Which intervention should the nurse in charge try first for a client that exhibits signs of sleep disturbance?

Correct Answer: D

Rationale: For a client with sleep disturbance, the nurse should start with the least invasive, most natural intervention: providing normal sleep aids like pillows, back rubs, and snacks (Choice D). These promote comfort and relaxation without medication or complex techniques, addressing common causes like discomfort or anxiety. Administering sleeping medication (Choice A) is a last resort due to risks like dependency and side effects, reserved for when simpler methods fail. Asking about sleep quantity (Choice B) is assessment, not intervention, and doesn't immediately improve sleep. Teaching relaxation techniques (Choice C) is effective but requires skill and time, making it less immediate than basic aids. For example, adjusting pillows or offering a warm snack can quickly ease a client into sleep by mimicking natural routines, aligning with holistic care principles. If ineffective, the nurse can escalate to other options, but starting with Choice D ensures safety, simplicity, and patient-centered care, making it the correct first step.

Correct Answer: A

Rationale: An Italian client complaining of pain then falling asleep suggests cultural expressiveness and fatigue, leading to the conclusion he may have a low pain threshold (Choice A). Italian heritage often correlates with vocalizing discomfort readily (per cultural studies, e.g., Zborowski), meaning small pain feels significant, yet sleep indicates exhaustion, not absence of pain. Faking pain (Choice B) assumes deceit without evidence; sleep doesn't disprove his report. Someone else medicating him (Choice C) is speculativeno record or timing supports this. Pain going away (Choice D) is unlikely, as sudden resolution wouldn't cause instant sleep. For example, postoperative pain might overwhelm him, prompting a loud complaint, then fatigue takes over. He may still need analgesia upon waking. Choice A reflects cultural sensitivity and clinical reasoning, making it correct.

Correct Answer: C

Rationale: Toddlers (1-3 years) have evolving sleep needs, decreasing from infancy's 14-17 hours. Near the end (around 3 years), '10-12 hours' is normal, per pediatric sleep norms (e.g., National Sleep Foundation), totaling 11-14 hours daily with naps. '7-8 hours' is too low, typical for older children or adults, risking fatigue or developmental delaye.g., a 3-year-old sleeping only 8 hours might be irritable. '8-10 hours' underestimates; while some toddlers manage, most need more for growth (e.g., brain development via REM). '12-15 hours' fits younger toddlers or infants, not the stage's end, where naps shorten. For instance, a 3-year-old might sleep 11 hours nightly plus a 1-hour nap, aligning with Choice C. Nursing education, per Taylor, stresses age-specific norms to guide parents, making 10-12 hours the correct, evidence-based answer.

Correct Answer: C

Rationale: Sleep disorders vary in prevalence, but 'insomnia' is most common, affecting 10-30% of adultse.g., difficulty falling or staying asleep >3 nights weeklyper DSM-5 and sleep surveys. 'Hypersomnia' , excessive sleepiness (e.g., narcolepsy), is rarer, at 1-2%. 'Parasomnia' , like sleepwalking, occurs in 1-10%, often in kids, not adults predominantly. 'Dyssomnia' is a category (including insomnia, hypersomnia), not a specific disorder, thus not 'most common.' Insomnia's causesstress, pain, caffeinemake it ubiquitous; e.g., a nurse might see 1 in 3 patients report it, per Taylor's epidemiology. Chronicity (3+ months) amplifies its impact, unlike episodic parasomnias. Choice C is the correct, evidence-backed answer.

Correct Answer: C

Rationale: Sedative-hypnotics (e.g., zolpidem) aid sleep but have limits. 'It loses its effectiveness after 1 or 2 weeks' is correct; tolerance developse.g., 10 mg works initially but wanes by 14 daysper pharmacology texts like Taylor, advising short-term use (e.g., 7-10 nights). Choice A, 'every night for several months,' risks dependencee.g., 3 months doubles withdrawal insomnia. Choice B, 'better taken with alcohol,' is dangerous; alcohol amplifies CNS depressione.g., risking apnea. Choice D, 'in the morning for long-term effects,' is absurd; morning dosing causes daytime sedation, not night sleep. Nurses teach time-limited use to avoid tolerance, per safety protocols, making Choice C the correct education.