Question 1

Why patient of pneumonia advise for complete bed rest-?

Accepted Answer

Answer reason: Bed rest limits activity and lowers metabolic work, thereby decreasing oxygen consumption and overall O2 demand in pneumonia. Options about increasing CO2 or improving O2 consumption are incorrect.

Question 2

A 6 year old child is admitted to the hospital with pneumonia. An immediate priority in this child's nursing care would be?

Accepted Answer

Answer reason: With pneumonia, conserving energy and decreasing oxygen demand is the immediate priority; providing rest supports ventilation and recovery. Nutrition, exercise, and elimination are important but not the first priority on admission.

Question 3

A patient states that he has difficulty sleeping in the hospital because of noise. Which of the following would be an appropriate nursing action?

Accepted Answer

Answer reason: The patient’s sleep problem is due to noise; reducing environmental stimuli by closing the door is a nonpharmacologic intervention that directly addresses the cause. Sedatives are not first-line, brief ambulation won’t reduce noise, and warm milk does not address the noise issue.

Question 4

A patient on paroxetine (Paxil) reports feeling 'wired' and unable to sleep; which nursing intervention is most appropriate?

Accepted Answer

Answer reason: Paroxetine (an SSRI) can cause activation and insomnia. The safest immediate nursing intervention is to promote sleep hygiene with relaxing activities before bedtime. Taking it at bedtime could worsen insomnia, dose changes require provider direction, and documentation alone does not address the patient’s problem.

Question 5

A client is admitted with hyperthyroidism. What nursing intervention is appropriate for managing symptoms of hyperthyroidism?

Accepted Answer

Answer reason: Hyperthyroidism causes hypermetabolism, anxiety, and restlessness; nursing care includes promoting rest and a calm environment. Other options are inappropriate: clients need high-calorie diets and a cool environment; sedatives are not first-line without a provider order.

Question 6

An elderly client who experiences nighttime confusion wanders from his room into the room of another client. The nurse can best help with decreasing the client's confusion by?

Accepted Answer

Answer reason: A nightlight helps reorient an elderly client with sundowning, decreases misperception in the dark, and promotes safer rest. Sedatives can worsen confusion and increase fall risk; a sitter or roommate does not address the confusion and may be unnecessary or counterproductive.

Question 7

The nurse is preparing to discharge a client with a long history of polio. The nurse should tell the client that?

Accepted Answer

Answer reason: Clients with a history of polio (post-polio syndrome) commonly experience fatigue and muscle weakness; energy conservation with planned rest periods is recommended. Strenuous exercise can worsen fatigue, hot baths may increase weakness and polio is not characterized by spasticity, and visual disturbances are not typical.

Question 8

The nurse is caring for a client with cerebral palsy. The nurse should provide frequent rest periods because?

Accepted Answer

Answer reason: In cerebral palsy, stress and activity can exacerbate involuntary athetoid/writhing movements, which diminish with relaxation and rest; providing frequent rest periods reduces these movements.

Question 9

A ten year-old client is recovering from a splenectomy following a traumatic injury. The clients laboratory results show a hemoglobin of 9 g/dL and a hematocrit of 28 percent. The BEST approach for the nurse to use is to?

Accepted Answer

Answer reason: With Hgb 9 g/dL and Hct 28%, the child is anemic and has reduced oxygen-carrying capacity; conserving energy is priority. Planning care around lengthy rest periods best prevents fatigue. Diet changes (iron, limiting milk) are longer-term and not the immediate priority; bed activities still expend energy.

Question 10

What is the meaning of insomnia?

Accepted Answer

Answer reason: Insomnia is difficulty initiating or maintaining sleep—a disturbance of sleeping—so the option referring to sleep is correct.

Question 11

Which of the following medications are the safest to administer to adults needing assistance in falling asleep?

Accepted Answer

Answer reason: Hypnotics Hypnotics are specifically intended to promote sleep initiation and maintenance and are generally preferred over broader sedatives when the goal is sleep. Benzodiazepines and many anti-anxiety agents can cause next-day sedation, cognitive impairment, and increased risk of dependence/falls, especially with repeated use. In adults who need help falling asleep, using a targeted hypnotic at the lowest effective dose for the shortest duration is typically the safest medication approach compared with more nonspecific sedatives.

