional should monitor the patient for which of the following adverse effects?

answer

bone loss

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A health care professional is caring for a patient who is receiving morphine to relieve severe pain. The health care professional should monitor the patient for which of the following adverse effects? (Select all that apply.) A) Diarrhea B) Urinary retention C) Respiratory depression D) Sedation E) Orthostatic hypotension

answer

B) Urinary retention C) Respiratory depression D) Sedation E) Orthostatic hypotension

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A health care professional should question the use of tramadol (Ultram) for patients who have which of the following?

answer

seizure disorder

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A health care professional is caring for an older adult patient who is about to begin taking aspirin to treat an ankle sprain. The health care professional should tell the patient to report which of the following adverse reactions?

answer

weight gain

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A patient recovering from a total knee arthroplasty has been prescribed acetaminophen (Tylenol) for mild discomfort that does not require an opioid. The health care professional should tell the patient to report which of the following early indications of acetaminophen overdose? (Select all that apply.) A) Diaphoresis B) Palpitations C) Shortness of breath D) Nausea E) Diarrhea

answer

A) Diaphoresis D) Nausea E) Diarrhea

question

A health care professional should question the use of celecoxib (Celebrex) for a patient who has which of the following? A) Rheumatoid arthritis B) Ankylosing spondylitis C) An allergy to sulfonamides D) Adrenocortical insufficiency

answer

C) An allergy to sulfonamides

question

A health care professional is caring for a patient who is about to begin taking celecoxib (Celebrex) to treat rheumatoid arthritis. The health care professional should tell the patient to report which of the following adverse reactions? A) Chest pain B) Tinnitus C) Constipation D) Diaphoresis

answer

chest pain

question

A health care professional should question the use of morphine for a patient who is taking which of the following drugs? A) Phenobarbital (Luminal) for a seizure disorder B) Warfarin (Coumadin) for anticoagulation C) Glipizide (Glucotrol) for diabetes mellitus D) Alendronate (Fosamax) for osteoporosis

answer

A) Phenobarbital (Luminal) for a seizure disorder

question

A health care professional is caring for a patient who is about to begin taking allopurinol (Zyloprim) to prevent hyperuricemia. The health care professional should advise the patient to report which of the following adverse effects? (Select all that apply.) A) Palpitations B) Sore throat C) Vertigo D) Bruising E) Vision changes

answer

B) Sore throat C) Vertigo D) Bruising E) Vision changes

question

A health care professional is caring for a patient who is about to begin taking allopurinol (Zyloprim) to treat gout. The health care professional should monitor the patient for hypersensitivity syndrome, which causes which of the following clinical manifestations? A) Fever B) Muscle pain C) Anxiety D) Tremors

answer

fever

question

A health care professional is caring for a patient who is about to begin taking butorphanol for pain control. The health care professional should monitor the patient for which of the following adverse effects? (Select all that apply.) A) Infection B) Nausea C) Tachycardia D) Dizziness E) Headache

answer

B) Nausea D) Dizziness E) Headache

question

A health care professional is caring for a patient who is about to begin taking tramadol (Ultram) to treat moderate acute pain from a shoulder injury. When talking with the patient about the drug, the health care professional should include which of the following instructions? (Select all that apply.) A) Increase fiber and fluid intake. B) Take the drug with food. C) Avoid driving after taking the drug. D) Change positions gradually. E) Reduce exercise level temporarily.

answer

A) Increase fiber and fluid intake. B) Take the drug with food. C) Avoid driving after taking the drug. D) Change positions gradually.

question

A health care professional is caring for a patient who is about to begin taking prednisone to treat systemic lupus erythematosus. When talking with the patient about the drug, the health care professional should include which of the following instructions? (Select all that apply.) A) Reduce the dose during periods of stress. B) Discontinue the drug gradually. C) Report illness or infection. D) Increase intake of calcium and vitamin D. E) Monitor for signs of gastric bleeding.

answer

B) Discontinue the drug gradually. C) Report illness or infection. D) Increase intake of calcium and vitamin D. E) Monitor for signs of gastric bleeding.

question

A health care professional should question the use of morphine for a patient who is recovering from which of the following procedures? A) Mastectomy B) Knee arthroplasty C) Cystoscopy D) Cholecystectomy

answer

D) Cholecystectomy

question

A health care professional is preparing for administer butorphanol (Stadol) to a patient for pain control. During administration, the health care professional should take which of the following actions? A) Caution the patient about the drug's potential for abuse. B) Withhold the drug for respiratory rates below 12/min. C) Administer one nasal spray into each nostril. D) Give the drug with an opioid agonist for maximal effects.

answer

B) Withhold the drug for respiratory rates below 12/min.

