Answer to Question 1
C
To promote sleep, daytime naps should be eliminated. If naps are used, they should be limited to 20 minutes or less twice a day.
Alcohol should be limited in the late afternoon and evening because it lightens and fragments sleep.
The use of nonprescription sleeping medications is not advisable. Over the long term, these drugs can lead to further sleep disruption, even when they initially seemed to be effective.
Following a bedtime routine should be consistent, but this does not necessarily include always going to bed at the same time. The client should engage in quiet activities that promote relaxa-tion, and then may go to bed. If the client hasn't fallen asleep in 30 minutes, the client should get up out of bed and do some quiet activity until he or she feels sleepy enough to go back to bed.
Answer to Question 2
D
Tertiary prevention occurs when a defect or disability is permanent and irreversible. At this level, the hospice nurse aims to help the client and his or her family to achieve a high level of function, despite the limitations caused by the client's illness.
Teaching a client how to irrigate a new colostomy would be an example of secondary prevention. If the colostomy is to be permanent, care may later move to the tertiary level of prevention.
Providing a lesson on hygiene for an elementary school class would be an example of primary prevention.
Informing a client about available immunizations would be an example of primary prevention.