Question 12

Which of the following is the appropriate meaning of CBR?

Accepted Answer

Answer reason: Complete Bed Rest CBR is a common medical/nursing abbreviation that means the patient is to remain on strict/complete bed rest. This order typically limits ambulation and often restricts the patient to bed with only essential activity as prescribed. The other options are not standard clinical meanings for the abbreviation CBR.

Question 13

It is most likely that an acutely ill client will need the room temperature set at which of the following temperatures?

Accepted Answer

Answer reason: Acutely ill clients are more comfortable and less physiologically stressed in a neutral thermal environment that avoids both chilling and overheating. A room temperature around 68°F (20°C) is commonly recommended in care settings to support comfort, conserve energy, and reduce metabolic demand. Warmer settings (74–78°F) can promote sweating and discomfort and may worsen fever, while cooler settings (64°F) can increase shivering and oxygen consumption.

Question 14

The nurse is teaching a female client with multiple sclerosis. When teaching the client how to reduce fatigue, the nurse should tell the client to?

Accepted Answer

Answer reason: Heat can worsen multiple sclerosis symptoms and fatigue due to heat sensitivity (Uhthoff phenomenon), so keeping cool helps conserve energy and reduce symptom exacerbation. A hot bath would increase body temperature and may increase fatigue and weakness. Increasing muscle relaxants can worsen sedation and weakness and should not be done without a provider order. Planned rest periods (including brief naps if needed) are generally helpful rather than being universally avoided.

Question 15

The nurse is making a care plan for the newly hospitalized patient who is having difficulty in sleeping. Which is the best intervention for the nurse to implement?

Accepted Answer

Answer reason: Individual sleep routines and usual sleep hygiene practices vary; assessing the patient’s baseline habits is the safest first step to tailor interventions and identify modifiable factors in the hospital environment. This supports patient-centered care and may reveal effective nonpharmacologic strategies (e.g., relaxation routine, preferred environment) that can be replicated. Sedative-hypnotics can increase fall risk, delirium, and respiratory depression, so they are not first-line without assessment. Snacks and leaving the TV on may worsen sleep depending on patient preferences and can add stimulation or gastrointestinal discomfort.

Question 16

A nurse is providing teaching to an older adult client about methods to promote nighttime sleep. Which of the following instructions should the nurse include?

Accepted Answer

Answer reason: A small, light snack can reduce hunger-related awakenings and may support sleep onset, especially in older adults. In contrast, staying in bed while unable to sleep can condition the bed with wakefulness; good sleep hygiene recommends getting up briefly and returning when sleepy. Long daytime naps and vigorous exercise close to bedtime can decrease sleep drive or increase physiologic arousal, making it harder to fall asleep at night.

Question 17

A nurse is teaching an older adult client about promoting nighttime sleep. Which instruction should be included?

Accepted Answer

Answer reason: A small snack can help prevent hunger-related awakenings and may support sleep onset in some older adults. Remaining in bed while unable to sleep can reinforce insomnia; getting up for a quiet activity and returning when sleepy is preferred. Long daytime naps and exercising right before bedtime can increase nighttime wakefulness by reducing sleep drive or increasing physiologic arousal.

Question 18

A patient complaining of restlessness and inability to sleep at night, what is your advice to him?

Accepted Answer

Answer reason: Caffeine is a stimulant that can increase arousal, worsen restlessness, and delay sleep onset, so limiting it—especially in the afternoon/evening—is a key sleep-hygiene intervention. Using a phone typically increases blue-light exposure and mental stimulation, which can further disrupt circadian rhythms and sleep quality. Excessive daytime resting can reduce sleep drive and contribute to insomnia at night.

Question 19

A client with multiple sclerosis tells the unlicensed assistive personnel (UAP) after physical therapy that she is too tired to take a bath. What is the priority nursing concern at this time?

Accepted Answer

Answer reason: After physical therapy, being “too tired” signals reduced physiologic reserve and increased risk of falls or injury during bathing, which is a high-risk ADL due to wet surfaces and transfers. Addressing fatigue first allows the nurse to modify the plan (rest periods, energy conservation, assist/supervise bathing) to prevent harm and support recovery. The other options describe downstream consequences (ADL limitation, reduced mobility, weakness) but do not capture the most immediate, modifiable driver of the current problem.