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A client asks about complementary therapies for relief of discomfort related to pregnancy. Which comfort measure mentioned by the client indicates a need for further teaching?

answer

Herbal remedies

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A nurse is assessing a full-term client in labor and determines the fetus is occiput posterior. The client states that all her discomfort is in her lower back. What intervention can the nurse provide that will help alleviate this discomfort?

answer

Use a fist to apply counter pressure to the lower back.

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As the nurse enters the room to teach the client about self-care at home, the client states, ?I am glad you are here. I need some pain medicine. I can't stand it anymore.? What is the best action of the nurse?

answer

Have client rate pain level and reschedule the teaching session.

question

Which of the following is the priority assessment for a nurse caring for a client with a Patient Controlled Analgesia (PCA) pump?

answer

Respiratory

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A family member tells the nurse that they resent that the client is using their pain to manipulate family members into driving the client everywhere versus the client driving themselves. What is the appropriate action by the nurse?

answer

Encourage an honest discussion of the problem with the client.

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A client in a double hip spica cast is constipated. The surgeon cuts a window into the front of the cast. Which outcome is intended?

answer

The window will provide some relief from pressure due to abdominal distention as a result of constipation.

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The nurse is beginning the examination of a 4-month-old infant. She takes the infant from the mother's arms to do the exam. Where should the nurse place the infant for the exam?

answer

In the crib facing the mom

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A client with complex somatic symptom disorder is complaining of significant pain in the joints. When providing care to this client, which would be most important for the nurse to keep in mind?

answer

The client's experience of pain is real.

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A nurse recommends to a client in labor to try concentrating intently on a photo of her family as a means of managing pain. The woman looks skeptical and asks, "How would that stop my pain?" Which explanation should the nurse give?

answer

"It distracts your brain from the sensations of pain."

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The nurse is educating the client's family about compulsive behavior. The nurse is correct when making which statement?

answer

The behavior neutralizes anxiety caused by obsessive thoughts.

question

General nursing measures employed when caring for the client with fracture include all of the following, except?

answer

Cranial nerve assessment

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A female client is being treated for increased intracranial pressure (ICP). Why should the nurse ensure that the client does not develop hypothermia? Choose the correct option.

answer

Because shivering in hypothermia can increase ICP

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A client sustained severe burns over both lower extremities 1 week ago. The client informs the nurse that he had to wait for 30 minutes last night to receive pain medication, which caused the pain not to be relieved after administration. What suggestions could the nurse make to the physician to provide adequate relief of pain?

answer

Provide the patient with a patient-controlled analgesia (PCA) pump.

question

The nurse recognizes that goal of treatment for metastatic bone cancer is to:

answer

Promote pain relief and quality of life

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The nurse is preparing to do a focused assessment of the abdomen on a client following an abdominal hysterectomy. Which intervention is most important for the nurse to do prior to the physical assessment?

answer

Ask the client to empty her bladder

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The parents of a school-age child with a brain tumor have elected to have only comfort measures instituted for their dying child. The child has been experiencing significant discomfort and has been receiving pain medication. A nurse knows that the pain-management principle most effective in controlling the child's pain is:

answer

striving to prevent pain by routine administration of pain medication.

question

The client with a fractured tibia has been taking methocarbamol. Which finding indicates that the drug is having the intended effect?

answer

relief of muscle spasms

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A nurse is preparing to start an intravenous (IV) line on a child and knows that it will cause pain. The nurse obtains EMLA cream to decrease the sensation of the injection. What type of care is the nurse providing?

answer

Atraumatic care

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A nurse is providing instructions for the client with chronic rhinosinusitis. The nurse accurately tells the client:

answer

Sleep with the head of bed elevated.

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A client is being taught to self-administer a narcotic analgesic by means of an intravenous pump system. Which of the following functions is designed to help prevent the patient from unintentionally overdosing?

answer

Programming the dosage and time interval into the device

question

Which of the following nursing interventions contributes to achieving a client's pain relief?

answer

Collaborate with the client about his or her goal for a level of pain relief.

