Practice Question
A nurse is caring for a dent in the outpatient health clinic.
Answer Choices:
Rationale:
Encourage a regular sleep-wake schedule
💎A regular sleep-wake schedule is crucial in managing the client's sleep difficulties and enhancing the effectiveness of the prescribed trazodone.
💎 Consistent sleep patterns help regulate the body’s internal circadian rhythm, improving the overall quality of rest and helping the client feel more refreshed during the day.
💎 This intervention is effective in mitigating the client’s stress and sleep disturbances, both of which are central to the client's current issues.
Encourage high-calorie finger foods
💎 The client has experienced weight loss (from 54.4 kg to 51.7 kg), and the BMI has decreased from 20.6 to 19.6, suggesting a need for increased caloric intake.
💎 Offering high-calorie finger foods is a practical way to support the client in consuming more calories, especially since their appetite has decreased.
💎 This intervention ensures that the client receives adequate nutrition, preventing further weight loss and promoting physical well-being while dealing with stress and anxiety.
Encourage naps during the day when client is tired
💎 Due to the client’s difficulty sleeping at night, they are likely experiencing daytime fatigue, which can affect mood and cognitive function.
💎 Encouraging short naps during the day helps manage fatigue and prevents exhaustion, allowing the client to stay more alert and functional during the day.
💎 This intervention works in tandem with the goal of improving the client’s overall mental health and coping with stress while addressing their sleeping difficulties.
Instruct client to avoid foods that have been fermented or aged
💎There is no indication in the clinical scenario that the client has a food sensitivity or dietary restriction that would require avoiding fermented or aged foods.
💎 This instruction is generally given to clients with specific conditions like tyramine sensitivity (e.g., clients taking MAO inhibitors), but there is no mention of such concerns here.
💎 Therefore, this intervention is not relevant to the current situation.
Advise client to rise slowly from sitting position
💎 The client does not exhibit symptoms of orthostatic hypotension or dizziness that would justify advising them to rise slowly from a sitting position.
💎 This intervention is typically recommended for clients experiencing low blood pressure or dizziness, but there is no evidence of such issues in this case.
💎 Hence, this intervention is not necessary and not indicated.
Advise client to notify provider if pregnant
💎 There is no mention or indication of pregnancy in the client's medical history or symptoms.
💎 Pregnancy-related complications or concerns are not relevant in this situation, making this advice not necessary.
💎 The client has not provided any indication of being pregnant, and this intervention is therefore not applicable.
Encourage client to sleep until later in the morning
💎 While the client is having difficulty sleeping, encouraging them to sleep until later in the morning may disrupt their sleep-wake schedule.
💎 A consistent, regular sleep pattern is more important than delaying wake-up time, which could interfere with establishing good sleep hygiene.
💎 The priority is to support a set bedtime and wake-up time, making this intervention not appropriate.
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This question is from RN Comprehensive Predictor-2023(2025 Edition) Exam 4 which contains 176 questions.
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From Exam
RN Comprehensive Predictor-2023(2025 Edition) Exam 4
176 Questions
View Full Exam Start PracticingQuestion Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI EXIT Exam(s)
- Domain: RN ATI Comprehensive Predictor Exam(s)~2025
- Answer Choices: 0