Which factor most contributes to fatigue in patients?

Correct Answer: B

Rationale: Fatigue is a pervasive sense of exhaustion that doesn't fully resolve with rest and is often linked to chronic illness, such as cancer, heart disease, or autoimmune disorders. These conditions tax the body's resources, leading to persistent tiredness that impacts daily functioning. Choice A, excessive sleep, might cause grogginess but isn't a primary driver of pathological fatigue; in fact, fatigue often persists despite rest. Choice C, high physical fitness, typically reduces fatigue by enhancing endurance, not contributing to it. Choice D, improved nutrition, supports energy levels rather than depleting them, unless malabsorption is involved, which isn't specified. Choice B, chronic illness, is the most significant contributor, as it disrupts physiological balance, increases metabolic demand, and often leads to the kind of unrelenting fatigue nurses must address through tailored interventions.

Correct Answer: B

Rationale: Providing a quiet environment best promotes comfort for a client at end-of-life in palliative care, reducing sensory overload and fostering peace amid physical and emotional decline. Noise can heighten agitation or anxiety, common in dying patients, while quiet supports rest and dignity. Choice A, encouraging aggressive treatment, contradicts palliative goalscurative efforts may prolong suffering, not ease it. Choice C, scheduling frequent assessments, disrupts rest, increasing distress rather than comfort, though monitoring is needed, it should be unobtrusive. Choice D, limiting family presence, is counterproductivefamily often provides emotional solace, enhancing comfort unless the client specifies otherwise. Choice B is correct, aligning with palliative care's focus on holistic comfort, addressing environmental factors nurses control to minimize stress, complementing pain management and emotional support for a serene end-of-life experience.

Correct Answer: C

Rationale: The basis of the nurse's response is to promote comfort, as morphine in palliative care manages severe pain or dyspnea, enhancing quality of life when curing isn't the goal. It targets opioid receptors to dull pain perception, easing suffering in terminal illness. Choice A, curing the illness, is incorrectpalliative care focuses on symptom relief, not cure, accepting disease progression. Choice B, improving alertness, contradicts morphine's sedative effect; it may calm agitation but typically drowses, not sharpens focus. Choice D, increasing appetite, isn't morphine's purposepain relief might indirectly help eating, but it's not primary. Choice C is correct, reflecting palliative care's ethosnurses explain morphine's role in comfort, reassuring families it's about dignity and peace, not hastening death, aligning with holistic end-of-life support.

Correct Answer: B

Rationale: The nurse recognizes that nonpharmacological pain relief measures have no side effects as their major advantage, unlike drugs risking nausea, addiction, or sedation. Methods like heat or relaxation rely on natural responses (e.g., circulation, calming), avoiding chemical risks. Choice A, replacing medications, isn't truethey complement, not supplant, drugs, especially for severe pain. Choice C, being more effective, variesnonpharmacological methods aid mild pain or adjunctively but rarely outdo opioids for intensity. Choice D, working immediately, isn't universal; effects (e.g., meditation) build slower than analgesics. Choice B is correct, highlighting safetynurses leverage this for clients wary of drugs or with comorbidities, integrating techniques like imagery or massage to enhance comfort without adding physiological burden, a key asset in holistic care.

Correct Answer: B

Rationale: The basis of the nurse's response is chronic pain itself, as persistent pain often causes depression by disrupting neurotransmitters (e.g., serotonin), fostering hopelessness, and limiting life enjoyment. This bidirectional linkpain worsening mood, mood amplifying painis well-established. Choice A, lack of activity, contributes but isn't primary; pain drives inactivity, not vice versa. Choice C, poor nutrition, may affect health but lacks direct evidence tying it to depression herepain's emotional toll is stronger. Choice D, medication side effects, like opioid-induced sedation, can depress mood, but the question implies pain's role, not treatment. Choice B is correct, guiding nurses to explain this connection, validating the spouse's observation, and suggesting integrated care (e.g., antidepressants, therapy) to break the pain-depression cycle, improving the client's overall well-being.