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The nurse is applying a hand mitt restraint for a client with pruritus (see figure). The nurse should first:

answer

verify the prescription to use the restraint.

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The physician has ordered that the client should ambulate three times a day. The nurse enters the room to ambulate the client and the client complains of pain. What is the nurse's most appropriate action?

answer

Medicate the client and wait to ambulate later.

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A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling proud and excited about her pregnancy while at the same time feeling fearful and anxious of its implications. Which action should the nurse do next?

answer

Inform the client this is a normal response to pregnancy that many women experience.

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A client has presented in the early phase of labor, experiencing abdominal pain and signs of growing anxiety about the pain. Which pain management technique should the nurse prioritize at this stage?

answer

Practicing effleurage on the abdomen

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A nurse is caring for a severely depressed client who is barely functioning. The priority nursing goal for this client would be to:

answer

assess for and maintain adequate nutrition and hydration.

question

After instructing the client in techniques of pushing to use during the second stage of labor, the nurse determines that the client needs further instructions when she says she will need to do which action?

answer

hold her breath throughout the length of the contraction

question

A client is receiving cyclobenzaprine for management of a herniated lumbar disk. Which finding indicates the drug is providing the intended relief?

answer

The client's muscles are not in spasm.

question

The nurse instructs the client about skin massage and the gate control theory of pain. Which statement would be appropriate for the nurse to include for client understanding of the nonpharmacologic pain relief methods?

answer

These methods are a technique to prevent the painful stimuli from entering the brain.

question

Nociception includes four specific processes: transduction, transmission, perception, and modulation. Which of the following actions illustrates the nociception process of pain transmission?

answer

A child quickly removing a hand when touching a hot object

question

A nurse is assessing pain in a client who has a spinal cord injury. The client states that even a light touch to his legs will illicit severe pain. The client is describing which type of pain?

answer

Allodynia

question

Which of the following is the analgesic of choice for burn pain?

answer

Morphine sulfate

question

When a client is experiencing panic, which is the priority intervention?

answer

Move the client to a quiet environment.

question

During a prenatal visit, a health care provider decides to admit a client to the hospital. Based on the nurse's progress note, which complication of pregnancy would the health care provider suspect?

answer

Hyperemesis gravidarum.

question

A nurse who "unblocks" and "clears" congested areas of energy in a patient's body to promote comfort is applying the phenomenon known as:

answer

Therapeutic Touch

question

A mother is concerned that she might be spoiling her 2-month-old daughter by picking her up each time she cries. Which suggestion should the nurse offer?

answer

"Continue to pick her up when she cries because young infants need cuddling and holding to meet their needs."

question

The therapeutic communication interaction is most comfortable when the nurse and the client are how far apart?

answer

3 to 6 feet

question

Fentanyl (Sublimaze) is categorized as which type of intravenous anesthetic agent?

answer

Opioid

question

The nurse recommends which of the following types of therapeutic baths for its antipruritic action?

answer

Colloidal (Aveeno, oatmeal)

question

A nurse is caring for a client diagnosed with cholelithiasis. Which of the following would be most appropriate for a client who is experiencing biliary colic?

answer

Administer analgesics to the client.

question

Which of the following is the hallmark symptom for peripheral arterial disease (PAD) in the lower extremity?

answer

Intermittent claudication

question

A 55-year-old patient arrives at the operating room. The nurse is reviewing the medical record and notes that the patient has a history of osteoporosis in her lower back and hips. The patient is scheduled to receive epidural anesthesia. Which of the following nursing diagnoses would be a priority for this patient?

answer

Risk for perioperative positioning injury related to operative position

question

A nurse is caring for a client diagnosed with arthritis who is experiencing pain that is interfering with her ability to ambulate. The nurse accurately documents which of the following as a nursing diagnosis in the client's records?

answer

Impaired physical mobility related to pain

question

The nurse is conducting a client interview and notices that the client answers every questions with a "yes" or "no" response. What is mostly likely the cause of this action by the client?

answer

Pain

question

During morning report, the night nurse tells the oncoming nurse that the client has been medicated for pain and is resting comfortably. Thirty minutes later, the client calls and requests pain medication. What is the nurse's most appropriate first action?

