A patient with a history of depression reports not feeling well rested in recent weeks. Before making the assumption that the complaint is related to depression, a nurse should investigate whether the patient has had any recent changes in:
a. work schedule that affect the hours of sleep.
b. vacations taken within the same time zone.
c. fluid intake with reduced overall intake of water.
d. food intake with decreased intake of heavy foods before bedtime.
A
Changes in schedule that affect circadian rhythms, such as work shifts that alter usual sleep patterns, can result in fatigue that is not related to mental health status. Other factors that alter sleep include changes in light and darkness and temperature changes. Vacations in the same time zone should not affect sleep, whereas food and fluid intake should enhance sleep by reducing risk of nocturia or indigestion.
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A nurse is seeing clients in the ophthalmology clinic. Which client should the nurse see first?
a. Client with intraocular pressure reading of 24 mm Hg b. Client who has had cataract surgery and has worsening vision c. Client whose red reflex is absent on ophthalmologic examination d. Client with a tearing, reddened eye with exudate
A pregnant patient from a nondominant culture arrives 2 hours late for a scheduled sonogram. What does this patient's behavior indicate to the nurse?
A) The patient is confused. B) The patient does not wear a wrist watch. C) Time orientation may be different for the patient's culture. D) The patient's culture may focus on the past and not the future.
A nurse is providing discharge instructions for a patient with a new colostomy. Which of the following is a recommended guideline for long-term ostomy care?
A) During the first 6 to 8 weeks after surgery, eat foods high in fiber. B) Drink at least 2 quarts of fluids, preferably water, daily. C) Use enteric-coated or sustained-release medications if needed. D) Use a mild laxative if needed.
In a home visit to the family of an active 15-month-old, the home health nurse's priority in giving anticipatory guidance would be which of the following?
a. providing instructions about potty training b. selecting a day-care center or in-home nanny so the mother can return to work c. locking low cabinets and getting gates on the stairways to the second floor d. selecting educational toys and materials for this developmental age