A client tells the nurse that one result of his chronic stress is ...

[JMatthes]

A client tells the nurse that one result of his chronic stress is that he has considerable fatigue. He has
  tried setting his alarm to give himself an extra 30 minutes of sleep each morning but feels no better.
  The nurse should suggest that
 
  a. You may need to speak to your doctor about taking a sedative..
  b. Keep doing what you have started. It takes a while to develop new sleep habits..
  c. Try going to bed a half hour earlier than usual and getting up at your regular
  time..
  d. Waking up to music, rather than an alarm, is often helpful in promoting
  relaxation..

Question 2

A client who is known to be angry and impulsive is hospitalized after an automobile accident in
  which he sustained severe orthopedic injuries.
 
  When in pain, he loudly berates nursing staff for not
  knowing enough to give me my pain medicine when I need it.. The nursing diagnosis of ineffective
  coping related to inappropriate methods for handling anger associated with delayed pain relief is
  recorded. A nursing intervention designed to address this would be
  a. telling the client to notify nursing staff one half-hour before the pain returns so
  they can prepare his medication.
  b. telling the client his verbal assaults on nurses will do nothing to shorten his wait
  for as-needed medication.
  c. urging the physician to change the as-needed order for pain medication to every 4
  hours.
  d. having the clinical nurse leader request a psychiatric consultation.

[maaaaaaaaaa]

Answer to Question 1

ANS: C
Sleeping later in the morning is rarely helpful. It often disturbs circadian rhythms. Going to bed
earlier and arising at the usual time alleviates fatigue more effectively. Option A: Sedatives may
disrupt sleep to a greater degree in the long run. Option B: This method results in circadian rhythm
disturbance. Option D is not evidence based.

Answer to Question 2

C
Scheduling the medication at specific intervals will help the client anticipate when the medication
can be given. Receiving the medication promptly on schedule, rather than expecting nurses to
intuitively know his pain level, should reduce anxiety and anger. Option A expects the client to
predict onset of pain before it occurs. Option B is a thinly veiled threat. Option D is not necessary at
this point.

[JMatthes]

Thanks for the timely response, appreciate it

[Jossy]

TYSM