answer

Go to the client and assess the client's pain.

question

For a client with a nursing diagnosis of Insomnia, the nurse should use which measure to promote sleep?

answer

Playing soft or soothing music

question

During a home visit to a primiparous client 1 week postpartum who is bottle-feeding her neonate, the client tells the nurse that her mother has suggested that she feed the neonate cereal so he will sleep through the night. What would be the nurse's best response?

answer

"Formula is the food best digested by the baby until about 4 to 6 months of age."

question

The most common issue associated with sleep disturbances in the hospitalized client with cancer is:

answer

psychological.

question

A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when he makes which statement?

answer

"I sleep on three pillows each night."

question

A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says

answer

"I should become involved in a weight loss program."

question

The nurse is caring for a 6-year-old sickle-cell client in an acute care setting. A high priority for this client's plan of care is pain relief. The nurse understands that untreated acute pain can lead to which physiological effects?

answer

Impaired mobility, anorexia, anxiety, sleep disturbances, and developmental regression

question

A client has been admitted to the surgical floor and is scheduled for an elective minor proecedure. During the health history, the client informs the nurse of difficulty sleeping until a few weeks ago when a hormone was recommended by a neighbor and started. To what hormone is this client referring?

answer

Melatonin

question

Which of the following is the most effective treatment for obstructive sleep apnea (OSA)?

answer

Continuous positive airway pressure (CPAP)

question

A new mother calls the pediatric nurse to talk to the nurse about her baby who sleeps "all day long." The nurse informs the new mother that an infant requires how many hours of sleep?

answer

14 to 20 hours of sleep each day

question

A client comes into the clinic stating he has been experiencing insomnia for a couple of weeks. After a thorough exam revealed no medical cause for the symptom, the nurse practitioner suggested the use of aromatherapy. Which of the following might the nurse suggest for its use in helping insomnia?

answer

Chamomile

question

Modafinil has been ordered for a client diagnosed with narcolepsy. The nurse understands that this medication:

answer

promotes wakefulness.

question

The client diagnosed with severe major depression has been taking escitalopram 10 mg daily for the past 2 weeks. Which parameter should the nurse monitor most closely at this time?

answer

suicidal ideation

question

An intoxicated client is admitted to the hospital for alcohol withdrawal. What should the nurse do to help the client become sober?

answer

Provide the client with a quiet room to sleep in.

question

The parent of a preschooler reports that the child creates a scene every night at bedtime. What is the best course of action?

answer

Establish a set bedtime and follow a routine.

question

A nurse is making an initial call on a new mother who gave birth to her third baby 5 days ago. The woman says,"I just feel so down this time. Not at all like when I had my other babies. And this one just doesn't sleep. I feel so inadequate." What is the best response to this new mother?

answer

"It sounds like you have the 'baby blues.' They are common after having a baby when you are not getting enough sleep, are busy with your other children, and are still a bit uncomfortable from the birth. They will most likely go away in a day or two."

question

The nurse establishes the following plan of care based on the nurisng diagnosis: Caregver role strain related to infant crying throughout night as manifested by parents stating, "We are exhausted.". Which nursing interventions are included in the plan of care? Select all that apply.

answer

Establish a quieting ritual for infant before bed. During night awakening, keep interactions minimal. Having one parent awake at a time with infant

question

When assessing a client with chest trauma, the nurse notes that the client is taking small breaths at first, then bigger breaths, then a couple of small breaths, then 10 to 20 seconds of no breaths. The nurse should record the breathing pattern as:

answer

Cheyne-Stokes respiration.

question

A nurse is caring for a client with restless leg syndrome who complains of sleeplessness. Which of the following nursing diagnoses is most appropriate for this client?

answer

Sleep deprivation

question

The nurse is completing an admission assessment for a client scheduled for back surgery after a construction accident. The nurse notes the client is having slowed speech and focus, irritability, yawning, and complaints of severe lumbar and right leg pain. The nurse suspects a nursing diagnosis of:

answer

Sleep Pattern Disturbance related to acute pain.

question

The parents of an adolescent boy are concerned their son seems to need 9 hours of sleep a night. The nurse should advise the parents:

answer

"As long as he seems otherwise well, this sounds like a typical teenager."

