9. When the family members of a postoperative patient leave after a visit, the patient tells the nurse that his family gave him a headache by fussing over him so much. What is an appropriate intervention by the nurse?

Correct Answer: B

Rationale: The correct answer is B) Ask the patient’s permission to use acupressure to ease his headache. Acupressure is a non-invasive technique that involves applying pressure to specific points on the body to alleviate symptoms, such as headaches. In this scenario, the patient's headache is likely tension-induced due to the stress of family fussing over him. Acupressure can help relieve his headache without the need for medication, promoting a holistic approach to care. Option A is incorrect because administering a PRN analgesic should not be the first line of treatment for a headache that is likely stress-induced. Option C is incorrect as simply reassuring the patient that his headache will subside may not effectively address the underlying cause. Option D is incorrect as teaching biofeedback methods is a more long-term solution and may not provide immediate relief for the patient's current headache. Educationally, this scenario highlights the importance of considering non-pharmacological interventions for common complaints like headaches, especially when stress or emotional factors are involved. It underscores the nurse's role in assessing the situation, implementing appropriate interventions, and promoting patient-centered care by involving the patient in decision-making regarding their care.

Correct Answer: B

Rationale: In the context of pharmacology and adult medical-surgical care, it is crucial to understand the clinical manifestations of insomnia for accurate assessment and intervention. The correct answer, "Fragmented sleep," is a hallmark sign of insomnia. Individuals with insomnia often experience difficulty maintaining continuous sleep, leading to fragmented or interrupted sleep patterns. Option A, "Narcolepsy," is incorrect as narcolepsy is a separate sleep disorder characterized by excessive daytime sleepiness, sudden muscle weakness, and even episodes of falling asleep during the day, which contrasts with the fragmented sleep seen in insomnia. Option C, "Long sleep latency," refers to the time it takes to fall asleep and is more indicative of sleep-onset insomnia rather than overall insomnia symptoms. Morning headache, option D, is not a typical clinical manifestation of insomnia but may be seen in other conditions like sleep apnea or tension headaches. Understanding these distinctions is essential for healthcare providers to accurately identify and address sleep disorders in their patients. By recognizing the specific clinical manifestations of insomnia, appropriate pharmacological and non-pharmacological interventions can be implemented to improve sleep quality and overall patient well-being.

Correct Answer: B

Rationale: In the context of pharmacological management of insomnia, the correct first-line therapy is cognitive-behavioral therapies such as relaxation therapy (Option B). This approach focuses on addressing the underlying causes of insomnia through behavioral interventions and lifestyle modifications. Cognitive-behavioral therapy for insomnia (CBT-I) has been shown to be effective in improving sleep quality and duration without the risks associated with pharmacological treatments. Option A, complementary therapies like melatonin, may be used as an adjunct to sleep hygiene practices but are not typically recommended as first-line treatment due to limited evidence of efficacy. Option C, benzodiazepine-receptor-like agents such as zolpidem, carry the risk of tolerance, dependence, and adverse effects, making them less desirable for long-term use. Option D, over-the-counter medications like diphenhydramine, can lead to cognitive impairment, drowsiness, and anticholinergic side effects, especially in older adults. Educationally, it is crucial to emphasize non-pharmacological approaches as the initial management strategy for insomnia to promote holistic patient care, reduce reliance on medications, and minimize potential adverse effects. Understanding the rationale behind selecting cognitive-behavioral therapies over pharmacological options aligns with evidence-based practice and patient-centered care in the treatment of insomnia.

Correct Answer: A

Rationale: In the context of pharmacology and nursing, managing rotating shifts is crucial for maintaining optimal performance and patient safety. The correct answer, "A) Take a brief onsite nap," is effective in decreasing the distress of rotating shifts for nurses because short naps have been shown to improve alertness, cognitive performance, and mood during night shifts. Napping can help mitigate the negative effects of sleep deprivation and shift work on the body's circadian rhythm. Option B, "Use sleep hygiene practices," is a good strategy for promoting better overall sleep quality, but it may not be as effective in combating the specific challenges of rotating shifts. Sleep hygiene practices alone may not be sufficient to address the unique sleep disruptions caused by irregular work hours. Option C, "Sleep just before going to work," may not always be feasible for nurses working rotating shifts, as their schedules may vary from day to day. Relying solely on pre-work sleep may not provide adequate rest and recovery, especially when transitioning between different shift times. Option D, "Maintain consistent sleep/wake schedules even on days off," while important for establishing a routine and promoting better sleep patterns, can be challenging for nurses working rotating shifts. The nature of their work often requires flexibility in sleep schedules to accommodate changing shifts. Educationally, it is essential for nurses and healthcare professionals to understand the impact of shift work on their health and performance. Teaching strategies like taking brief onsite naps can empower nurses to proactively manage their well-being and optimize their work productivity while working non-traditional hours in the medical field.

Correct Answer: A

Rationale: In the context of pharmacology, understanding the dimensions of pain is crucial for effective pain management. The correct answer is A) Biological dimension: Physiological aspects of pain. This dimension refers to the physiological processes involved in pain perception, such as nociception and neurotransmitter activity. Option B) Behavioral dimension: Observable responses to pain, focuses on the outward behaviors exhibited in response to pain, such as facial expressions or guarding. While important in assessing pain, it does not encompass the underlying physiological mechanisms. Option C) Cognitive dimension: Thought processes related to pain, involves the cognitive appraisal of pain and the impact of beliefs and expectations on pain perception. While cognitive factors play a role in pain experience, they do not directly address the physiological aspects of pain. Option D) Emotional dimension: Psychological reactions to pain, pertains to the emotional responses and psychological factors influencing pain perception. While emotions can influence pain experience, they do not solely encompass the physiological processes involved in pain perception. Educationally, understanding the dimensions of pain provides a comprehensive view of pain experience, which is essential in pharmacology for selecting appropriate pain management strategies. By recognizing the biological dimension of pain, healthcare providers can target specific physiological mechanisms to achieve optimal pain relief.