A patient says, "One result of my chronic stress is that I feel so tired. I usually sleep from 11:00 PM to 6:30 AM. I started setting my alarm to give me an extra 30 minutes of sleep each morning, but I don't feel any better and I'm rushed for work."
Which nursing response would best address the patient's concerns?
a. "You may need to speak to your doctor about taking a sedative to help you sleep."
b. "Perhaps going to bed a half-hour earlier would work better than sleeping later."
c. "A glass of wine in the evening might take the edge off and help you to rest."
d. "Exercising just before retiring for the night may help you to sleep better."
ANS: B
Sleeping later in the morning may disturb circadian rhythms and in this case is adding, rather than reducing, stress. Going to bed earlier and arising at the usual time alleviates fatigue more effectively. Sedatives may offer some benefit but are a short-term intervention with potential side effects, and other nonpharmacological interventions might work as well or better. Exercise earlier in the evening could induce tiredness and ease the process of falling asleep, but doing so right before bedtime would stimulate and interfere with sleep. Alcohol is sedating but potentially addictive; encouraging its use could increase the risk of using alcohol maladaptively as a response to stress in general.
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