question

A client in her third trimester reports to the nurse shortness of breath when sleeping. The nurse informs the client that this is normal and occurs because the growing fetus puts pressure on the diaphragm. Which measure should the nurse suggest to help alleviate this problem?

answer

Use extra pillows.

question

A parent brings a 6-year-old to the clinic and informs the nurse that the child is tired all the time even though the child sleeps 7 to 8 hours each night. What is the best response by the nurse?

answer

"Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school."

question

While reviewing a patient's chart, the nurse notes the patient has been experiencing enuresis. To assess if this remains an ongoing problem for the patient, the nurse will ask which of the following questions?

answer

"Do you urinate while sleeping?"

question

The nurse makes the following assessment. A middle-aged client reports falling asleep frequently at his job during the day, feels like he is not getting enough sleep at night even though the number of hours of sleep are unchanged, and continues to feel tired and is not able to think clearly. Also, the client reports his wife believes he is irritable upon awakening. Nursing interventions include teaching the client to

answer

use caution when driving an automobile.

question

Which of the following statements about the sleep patterns of toddlers should the nurse incorporate into a teaching plan for parents?

answer

Getting the child to sleep can be difficult

question

A nurse is caring for a client with a pulmonary infection secondary to acquired immunodeficiency syndrome (AIDS). Which of the following would be most effective to manage signs and symptoms of night sweats?

answer

Administer an antipyretic medication prophylactically as needed before the client goes to sleep.

question

The pediatric nurse teaches parents about normal sleep patterns in their children. Which of the following teaching points should the nurse include?

answer

Inform parents that daytime napping decreases during the preschool period, and, by the age of 5 years, most children no longer nap.

question

What interview question would be the best choice for the nurse to use to assess for recent changes in a patient's sleep-wakefulness pattern?

answer

Do you usually go to bed and wake up about the same time each day?

question

For which of the following patients would the nurse be most likely to administer a benzodiazepine-like drug?

answer

A patient who is being treated for short-term insomnia

question

A client at 27 weeks' gestation still walks daily but reports "terrible" heartburn at night. Which action should the nurse point out will best address this situation?

answer

Elevate the head of the bed.

question

When assessing a preschooler who has sustained a head trauma, the nurse notes that the child appears to be obtunded. Which finding supports this level of consciousness?

answer

Can be roused with stimulation

question

A nurse is caring for a veteran, who exhibits signs and symptoms of posttraumatic stress disorder (PTSD). Signs and symptoms of posttraumatic stress disorder include:

answer

hyperalertness and sleep disturbances.

question

A 77-year-old client is brought to the emergency department by her son. The client has a severe headache and lack of sleep because "I am so worried about everything." Her son says that she has heart failure and chronic schizophrenia. "In addition to all of her heart medicines, she is on aripiprazole, which was increased to 30 mg by her health care provider (HCP) 3 days ago." In addition to documenting all of the client's medications and exact dosages, the nurse should particularly investigate which factors? Select all that apply.

answer

the client's symptoms of schizophrenia the dose of aripiprazole the client's symptoms of heart failure

question

A client suffers from low mood and disturbed sleep. This client is most likely experiencing a change in which neurotransmitter?

answer

Serotonin

question

The client has been in the intensive care unit for several days. The client appears to be sleeping throughout the night. The nurse records the data listed above. The nurse evaluates that rapid eye movement (REM) sleep is occurring at

answer

0100

question

A child with attention deficit hyperactivity disorder (ADHD) has been prescribed dextroamphetamine. For what effects should the nurse tell the parents to monitor the child? Select all that apply.

answer

Insomnia Weight loss Appetite suppression

question

The nurse is assessing a client for sleep disorders. The initial step in sleep assessment is:

answer

observe their hours of sleep and review their sleep diary.

question

The nurse is performing a physical health assessment of a client who has been diagnosed with posttraumatic stress disorder (PTSD). What aspect of this assessment should the nurse prioritize?

answer

Sleep assessment

question

A woman with cardiac disease at 32 weeks' gestation reports she has been having spells of light-headedness and dizziness every few days. Which instruction should the nurse prioritize?

answer

Decrease activity and rest more often.

question

According to the gate control theory, pain: A. is caused by gates in the CNS. B. can be blocked or intensified by gates in the CNS. C. is caused by gates in peripheral nerve sensors. D. cannot be affected by learned experiences.

