A nurse is caring for a patient who is sleeping for abnormally long periods of time. This condition may be caused by injury to which of the following body structures?

Correct Answer: C

Rationale: Excessive sleep, or hypersomnia, often stems from central nervous system dysfunction, particularly the hypothalamus , which regulates sleep-wake cycles via the suprachiasmatic nucleus (SCN) and orexin neurons. Injury heree.g., from trauma or tumordisrupts circadian rhythm and arousal, causing prolonged sleep, as seen in conditions like narcolepsy or post-traumatic hypersomnia. The spinal cord conducts signals but doesn't control sleep; injury might cause paralysis, not hypersomnia. The pancreas manages glucose, and while hypoglycemia can induce fatigue, it doesn't directly govern sleep duration. The thyroid influences metabolism; hypothyroidism causes lethargy, but not abnormally long sleep periods distinct from fatigue. For example, a hypothalamic lesion might reduce orexin, a wake-promoting neurotransmitter, leading to 16-hour sleep days versus a normal 7-9. Nursing assessments would note this brain region's role in sleep homeostasis, per Taylor's text, confirming Choice C as the correct answer.

Correct Answer: A

Rationale: CPAP (continuous positive airway pressure) treats sleep apnea, typically obstructive (OSA). 'Positive air pressure holds the airway open' is the rationale; it splints the pharynxe.g., 10 cmH2O pressure prevents collapse during inhalation, per AASM guidelines. Choice B, 'negative air pressure holds the airway closed,' is opposite and nonsensicale.g., worsening obstruction. Choice C, 'delivery of oxygen facilitates respiratory effort,' aids hypoxemia but isn't CPAP's mechanism; it's pressure, not O2, per se. Choice D, 'alternating waves of air,' fits BiPAP, not CPAP's constant flowe.g., no 'waves' in standard use. A nurse might adjust CPAP for a patient with 30 apneas/hour, per Taylor's respiratory care, ensuring patency. Choice A is the correct, mechanistic answer.

Correct Answer: C

Rationale: Effective sleep plans yield measurable rest gains. 'Identifies factors that interfere with normal sleep pattern' shows success; awarenesse.g., 'Caffeine at 8 p.m. keeps me up'enables change, per Taylor's outcome criteria. Choice A, 'inability to sleep without medications,' signals failuree.g., dependence, not independence. Choice B, 'continues to read in bed for hours,' persists poor hygienee.g., delaying sleep to 1 a.m. Choice D, 'minimal improvement,' admits partial gaine.g., 6 vs. 5 hoursbut not optimal. Identifying barriers (e.g., noise, stress) empowers patients, making Choice C the correct, effective outcome.

Correct Answer: D

Rationale: Pain inside a cast stems from physical forces. 'Mechanical' is correct; pressure or frictione.g., a tight cast compressing tissue or rubbing skincauses this, per Taylor's pain classification. Thermal pain requires heat/colde.g., a burn, not cast-related. Chemical pain involves irritantse.g., acid exposure, not typical here. Electrical pain needs currente.g., a shock, irrelevant to casts. A cast too snug might pinch nerves or musclese.g., swelling post-fracture increases pressureproducing sharp or aching mechanical pain. Nurses assess for compartment syndrome or fit issues, adjusting or bivalving the cast. This contrasts with chemical pain from inflammation (e.g., prostaglandins) or thermal from external sources. The physical interaction of cast and limb drives this scenario, making Choice D the most likely type.

Correct Answer: B

Rationale: Pain activates the sympathetic nervous system. 'Increased pulse and blood pressure' is expectede.g., acute pain (moaning) spikes heart rate (e.g., 70 to 100 bpm) and BP (e.g., 120/80 to 140/90) via adrenaline, per Taylor's physiology. Choice A, 'decreased pulse and respirations,' fits sedatione.g., opioids, not untreated pain. Choice C, 'increased temperature,' needs inflammatione.g., fever, not instant pain response. Choice D, 'no change,' ignores stresse.g., even 4/10 pain elevates vitals. A patient with a broken leg moaning shows tachycardia and hypertensione.g., 10-20% riseuntil relieved. Nurses note this fight-or-flight reaction, making Choice B the correct finding.