Question 20

The nurse is assigned to care for a client who had a myocardial infarction (MI) 2 days ago. The client has many questions about this condition. What area is a priority for the nurse to discuss at this time?

Accepted Answer

Answer reason: Two days after an MI, clients need clear limits on exertion, guidance on graded activity, and warning signs to stop activity (e.g., chest pain, dyspnea, palpitations), which directly reduces risk of ischemia/arrhythmias. Providing structured rest periods and pacing strategies is an immediate safety need during acute hospitalization and early discharge planning. Broader topics like long-term rehabilitation or detailed diet plans are important but are typically secondary to immediate activity tolerance and energy-conservation education at this stage.

Question 21

A patient recently underwent coronary artery bypass graft surgery (CABG). The Nursing diagnosis includes sleep deprivation related to intensive care environment. The goal for this diagnosis would be that the patient?

Accepted Answer

Answer reason: Uninterrupted nighttime sleep reflects improved sleep quality and restoration, which is commonly disrupted by ICU noise, alarms, and frequent care interruptions. A measurable target like 4 hours helps evaluate whether interventions (clustering care, reducing nighttime stimuli, relaxation measures) are effective. Daytime naps may compensate for fatigue but do not necessarily correct poor nocturnal sleep and can worsen night sleep fragmentation. Pain control and early ambulation are important post-CABG outcomes, but they do not directly measure resolution of the sleep deprivation diagnosis.

Question 22

The nurse has taught a client with multiple sclerosis (MS). Which of the following statements by the client would indicate a correct understanding of the teaching?

Accepted Answer

Answer reason: " Energy conservation and fatigue management are core self-care strategies in MS, and scheduling demanding activities during peak energy helps maintain function and reduces symptom exacerbation. This statement reflects planning and pacing activities when rested, which aligns with teaching to alternate activity with rest and prioritize tasks. In contrast, heat exposure commonly worsens MS symptoms (Uhthoff phenomenon), making a hot bath an unsafe relaxation strategy. Blurred vision from optic neuritis may improve, but it is not appropriate to teach that it should reliably resolve after “several weeks” of medication as a general expectation.

Question 23

Which of the information about sleep and rest is accurate?

Accepted Answer

Answer reason: Setting regular bedtime and wake times is a core nonpharmacologic sleep-hygiene intervention taught in nursing care. Vigorous activity close to bedtime tends to increase arousal and delay sleep rather than promote it. Sleep need varies by age and individual, so a fixed “seven to 8 hours” statement is not universally accurate. One option is unrelated to sleep/rest teaching and is therefore incorrect.

Question 24

Which nursing intervention is most appropriate when caring for an infant with heart failure?

Accepted Answer

Answer reason: Infants with heart failure have limited cardiac reserve and fatigue easily, so minimizing energy expenditure is a priority to reduce oxygen demand and cardiac workload. Grouping care allows longer uninterrupted rest periods, improving feeding tolerance and overall cardiopulmonary stability. Fluid restriction may be ordered in some cases, but it is not universally appropriate without a specific prescription and can risk inadequate hydration/caloric intake in infants. Routine prone positioning is not recommended due to increased SIDS risk, and avoiding infant seats is not a primary heart-failure intervention.

Question 25

A child is hospitalized with bacterial endocarditis. Which nursing diagnosis is most appropriate?

Accepted Answer

Answer reason: These constraints commonly lead to boredom, frustration, and lack of age-appropriate stimulation, making a problem-focused psychosocial/comfort diagnosis highly relevant to nursing care. The other options are not the most universally expected priority diagnoses for this condition: constipation and excess fluid volume may occur but are not inherent, and overnutrition is unlikely in an acutely ill hospitalized child. Nursing care should therefore emphasize providing suitable activities, maintaining routines, and supporting coping during enforced rest.

Question 26

A client diagnosed with a sleep disorder awakens with a piercing scream. The nurse understands this behavior is associated with which condition?

Accepted Answer

Answer reason: The client is typically difficult to console and often has little or no recall of the event afterward, which aligns with the described piercing scream on awakening. Nightmare disorder, in contrast, occurs during REM sleep and is usually followed by full alertness with clear recall of the disturbing dream. Hypersomnia involves excessive sleepiness rather than sudden screaming episodes, and sleepwalking typically involves ambulation with reduced responsiveness rather than a prominent piercing scream as the key feature.