answer

B. can be blocked or intensified by gates in the CNS.

question

Opioid receptors are found throughout the body: A. only in people who have become addicted to opiates. B. in increasing numbers with chronic pain conditions. C. to incorporate pain perception and blocking. D. to initiate the release of endorphins.

answer

C. to incorporate pain perception and blocking

question

Most narcotics are controlled substances because they A. are very expensive. B. can cause respiratory depression. C. can be addictive. D. can be used only in a hospital setting.

answer

C. can be addictive.

question

Injecting a narcotic into an area of the body that is chilled can be dangerous because A. an abscess will form. B. the injection will be very painful. C. an excessive amount may be absorbed all at once. D. narcotics are inactivated in cold temperatures.

answer

C. an excessive amount may be absorbed all at once.

question

Proper administration of an ordered narcotic A. can lead to addiction. B. should be done promptly to prevent increased pain and the need for larger doses. C. would include holding the drug as long as possible until the patient really needs it. D. should rely on the patient's request for medication.

answer

B. should be done promptly to prevent increased pain and the need for larger doses.

question

Migraine headaches A. occur during sleep and involve sweating and eye pain. B. occur with stress and feel like a dull band around the entire head. C. often occur when drinking coffee. D. are throbbing headaches on one side of the head.

answer

D. are throbbing headaches on one side of the head.

question

The triptans are a class of drugs that bind to selective serotonin receptor sites and cause A. cranial vascular dilation. B. cranial vascular constriction. C. clinical depression D. nausea and vomiting.

answer

B. cranial vascular constriction.

question

The only triptan that has been approved for use in treating cluster headaches as well as migraines is A. naratriptan. B. rizatriptan. C. sumatriptan. D. zolmitriptan.

answer

C. sumatriptan.

question

Narcotics are drugs that react with opioid receptors throughout the body. Which of the following would the nurse expect to find when assessing a patient who was taking a narcotic? SELECT ALL THAT APPLY A. Hypnosis B. Sedation C. Analgesia D. Euphoria E. Orthostatic hypotension F. Increased salivation

answer

B. Sedation C. Analgesia D. Euphoria E. Orthostatic hypotension

question

The nurse would expect to administer a narcotic as the analgesic of choice for which patients? A. A patient with severe postoperative pain B. A patient with severe chronic obstructive pulmonary disease and difficulty breathing C. A patient with severe, chronic pain D. A patient with ulcerative colitis E. A patient with recent biliary surgery F. A cancer patient with severe bone pain

answer

A. A patient with severe postoperative pain C. A patient with severe, chronic pain F. A cancer patient with severe bone pain

question

A nurse instructor is teaching a class of student nurses about the nature of pain. Which statements accurately describe this phenomenon? Select all that apply. A. Pain is whatever the physician treating the pain says it is. B. Pain exists whenever the person experiencing it says it exists. C Pain is an emotional and sensory reaction to tissue damage. D. Pain is a simple, universal, and easy-to-describe phenomenon. E. Pain that occurs without a known cause is psychological in nature. F. Pain is classified by duration, location, source, transmission, and etiology.

answer

B, C, F

question

One of the most common distinctions of pain is whether it is acute or chronic. Which examples describe chronic pain? Select all that apply. A. A patient is receiving chemotherapy for bladder cancer. B. An adolescent is admitted to the hospital for an appendectomy. C. A patient is experiencing a ruptured aneurysm. D. A patient who has fibromyalgia requests pain medication. E. A patient has back pain related to an accident that occurred last year. F. A patient is experiencing pain from second-degree burns.

answer

A, D, E

question

A patient complains of abdominal pain that is difficult to localize. The nurse documents this as which type of pain?

answer

Visceral

question

A female patient who is having a myocardial infarction complains of pain that is situated in her jaw. The nurse documents this as what type of pain?

answer

referred pain

question

The three types of responses to pain are physiologic, behavioral, and affective. Which are examples of behavioral responses to pain? Select all that apply. A. A patient cradles a wrist that was injured in a car accident. B. A child is moaning and crying due to a stomachache. C. A patient's pulse is increased following a myocardial infarction. D. A patient in pain strikes out at a nurse who attempts to bathe him. E. A patient who has chronic cancer pain is depressed and withdrawn. F. A child pulls away from a nurse trying to give him an injection.

