Chapter 45 Kozier And Erbs Fundamentals of Nursing 10th Edition by Berman Snyder

Chapter 45 Kozier And Erbs Fundamentals of Nursing 10th Edition by Berman Snyder

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The mother of a newborn tells the nurse, “I am concerned about my baby. When she first goes to sleep, her eyes dart around under her eyelids, she doesn’t breathe regularly, and she sometimes twitches.” What advice should the nurse give this mother?

1. Please bring your baby in immediately for a checkup.
2. These are common behaviors in newborns and are normal.
3. You should ask the physician about these symptoms at your next checkup.
4. If your baby does this again, take her to the emergency department.

Correct Answer: 2

Rationale 1: There is no need for the mother to bring the baby in for an immediate checkup.

Rationale 2: These are indications of normal REM sleep in the newborn. The mother should be reassured that this is normal.

Rationale 3: Having the mother wait until the next checkup unnecessarily delays reassurance that this is normal sleep behavior for a newborn.

Rationale 4: This is normal sleep behavior for a newborn. The baby does not need to be seen in the emergency department.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1.  Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2. Identify the characteristics of the NREM and REM sleep states.

MNL Learning Outcome: 4.12.1. Explain the physiology of sleep and its impact on a client’s state of rest.

Page Number: 1068

 

Question 2

Type: MCSA

The parents of a 6-month-old tell the nurse that they are exhausted because their baby wakes up several times every night. What advice should the nurse give these parents?

1. Be certain that the baby is truly awake before picking him up for feeding.
2. Let the baby “cry it out” for a few nights until he can sleep through the night.
3. Continue to respond to the baby whenever he is restless during the night.
4. Bring the baby in for a possible sleep study to check for sleeping disorders.

Correct Answer: 1

Rationale 1: Babies often move and make noises while sleeping that do not indicate wakefulness. The parents should be certain the baby is awake before picking him up to feed, change, or comfort.

Rationale 2: Letting the baby “cry it out” is not appropriate if he really needs care.

Rationale 3: Continuing to respond to the baby whenever he is restless during the night is not necessary and may result in parental exhaustion.

Rationale 4: There is no indication for need of a sleep study for this baby.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1.  Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8. Describe interventions that promote sleep.

MNL Learning Outcome: 4.12.1. Explain the physiology of sleep and its impact on a client’s state of rest.

Page Number: 1069

 

Question 3

Type: MCSA

The 70-year-old client tells the nurse, “I can go to sleep without a problem, but then I wake up in a couple of hours and can’t go back to sleep.” What nursing action would help promote rest and sleep in this client?

1. Have the client develop a bedtime ritual of quiet music and a glass of wine.
2. Encourage the client to avoid taking pain medication prior to sleep.
3. Evaluate if the client perceives sleeplessness to be a serious problem.
4. Have the client perform moderate exercises before bedtime.

Correct Answer: 3

Rationale 1: Alcohol can interfere with sleep.

Rationale 2: If the client has pain, the nurse should not encourage avoidance of medication.

Rationale 3: The first intervention is to determine what the pattern of sleeplessness means to the client. Many older clients will “nap” off and on through the day and night and spend wakeful times engaged in activity, even if the active times are not during traditional active hours.

Rationale 4: Exercise can interfere with sleep.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1.  Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8. Describe interventions that promote sleep.

MNL Learning Outcome: 4.12.1. Explain the physiology of sleep and its impact on a client’s state of rest.

Page Number: 1071