Question 27

What is the most appropriate nursing diagnosis for a client with a sleep disorder?

Accepted Answer

Answer reason: A sleep disorder is fundamentally an alteration in the quantity/quality/timing of sleep, making an actual sleep-focused diagnosis the best fit. “Risk for injury” can be relevant in specific sleep disorders (e.g., sleepwalking, severe daytime somnolence) but it is not universally present and is secondary unless safety cues are provided. The other options target different problem domains (self-esteem or hallucination-related perception changes) and are not the most appropriate default diagnosis for sleep disorders.

Question 28

A nurse is interviewing a client newly admitted to the unit. While stating a list of medications, the client falls asleep. The nurse understands that the client is most likely exhibiting which disorder?

Accepted Answer

Answer reason: Falling asleep while reciting medications suggests an abrupt sleep episode rather than difficulty initiating or maintaining sleep. Hypersomnia involves prolonged sleep or persistent sleepiness but typically not sudden sleep-onset episodes in the middle of an interaction. Parasomnias are abnormal behaviors during sleep (e.g., sleepwalking, night terrors) and do not primarily present as unexpected sleep attacks while awake.

Question 29

A client complains of an inability to sleep while on the medical unit. Which intervention should the nurse perform first?

Accepted Answer

Answer reason: Nursing care follows the process of assessing before intervening unless an urgent safety problem exists. Sleep difficulty in the hospital can be driven by baseline routines, pain, anxiety, caffeine, nocturia, or environmental factors, and identifying the patient’s usual sleep pattern guides individualized, effective measures. Giving a sedative is not a first action because it requires an order and carries fall/delirium/respiratory depression risk. Comfort or environmental changes (e.g., backrub, moving beds) may help, but they should be selected after clarifying what is disrupting sleep and what typically helps the client rest.

Question 30

Which nursing intervention is most appropriate when caring for an infant with neonatal chronic lung disease (bronchopulmonary dysplasia)?

Accepted Answer

Answer reason: Infants with bronchopulmonary dysplasia have limited respiratory reserve and fatigue easily, so care should minimize oxygen consumption by clustering activities and promoting uninterrupted rest. A consistent schedule helps space feeding, treatments, and handling to reduce energy expenditure and work of breathing while supporting growth. Reducing supplemental oxygen during feeding is unsafe because feeding increases metabolic demand and can worsen hypoxemia. Frequent playful stimulation increases activity and fatigue and can precipitate respiratory distress; open-crib placement is not the priority compared with conserving energy and maintaining adequate oxygenation.

Question 31

The nurse is teaching a client with multiple sclerosis (MS) about ways to avoid exacerbation of the disease. What is the best information for the nurse to include?

Accepted Answer

Answer reason: Regular sufficient nighttime sleep supports immune and neurologic recovery and improves coping with neuromuscular weakness. Heat exposure can worsen conduction in demyelinated nerves and may transiently exacerbate symptoms, making hot baths a poor teaching point. Hydration is generally healthy but is not as directly tied to preventing MS exacerbations as managing fatigue and avoiding overheating.

Question 32

What is the nursing intervention most appropriate for an individual experiencing symptoms of depression?

Accepted Answer

Answer reason: Nonpharmacologic sleep hygiene is a first-line nursing intervention for insomnia that commonly accompanies depression. A warm bath promotes relaxation and can facilitate sleep onset by reducing physiologic arousal and supporting a consistent bedtime routine. Sedative-hypnotics require a provider order and add risk (daytime sedation, falls, dependence), so they are not the most appropriate initial nursing action. Watching television is a stimulating activity that can worsen insomnia by increasing cognitive arousal and disrupting healthy sleep routines.

Question 33

The nurse is observing an individual who is sleeping. The nurse determined the client is in REM sleep. Which characteristics represent REM sleep?

Accepted Answer

Answer reason: During this stage, heart rate and respirations tend to become more irregular and overall physiologic activity increases compared with deeper NREM stages. The option describing decreased physiologic activity and a slowed pulse better matches deeper NREM sleep (especially N3). Jerky limb movements and frequent position changes are more consistent with lighter NREM stages or movement disorders rather than typical REM physiology.