answer

A, B, F

question

An elderly patient is confined to bedrest following cervical spine surgery to treat nerve pinching. The nurse is vigilant about turning the patient and assessing the patient regularly to prevent the formation of pressure ulcers. What type of agent is the stimulus for pressure ulcers?

answer

mechanical

question

A nurse uses a whirlpool to relax a patient following intense physical therapy to restore movement in her legs. What is a potent pain-blocking neuromodulator, released through relaxation techniques?

answer

Endorphins

question

A patient is postoperative following an emergency cesarean section birth. The patient asks the nurse about the use of pain medications following surgery. What would be a correct response by the nurse?

answer

"Your doctor has ordered pain medications for you, which you should not be afraid to request any time you have pain."

question

Applying the gate control theory of pain, what would be an effective nursing intervention for a patient with lower back pain?

answer

Applying a moist heating pad to the area at prescribed intervals

question

The nurse is assessing the pain of a neonate who is admitted to the NICU with a heart defect. Which pain assessment scale would be the best tool to use with this patient?

answer

CRIES scale

question

Mr. Wright is recovering from abdominal surgery. When the nurse assists him to walk, she observes that he grimaces, moves stiffly, and becomes pale. She is aware that he has consistently refused his pain medication. What would be a priority nursing diagnosis for this patient?

answer

Acute Pain related to fear of taking prescribed postoperative medications

question

When developing the plan of care for a patient with chronic pain, the nurse plans interventions based on the knowledge that chronic pain is most effectively relieved when analgesics are administered in what matter?

answer

Around the clock (ATC)

question

When assessing pain in a child, the nurse needs to be aware of what considerations?

answer

Inadequate or inconsistent relief of pain is widespread.

question

A pregnant woman is receiving an epidural analgesic prior to delivery. The nurse provides vigilant monitoring of this patient to prevent the occurrence of:

answer

Respiratory depression

question

When assessing a patient receiving a continuous opioid infusion, the nurse immediately notifies the physician when the patient has:

answer

A sedation level of 4

question

A nurse assesses a patient's body temperature in the late afternoon as 37.2°C (99°F). What would be the nurse's best action related to this slight elevation in temperature? Assess the patient for infection. Record the temperature as a normal finding. Call the physician for an order for antipyretics. Decrease the room temperature.

answer

Record the temperature as a normal finding.

question

A nurse observes some involuntary muscle jerking in a sleeping patient. The nurse determines that the patient is most likely in which stage of sleep? Stage I NREM sleep Stage II NREM sleep Stage IV NREM sleep REM sleep

answer

Stage I NREM sleep

question

A nurse observes a slight increase in a patient's vital signs while he is sleeping during the night. According to the patient's stage of sleep, the nurse expects what conditions to be true? Select all that apply. A. He is aware of his surroundings at this point. B. He is in delta sleep at this time. C. It would be most difficult to awaken him at this time. D. This is most likely an NREM stage. E. This stage constitutes around 20% to 25% of total sleep. F. The muscles are relaxed in this stage.

answer

C. It would be most difficult to awaken him at this time. E. This stage constitutes around 20% to 25% of total sleep.

question

A nurse working the night shift at a hospital observes the developmental factors that may affect sleep. Which statements accurately describe these variations? Select all that apply. A. REM sleep constitutes much of the sleep cycle of a preschool child. B. By the age of 8 years, most children no longer take naps. C. Sleep needs usually decrease when physical growth peaks. D. Many adolescents do not get enough sleep. E. Total sleep decreases in adults with a decrease in stage IV sleep. F. Sleep is less sound in older adults and stage IV sleep may be absent.

answer

D. Many adolescents do not get enough sleep. E. Total sleep decreases in adults with a decrease in stage IV sleep. F. Sleep is less sound in older adults and stage IV sleep may be absent.

question

A nurse is discussing with an older female patient the factors that affect sleep. What fact does the nurse teach her? Drinking a cup of regular tea at night induces sleep. Using alcohol moderately promotes a deep sleep. Aging decreases the amount of REM sleep a person experiences. Exercising decreases REM and NREM sleep.

answer

Aging decreases the amount of REM sleep a person experiences.

