Correct Answer: B

Rationale: Holding the pain medication until the patient wakes up is not the best choice. Pain can disrupt sleep and it's important to keep the patient as comfortable as possible. If the patient is sleeping it may be because the pain is well-controlled and delaying the medication could lead to a return of pain. The patient should be given the scheduled pain medication. This is the best choice because it ensures that the patient's pain is managed effectively. Even if the patient is sleeping the medication should be given to prevent the pain from returning. Calling the family and asking if the patient would like to be woken up to have their pain medication is not the best choice. The nurse should make this decision based on the patient's pain level and the medication schedule not on the family's preferences. The statement that the patient has become addicted to the medication and is sleeping the last dose off is not accurate. Addiction is a complex condition characterized by compulsive drug use despite harmful consequences. In this case the patient is receiving the medication for a legitimate medical reason and there is no indication of addiction.

Correct Answer: B,D

Rationale: This statement is incorrect. Exercise actually promotes the release of endorphins which are chemicals in the brain that act as natural painkillers and mood elevators. This statement is correct. Regular exercise can help improve sleep quality and duration. This statement is incorrect. Exercise actually increases energy levels by improving circulation and heart health. This statement is correct. Regular exercise can help decrease stress and improve mood by promoting the release of endorphins.

Correct Answer: D

Rationale: Initiating life-saving measures such as a rapid response call would not be appropriate in this context. The patient is in a hospice setting which focuses on providing comfort and quality of life for patients who are nearing the end of life rather than aggressive lifesaving interventions. Calling the provider because these signs and symptoms are abnormal would not be the correct response. In a hospice setting these symptoms are expected and are indicative of the natural dying process. The statement that rapid respirations that are unusually deep and regular are curative for the patient is incorrect. Cheyne-Stokes respirations characterized by a pattern of increasing and then decreasing depth of breath followed by a period of apnea are often seen in patients nearing the end of life. They are not curative but are a sign of the body's decreasing metabolic demands and changing physiology as death approaches. The nurse understanding that these are impending signs of death and are normal is the correct response. The symptoms described including loss of appetite swelling of the limbs increased sleep Cheyne-Stokes respirations and hallucinations are all common in the final stages of life. Recognizing these signs can help the nurse provide appropriate care and support to the patient and their family during this time.

Correct Answer: B

Rationale: While it's important for the client to understand the alternatives to the procedure it's typically the responsibility of the physician or surgeon to explain these alternatives not the nurse. One of the nurse's responsibilities in the informed consent process is to confirm that the client is competent to sign for the procedure. This means ensuring that the client understands the procedure its risks and benefits and is making the decision voluntarily. Discussing the risks of the procedure with the client is typically the responsibility of the physician or surgeon not the nurse. While the nurse may provide some information about what will occur during the procedure it's typically the responsibility of the physician or surgeon to provide detailed information about the procedure.

Correct Answer: A

Rationale: Socioeconomic stressors are related to a person's social and economic status. Homelessness is a clear example of a socioeconomic stressor as it is often caused by factors such as unemployment poverty and lack of affordable housing. Adventitious stressors are unexpected and often traumatic events that occur outside of the normal course of life. These could include natural disasters accidents or violent crimes. While homelessness can be traumatic it is not considered an adventitious stressor because it is related to the individual's social and economic circumstances. Developmental stressors are those that occur as a result of going through the normal stages of life such as starting school getting a job getting married having children and retiring. Homelessness is not a developmental stressor because it is not a normal or expected part of life. Cultural stressors are related to a person's cultural background and experiences. While culture can influence a person's socioeconomic status homelessness itself is not a cultural stressor.