Practice Question
Which nursing action is appropriate for a client with sensory overload?
Answer Choices:
Correct Answer:
Clustering care as much as possible
Rationale:
🌸 Sensory overload occurs when too much environmental stimulation overwhelms a client’s ability to process information.
🌸 Clustering care reduces repeated interruptions, giving the client longer uninterrupted periods of rest.
🌸 This decreases incoming auditory, visual, and cognitive stimuli, helping the client regain control and comfort.
🌸 It also promotes a calm environment, which is essential for restoring mental focus and reducing agitation.
🌸 Clustering interventions is an evidence-based strategy used in clients with neurological stress or ICU overstimulation.
🌸 This method also supports the nurse’s workflow while providing therapeutic benefit.
🌸 Reducing sensory input is the cornerstone of managing sensory overload effectively.
🚫 Incorrect: Leaving the room door open
🚫 Leaving the door open increases noise, light, hallway traffic, and staff conversations, worsening sensory overload.
🚫 It exposes the client to unnecessary external stimuli when they need a low-stimulation environment.
🚫 The client cannot filter excessive sensory input, which increases confusion and anxiety.
🚫 This action is appropriate for sensory deprivation, not overload.
🚫 It directly contradicts the goal of reducing environmental stimulation.
🚫 Incorrect: Rushing to complete tasks
🚫 Rushing stimulates the client with rapid movements, quick speech, and increased noise.
🚫 Sensory overload clients need slow, calm actions, not hurried care.
🚫 Fast-paced activity increases the client’s stress and impairs their ability to process instructions.
🚫 It makes the environment feel chaotic rather than therapeutic.
🚫 This behavior will worsen symptoms rather than relieve them.
🚫 Incorrect: Calling the client’s family to visit
🚫 Additional visitors add more noise, voices, and emotional stimulation, worsening sensory overload.
🚫 Family visits may increase stress if the client is already overwhelmed.
🚫 This intervention increases sensory input at a time when the goal is to reduce input.
🚫 Family presence is helpful for sensory deprivation—but harmful in overload.
🚫 It does not support the client’s immediate need for quiet and control.
Want to practice more questions like this?
This question is from 106 Mock exam which contains 99 questions.
More Questions from This Exam
The nurse is getting ready to discharge an elderly male client that was on the med-surge unit. The client came to the hospital because of a fall and had also broken his right shoulder. Which instruction should the nurse be certain to include when providing discharge teaching for this client who has a serious visual deficit?
Answer Choices:
The nurse understands that which of the following individuals are most likely to have increased levels of stress?
Answer Choices:
Your client requires intensive nutrition support. The health care provider has prescribed centrally administered total parenteral nutrition (TPN). The nurse understands what to be true about TPN.
Answer Choices:
A client was admitted to the med-surg unit last night with a diagnosis of left-sided heart failure. The health care provider prescribed continuous positive airway pressure (CPAP) for the client and explained to the client why the CPAP will be used. The nurse caring for the client reinforces that the CPAP is used for which of the following?
Answer Choices:
A student nurse is shadowing on an oncology unit and asks the client about their history of lung cancer. The student should know which of the following is the most common risk categories associated with lung cancer?
Answer Choices:
Question Details
- Category: RN Nursing Exam(s)
- Subcategory: General Exams
- Domain: Medical-surgical📚
- Answer Choices: 4