question

A nurse is assessing patients in a skilled nursing facility for sleep deficits. Which patients would be considered at a higher risk for having sleep disturbances? Select all that apply. A. A patient who has uncontrolled hypothyroidism B. A patient with coronary artery disease C. A patient who has gastroesophageal reflux (GERD) D. A patient who is HIV positive E. A patient who is taking corticosteroids for arthritis F. A patient with a urinary tract infection

answer

A. A patient who has uncontrolled hypothyroidism B. A patient with coronary artery disease C. A patient who has gastroesophageal reflux (GERD)

question

A nurse is providing discharge teaching for patients regarding their medications. For which patients would the nurse recommend actions to promote sleep? Select all that apply. A. A patient who is taking iron supplements for anemia B. A patient with Parkinson disease who is taking dopamine C. An elderly patient taking diuretics for congestive heart failure D. A patient who is taking antibiotics for an ear infection E. A patient who is prescribed antidepressants F. A patient who is taking low-dose aspirin prophylactically

answer

B. A patient with Parkinson disease who is taking dopamine C. An elderly patient taking diuretics for congestive heart failure E. A patient who is prescribed antidepressants

question

A nurse working the night shift in a pediatric unit observes a 10-year-old male patient walking the hallway in a sleep state. The child is unaware of his environment and doesn't recall the incident in the morning. Which sleep disorder would the nurse expect? Bruxism Cataplexy Restless leg syndrome Somnambulism

answer

Somnambulism

question

A nurse is performing a sleep assessment on a patient being treated for a sleep disorder. During the assessment, the patient falls asleep in the middle of a conversation. The nurse would suspect which disorder? REM behavior disorder Narcolepsy Enuresis Sleep apnea

answer

Narcolepsy

question

A nurse is teaching a patient with a sleep disorder how to keep a sleep diary. Which data would the nurse have the patient document? Select all that apply. A. Daily mental activities B. Daily physical activities C. Morning and evening body temperature D. Daily measurement of fluid intake and output E. Presence of anxiety or worries affecting sleep F. Morning and evening blood pressure readings

answer

A. Daily mental activities B. Daily physical activities E. Presence of anxiety or worries affecting sleep

question

To promote sleep in a patient, a nurse suggests what intervention? Follow the usual bedtime routine if possible. Drink two or three glasses of water at bedtime. Have a large snack at bedtime. Take a sedative-hypnotic every night at bedtime.

answer

Follow the usual bedtime routine if possible.

question

A nurse formulates the following diagnosis for an elderly patient who is having trouble getting to sleep at night: Disturbed Sleep Pattern: Initiation of Sleep. Which of the following nursing interventions would the nurse perform related to this diagnosis? Select all that apply. A. Arrange for assessment for depression and treatment. B. Discourage napping during the day. C. Decrease fluids during the evening. D. Administer diuretics in the morning. E. Encourage patient to engage in some type of physical activity. F. Assess medication for side effects of sleep pattern disturbances.

answer

A. Arrange for assessment for depression and treatment. B. Discourage napping during the day. E. Encourage patient to engage in some type of physical activity. F. Assess medication for side effects of sleep pattern disturbances.

question

A nurse is caring for a patient who states he has had trouble sleeping ever since his job at a factory changed from the day shift to the night shift. Which diagnosis would be most appropriate for this patient? Ineffective Coping: Multiple Stressors of New Job Sleep Deprivation: Difficulty Falling Asleep Disturbed Sleep Pattern: Altered Sleep-Wake Pattern Risk for Injury: Activity Intolerance/Sleep Deprivation

answer

Disturbed Sleep Pattern: Altered Sleep-Wake Pattern

question

A nurse caring for patients in a busy hospital environment should implement which recommendation to promote sleep? Keep the room light dimmed during the day. Keep the room cool. Keep the door of the room open. Offer a sleep aid medication to patients on a regular basis.

answer

Keep the room cool.

question

A nurse caring for patients in a long-term care facility is implementing interventions to help promote sleep in elderly patients. Which action is recommended for these patients? Increase physical activities during the day. Encourage short periods of napping during the day. Increase fluids during the evening. Dispense diuretics during the afternoon hours.

answer

Increase physical activities during the day.

RNSG1430 Exam 2: Comfort and Sleep – Flashcards

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