The nurse is assessing a client who reports pain in the right arm. Which finding would suggest the pain is somatic rather than neuropathic?

Correct Answer: C

Rationale: A dull ache suggests somatic pain, as it arises from musculoskeletal tissues (e.g., muscles, bones) due to injury or strain, producing a localized, aching qualityunlike neuropathic pain's neural quirks. Choice A, burning sensation, fits neuropathy (e.g., nerve damage), not somatic's mechanical feel. Choice B, tingling, also indicates neuropathy (e.g., pinched nerve), not somatic's deeper pain. Choice D, numbness, reflects nerve dysfunction, not painsomatic pain is felt, not absent. Choice C is correct, guiding nurses to identify somatic paine.g., from arm strainprompting treatments like rest or NSAIDs, distinct from neuropathic options, ensuring accurate care based on the pain's tissue origin.

Correct Answer: C

Rationale: Under the False Claims Act, billing for a higher level of service than provided is illegal. Using a CPT code for a 50-minute psychotherapy session when only 30 minutes were delivered is upcoding (Choice C), as it inflates reimbursement by misrepresenting the service's intensity or duration. Unbundling (Choice A) involves billing separate components of a bundled service individually, not applicable here. Overbilling (Choice B) is a broader term for excessive charges but doesn't specifically describe coding mismatches. Misrepresentation (Choice D) is vague and not a legal term in this context. Upcoding violates federal regulations, risking penalties, because it falsely claims more resources were used. For example, CPT code 90834 (45-50 minutes) pays more than 90832 (30 minutes), and choosing the former for a shorter session is fraudulent. Accurate coding ensures ethical billing, making Choice C the precise and correct answer.

Correct Answer: A

Rationale: A high-protein diet emphasizes foods rich in amino acids for tissue repair, muscle maintenance, or recovery. Baked beans, hamburger, and milk (Choice A) are protein powerhouses: beans (7-10 g/cup), hamburger (20-25 g/patty), and milk (8 g/cup) total over 35 g per meal, far exceeding others. Spaghetti with cream sauce, broccoli, and tea (Choice B) leans carbohydrate-heavy (pasta), with broccoli offering minimal protein (3 g/cup) and tea none. Bouillon, spinach, and soda (Choice C) provide negligible proteinspinach has 5 g/cup, but bouillon and soda contribute little. Chicken cutlet, spinach, and soda (Choice D) include protein from chicken (25-30 g), but spinach and soda add little, totaling less than Choice A. For a client needing 50-60 g daily, Choice A's variety and quantity signal successful teaching, making it the correct answer.

Correct Answer: B

Rationale: Sleep is a natural, recurring state distinct from wakefulness, and its definition hinges on physiological and perceptual changes. 'Altered consciousness, relative inactivity' best captures this, reflecting sleep's reduced awareness and minimal physical movement, as seen in EEG shifts from beta to delta waves during non-REM stages. Choice A, 'decreased state of activity, refreshed,' partially appliesactivity drops, and waking often refreshesbut it omits the critical consciousness shift, making it incomplete. Choice C, 'comatose, immobility,' describes a pathological state, not normal sleep; coma lacks the reversibility and cycles (REM/NREM) of sleep. Choice D, 'alert, responsive,' defines wakefulness, the opposite of sleep. For example, during NREM stage 3, a sleeper's consciousness alters (less responsive to stimuli), and muscle tone decreases, yet they can awakenunlike coma. Nursing texts like Taylor's Fundamentals emphasize sleep as a dynamic state of altered consciousness with reduced, not absent, activity, aligning with circadian biology. Thus, Choice B is the most accurate and comprehensive descriptor.

Correct Answer: B

Rationale: Exercise impacts sleep via arousal and body temperature effects, and timing matters. 'Exercise within 2 hours of bedtime can hinder ability to sleep' is correct; it raises heart rate, adrenaline, and core temperaturee.g., a 7 p.m. run might delay sleep onset from 10 p.m. to midnightcountering melatonin's cooling effect. Choice A, 'exercise immediately before bedtime enhances ability to sleep,' is false; while exercise generally aids sleep, late timing stimulates, not sedates, per sleep research (e.g., ACSM guidelines). Choice C, 'the time of day does not matter,' ignores circadian rhythm; morning or afternoon exercise (e.g., 3 p.m.) boosts sleep quality without delay. Choice D, 'the fatigue from exercise may be a hindrance,' misattributes; fatigue aids sleep if timed right (e.g., 5 p.m.). Nurses teach patients to finish vigorous activity 3-4 hours before bed, per Taylor, making Choice B the correct guidance.