A nurse working the night shift assesses a patients vital signs at 4 a.m. (0340). What would be the expected findings, based on knowledge of NREM sleep?

Correct Answer: A

Rationale: During NREM sleep, especially stages 3-4 (deep sleep) at 4 a.m., the body enters a restorative state with parasympathetic dominance, lowering metabolic demand. 'Decreased TPR and BP' reflects this: total peripheral resistance (TPR) and blood pressure (BP) drop as heart rate slows (e.g., from 70 to 50 bpm) and vessels dilate, per circadian dips and sleep physiology. 'Increased TPR and BP' occurs in REM or stress, not NREM's calm. 'No change from daytime readings' ignores sleep's autonomic shift; daytime wakefulness elevates vitals (e.g., BP 120/80 vs. 100/60 at night). 'Highly individualized, cannot predict' overstates variability; while baselines differ, NREM consistently reduces vitals across healthy adults. For example, a nurse might record BP dropping 10-20% from daytime, aligning with Taylor's description of NREM's energy conservation. Choice A is the expected, evidence-based finding.

Correct Answer: B

Rationale: Frequent nocturia from high fluid intake disrupts sleep, fixable via timing. 'Drink most of the liquids before 5 p.m.' is correct; front-loading hydratione.g., 80% of 2L by late afternoonlets the bladder empty pre-bedtime, cutting awakenings (e.g., from 4 to 1), per nursing hydration advice. Choice A, 'during the night,' worsens ite.g., 500 mL at 10 p.m. fills the bladder by 2 a.m. Choice C, 'coffee instead of water,' adds caffeine's diuretic and stimulant effectse.g., doubling voids. Choice D, 'before noon,' risks dehydration latere.g., unmet needs by evening. Taylor's sleep hygiene supports Choice B's balance of hydration and rest, making it correct.

Correct Answer: D

Rationale: Remission' in cancer means disease control. 'The disease is present but the patient is not experiencing symptoms' is correcte.g., breast cancer cells remain but no fatigue or lumps, per oncology norms in Taylor. Choice A, 'experiencing symptoms,' contradicts remissione.g., active disease has pain. Choice B, 'end-stage cancer,' is terminal, not remissione.g., metastasis dominates. Choice C, 'unremitting pain,' fits active cancer, not remission's reliefe.g., post-chemo calm. Remission (partial or complete) signals treatment successe.g., scans show tumors but no growthmaking Choice D the precise answer.

Correct Answer: C

Rationale: Stabbing facial pain post-stimulus points to a nerve disorder. 'Trigeminal neuralgia' fits; it's sharp, electric-like pain in the trigeminal nerve's domain (mouth, gums, teeth, chin)e.g., triggered by brushing, per Taylor's pain syndromes. 'Complex regional pain syndrome' affects limbs post-injurye.g., burning after a fracture, not facial. 'Postherpetic neuralgia' follows shinglese.g., persistent burn, not stabbing post-brushing. 'Diabetic neuropathy' causes distal numbness/paine.g., feet tingling, not facial stabs. Trigeminal neuralgia's hallmarke.g., 10/10 pain from light touchmatches this, often unilateral and paroxysmal. Nurses note triggers (e.g., chewing) and suggest carbamazepine. Choice C is the correct, specific diagnosis.

Correct Answer: C

Rationale: Infant distress needs targeted response. 'That means his ear hurt. Bring him in to be checked' is correcte.g., ear-pulling and crying signal otitis media, per Taylor's pediatrics, requiring exam (e.g., tympanic redness). Choice A, 'hungry and wet,' dismisses specificse.g., ear focus, not general fussiness. Choice B, 'cry at night, think nothing,' ignores signse.g., pain isn't normal crying. Choice D, 'tummy ache,' misattributese.g., no GI clues like vomiting. A baby tugging an ear all nighte.g., 80% chance of infectionneeds otoscopy, not guesses. Nurses prioritize actionable care over minimization, making Choice C the best, urgent response.