Question 34

The nurse is planning the care of a client diagnosed with acute bacterial endocarditis who has been admitted for intravenous therapy. Which intervention should the nurse include in the plan of care?

Accepted Answer

Answer reason: Acute bacterial endocarditis produces systemic infection and significant fatigue, so conserving energy and supporting physiologic recovery is a core nursing priority while IV antibiotics are administered. Cluster care and reduce unnecessary disturbances to promote rest, which also helps decrease cardiac workload and oxygen demand. Routine oxygen at a fixed low flow is not indicated unless assessment shows hypoxemia or respiratory distress. Cardiac rehabilitation and discussions about valve replacement are not standard initial plan-of-care interventions for all hospitalized acute cases and depend on clinical stability and complications.

Question 35

A male client is seen in the physician’s office with complaints of ongoing sleepiness during the day requiring napping. The client reports that he has “nodded off” at the wheel of his car during the day and snores loudly at night. The client is 6’0 tall and weighs 300 lbs. What is the most likely diagnosis for this client?

Accepted Answer

Answer reason: Excessive daytime sleepiness with loud habitual snoring in an obese client strongly indicates recurrent upper-airway obstruction during sleep with fragmented, nonrestorative sleep. Obesity is a major risk factor because increased soft tissue in the neck narrows the airway and promotes collapse, leading to repeated arousals and daytime somnolence severe enough to cause drowsy driving. Narcolepsy typically features sudden sleep attacks with cataplexy, sleep paralysis, or hypnagogic hallucinations and is not characterized by loud snoring or obesity-related airway obstruction. Insomnia and delayed sleep phase syndrome primarily involve difficulty initiating/maintaining sleep or shifted sleep timing rather than loud snoring with high-risk daytime sleepiness.

Question 36

The pediatric nurse is preparing a child with acute lymphocytic leukemia for discharge. The discharge plan should include all but which of the following statements?

Accepted Answer

Answer reason: Encouraging daytime naps as needed helps maintain activity tolerance and supports recovery rather than being routinely restricted. Discharge teaching more appropriately emphasizes adequate nutrition to support hematopoiesis and overall growth, and tracking intake can help identify deficiencies or poor appetite. Therefore, advising restriction of naps is the least appropriate statement for the discharge plan.

Question 37

The nurse is teaching a client newly diagnosed with multiple sclerosis. Which of the following statements by the client would indicate a correct understanding of the teaching?

Accepted Answer

Answer reason: Energy conservation is a key self-management strategy in multiple sclerosis because fatigue is common and can worsen with overexertion. Scheduling tasks, pacing activity, and allowing planned rest periods reduces fatigue severity and helps maintain function throughout the day. In contrast, heat exposure can exacerbate MS symptoms (Uhthoff phenomenon), so hot baths are generally discouraged when symptoms flare. For diplopia, patching is typically done over one eye (not both) to reduce double vision while preserving some vision and safety.

Question 38

Overstimulation may cause increased oxygen use in a preterm infant. Which nursing intervention helps to avoid this problem?

Accepted Answer

Answer reason: Minimizing stimulation decreases a preterm infant’s stress response and therefore reduces energy expenditure and oxygen consumption. Clustering care limits the number of handling episodes and allows longer uninterrupted rest periods, supporting physiologic stability and better oxygenation. In contrast, writing on charts atop the incubator and giving report at the bedside increase noise, vibration, light, and activity near the infant, which can worsen overstimulation. Parent teaching is important but does not directly reduce immediate environmental stimuli and handling in the moment, so it is less effective for preventing increased oxygen use.

Question 39

A client who is diagnosed with breast cancer is undergoing chemotherapy. Which is the best nursing intervention for the care of a client with cancer?

Accepted Answer

Answer reason: Chemotherapy commonly causes fatigue, deconditioning, and decreased functional reserve, so nursing care prioritizes energy conservation paired with light, regular activity to maintain strength and tolerance of treatment. Balancing rest with appropriate exercise helps reduce cancer-related fatigue, supports mood and appetite, and improves overall functional status. Vigorous rubbing/scratching dry skin increases risk of skin breakdown and infection, which is unsafe in potentially immunosuppressed clients. Increasing sweet/fatty/spicy foods can worsen nausea, mucositis, and poor intake, and discouraging saliva substitutes is inappropriate because xerostomia and mucositis often benefit from moisture, sugar-free lozenges, and saliva substitutes.

