A male client is admitted to the hospital with blunt chest trauma after a motor vehicle accident. The first nursing priority for this client would be to:

Correct Answer: A

Rationale: Blunt chest trauma from a motor vehicle accident can compromise airway, breathing, or circulation (ABCs), the nurse's top priorities. Assessing the client's airway (Choice A) is first because obstruction (e.g., from blood, swelling, or foreign objects) or injury (e.g., pneumothorax) threatens life within minutes. Signs like stridor, cyanosis, or absent breath sounds demand immediate actione.g., suctioning or intubation. Pain relief (Choice B) is vital but secondary, as unrelieved pain won't kill instantly, unlike airway loss. Encouraging deep breathing and coughing (Choice C) risks worsening injuries like rib fractures or flail chest if airway isn't secured. Splinting the chest (Choice D) aids breathing but assumes airway patency. For example, a tracheal deviation from tension pneumothorax detected during airway assessment takes precedence over pain. ABC prioritization ensures survival, making Choice A the correct first step.

Correct Answer: D

Rationale: Diet influences sleep via neurotransmitter and blood sugar effects. 'A carbohydrate snack' promotes sleep by raising tryptophan levels, a serotonin and melatonin precursore.g., a banana or crackers 1-2 hours before bed stabilizes glucose, easing sleep onset. 'One cup of hot chocolate' has caffeine (e.g., 5-20 mg), a stimulant delaying sleep, despite warmth's relaxation. 'Three glasses of red wine' sedates initially but disrupts REM sleep latere.g., alcohol metabolism at 3 a.m. causes awakeningsper sleep studies. 'A high-protein snack' , like turkey, has tryptophan but digestion (e.g., tyrosine release) can stimulate, not sedate. Nursing, per Taylor, favors carbs for their insulin-mediated tryptophan boost, avoiding stimulants or heavy meals. Choice D is the correct, evidence-based recommendation.

Correct Answer: B

Rationale: Cataplexy, tied to narcolepsy, involves muscle weakness triggered by emotions. 'Sudden loss of motor tone that may cause the person to fall asleep; usually experienced during a period of strong emotion' is correcte.g., laughter drops a patient's jaw or knees, lasting seconds, per AASM. Choice A, 'irresistible urge to sleep,' is narcolepsy's sleep attacks, not cataplexye.g., no muscle loss. Choice C, 'nightmare or vivid hallucinations,' fits hypnagogic events, not cataplexy's waking state. Choice D, 'skeletal paralysis during transition,' describes sleep paralysis, not emotion-driven cataplexye.g., no falling asleep. A nurse might see a patient slump during joy, per Taylor's neurology. Choice B precisely defines this feature.

Correct Answer: D

Rationale: Sleep drugs vary in mechanism. 'Ramelton (Rozerem)' normalizes cycles by mimicking melatonin, binding MT1/MT2 receptorse.g., aligning sleep to 11 p.m.per Taylor's pharmacology. 'Flurazepam (Dalmane)' and 'temazepam (Restoril)' , benzodiazepines, sedate via GABAe.g., 15 mg knocks out, not syncing cycles. 'Eszopiclone (Lunesta)' , a non-benzodiazepine, enhances GABA tooe.g., 3 mg aids sleep onsetbut doesn't target melatonin. Ramelton's unique actione.g., no tolerance vs. others' 2-week fademimics the body's clock, making Choice D correct.

Correct Answer: C

Rationale: Chronic pain's defining trait is its impact over time. 'It interferes with normal functioning' is true e.g., arthritis pain limits mobility or sleep, per Taylor's chronic pain framework, persisting beyond 3-6 months and disrupting life (e.g., work absenteeism). Choice A, 'less than 6 months,' defines acute paine.g., a sprain heals in weeks, not chronic. Choice B, 'always present and intense,' overstates; chronic pain variese.g., fibromyalgia waxes and wanes, not constant 10/10. Choice D, 'disappears with treatment,' is false; chronic pain often resists curee.g., neuropathy lingers despite drugs. For example, a patient with back pain for years might skip social events, showing functional loss, not just discomfort. Unlike acute pain's warning, chronic pain's persistence shifts focus to management (e.g., PT, meds), not resolution. Nursing recognizes its biopsychosocial toll, making Choice C the accurate statement.