18. Melatonin’s use is based on scientific evidence. The patient with which problem would benefit from melatonin?

Correct Answer: A

Rationale: The correct answer is A) Sleep problems. Melatonin is a hormone that regulates sleep-wake cycles, and its use is supported by scientific evidence for managing sleep disorders such as insomnia. Melatonin supplementation can help regulate the body's internal clock and improve sleep quality. Option B) Mild depression would not benefit from melatonin as its primary function is not related to managing depression. Depression is a complex condition that typically requires more targeted interventions such as psychotherapy or antidepressant medications. Option C) High cholesterol is unrelated to melatonin's primary function of regulating sleep. High cholesterol is managed through lifestyle modifications, dietary changes, and sometimes medications like statins. Option D) Benign prostatic hyperplasia is a condition involving the enlargement of the prostate gland in males. Melatonin is not indicated for managing this condition, which typically requires specific medications or procedures to address urinary symptoms associated with BPH. In an educational context, understanding the appropriate use of medications like melatonin based on scientific evidence is crucial for healthcare providers. By knowing the specific conditions for which melatonin is effective, healthcare professionals can make informed decisions when recommending treatment options for their patients with sleep problems. This knowledge helps optimize patient care and outcomes by ensuring that interventions are evidence-based and appropriate for the individual's needs.

Correct Answer: A

Rationale: In the intensive care unit (ICU), creating an environment conducive to sleep is essential for patient recovery. Option A, turning off the lights in the room during the night, is the most effective strategy as it helps regulate the patient's circadian rhythm and promote restful sleep. This option aligns with the principles of sleep hygiene, which emphasize a dark and quiet environment for optimal rest. By minimizing light exposure, the nurse can support the patient's natural sleep-wake cycle. On the other hand, options B, having the television on at all times for background noise, and C, silencing the alarms on the bedside monitor and infusion pumps, can both disrupt the patient's sleep patterns. Background noise and alarms can be disturbing and prevent the patient from entering deep sleep stages. Option D, administering ordered analgesics around the clock even if the patient denies pain, is not directly related to creating a sleep-conducive environment. While pain management is crucial for patient comfort, it may not be the primary factor affecting the patient's ability to sleep in this scenario. Educationally, understanding the importance of environmental factors in promoting sleep in the ICU is vital for nurses to provide holistic care. By implementing appropriate strategies like turning off lights, nurses can enhance patient outcomes and overall well-being during their hospital stay.

Correct Answer: D

Rationale: In the immediate postoperative period following an uvulopalatopharyngoplasty (UPPP), the nurse must prioritize monitoring for potential complications to ensure patient safety. The correct answer is D) Airway obstruction and hemorrhage. This is because after UPPP surgery, there is a risk of swelling and bleeding in the surgical site, which can lead to airway compromise and hemorrhage, posing a significant threat to the patient's life. Option A) Snoring and foul-smelling breath are not immediate postoperative complications of UPPP. Snoring may be improved by the surgery, and foul-smelling breath is not typically associated with this procedure. Option B) Infection and electrolyte imbalance are potential complications postoperatively, but they are not specific to the immediate period following UPPP. These complications usually develop over time and may require longer-term monitoring and management. Option C) Loss of voice and severe sore throat are also not immediate postoperative complications of UPPP. While some throat discomfort is expected after this surgery, severe sore throat and loss of voice would not be typical in the immediate period. Educationally, understanding the potential complications of surgical procedures like UPPP is crucial for nurses to provide safe and effective care. By knowing which complications to monitor for, nurses can intervene promptly if issues arise, ensuring better outcomes for their patients. Vigilant monitoring and knowledge of postoperative complications are essential aspects of nursing care in the surgical setting.

Correct Answer: B

Rationale: The correct answer is B) The area should be treated as a painful lesion, using gentle cleansing and dressing. In the context of an unconscious patient with a stage 2 pressure ulcer, it is crucial for the nurse to understand that even though the patient may not be able to verbalize pain, the presence of a pressure ulcer indicates tissue damage that can still elicit a pain response. Therefore, the nurse should treat the area as a painful lesion by using gentle cleansing and appropriate dressing to promote healing while minimizing discomfort for the patient. Option A is incorrect because the absence of a behavioral response does not necessarily mean the patient is not experiencing pain. Pain perception is subjective and can vary among individuals, especially in patients who are unconscious or unable to communicate. Option C is incorrect because assuming that the patient cannot perceive pain due to being unconscious is a dangerous assumption. Pain perception can still occur even in unconscious patients, and aggressive scrubbing can further damage the fragile tissue of a pressure ulcer. Option D is incorrect because not all nociceptive stimuli necessarily lead to the perception of pain. Pain is a complex phenomenon influenced by various factors beyond just the transmission of signals to the brain. This scenario highlights the importance of a comprehensive understanding of pain perception and management in patients, especially those who are unable to communicate their discomfort. Nurses must approach care with empathy, knowledge, and a patient-centered mindset to ensure optimal outcomes and comfort for all patients.

Correct Answer: C

Rationale: In this scenario, the health care provider would recommend adding transdermal fentanyl (Duragesic) to the patient's medication plan due to its potent opioid analgesic properties, making it suitable for severe cancer pain management. Fentanyl is a strong opioid that can provide effective pain relief when other medications are no longer sufficient, as in this case where the patient's pain is increasing. Option A is incorrect because adding PO oxycodone to the current regimen may not provide the necessary increase in pain relief compared to transdermal fentanyl. Option B is incorrect as propoxyphene is not recommended for use due to safety concerns and its withdrawal from the market. Option D is also incorrect as hydrocodone with acetaminophen may not be as potent as transdermal fentanyl for severe cancer pain. Educationally, it is important to understand the principles of opioid selection in pain management, especially in cancer patients. Transdermal fentanyl is often reserved for moderate to severe pain that requires around-the-clock treatment, making it a suitable choice in this situation. It is crucial for healthcare providers to have a strong knowledge of opioid pharmacology to ensure effective pain management in patients with complex needs.