Question 40

A client complains of waking up feeling very tired even after 8 hours of sleep. Which action should the nurse take first?

Accepted Answer

Answer reason: Nursing care follows the nursing process, so assessment and data gathering come before teaching or referrals when the situation is non-emergent. Daytime fatigue despite adequate sleep duration can result from poor sleep quality due to environment (noise, light, temperature), substances (caffeine/alcohol), medications, inconsistent schedules, or symptoms such as snoring/apnea. Identifying these factors first guides the most appropriate, individualized intervention and determines whether further evaluation is warranted. Jumping to education or specialist referral without assessing risks missing a reversible cause and is not the best initial step.

Question 41

An older adult client who was hospitalized 3 days ago is having trouble sleeping with some periods of confusion during waking hours. What is the best interpretation by the nurse regarding this client data?

Accepted Answer

Answer reason: Hospitalization commonly disrupts circadian rhythm through noise, frequent interruptions, unfamiliar surroundings, and reduced daytime activity, and in older adults this sleep deprivation can precipitate intermittent confusion (often early delirium features). The timing (3 days after admission) and symptom pattern (poor sleep with episodic confusion) most directly supports an environment-related sleep–wake disturbance as the primary interpretation. The other options either infer broader psychosocial or self-management problems not evidenced by the data or introduce hallucinations without supporting cues. Interpreting the problem as sleep disruption guides nursing actions like sleep hygiene, clustering care, and minimizing nighttime stimuli while monitoring for delirium.

Question 42

Appropriate intervention is vital for many children with heart disease in order to go on to live active, full lives. Which of the following outlines an effective nursing intervention to decrease cardiac demands and minimize cardiac workload?

Accepted Answer

Answer reason: Clustering nursing care to allow longer, uninterrupted rest decreases sympathetic stimulation, lowers heart rate and respiratory work, and helps prevent fatigue-related decompensation. Prolonged feeding would increase energy expenditure and can worsen tachypnea and fatigue, increasing cardiac workload. A consistent plan and avoiding conflict may support overall care but do not directly and reliably reduce physiologic cardiac demands like protected rest does.

Question 43

The nurse is assessing the client. Which statement made by the client best indicates the possibility of a sleep disorder?

Accepted Answer

Answer reason:  A sleep disorder is suggested when sleep quantity/quality is insufficient to restore normal daytime functioning, producing fatigue or impaired alertness. This statement shows a clear change from baseline sleep duration along with nonrestorative sleep symptoms (waking unrefreshed and tired), which is a key indicator of clinically significant sleep disturbance. In contrast, waking to urinate every few hours points more toward nocturia as an underlying cause that should be assessed rather than a primary sleep disorder. A prior period of insomnia related to untreated hyperthyroidism indicates a resolved, secondary cause rather than a current sleep disorder.

Question 44

A 35 year-old patient was admitted to the Medical Ward through Emergency Department accompanied by her mother. Her chief complaints include sever epigastria pain, abdominal tenderness and distension for the last 24 hours. She was anorexic and had passed six watery diarrhoea since the last few hours. She was feeling lethargic due to frequent elimination and body fluid loss. Her medical order sheet has a list of procedures to be done. What should the nurse do to reduce patient's feeling of exertion?

Accepted Answer

Answer reason: Minimizing stimulation and clustering care to allow uninterrupted rest reduces energy expenditure, supports physiologic recovery, and can improve tolerance of ongoing symptoms like diarrhea and abdominal pain. While hydration is important, it does not directly address the immediate nursing goal of reducing exertion and may be limited by nausea or abdominal discomfort. Emotional reassurance and support are therapeutic but are less effective than protected rest for decreasing physiologic fatigue in this presentation.

Question 45

Which nursing question would elicit the most thorough assessment data regarding the client's recent sleeping patterns?

Accepted Answer

Answer reason: Open-ended questions elicit richer, more specific assessment data by encouraging the client to describe patterns, duration, quality, awakenings, routines, and contributing factors. This phrasing invites a narrative response and allows follow-up about onset, frequency, sleep hygiene, and daytime effects. The other options are closed-ended and tend to produce yes/no or vague judgments, which can miss key details needed for planning care. A broad invitation to discuss sleep supports therapeutic communication and a comprehensive sleep assessment.

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