NURS 120/ NURS120 Midterm exam | Questions and Verified Answers | 100 out of 100 | Latest Update | Download To Score An A

NURS 120/ NURS120 Midterm exam | Questions and Verified Answers | 100 out of 100 | Latest Update | Download To Score An A Question: The nurse is preparing to assess comfort for several clients. If the nurse, in addition to assessing the client's physical experience of pain, assesses whether the client has a present and reliable personal support network, then the nurse is assessing which context of holistic human experience during this process? A) Transcendence B) Environmental C) Psychospiritual D) Sociocultural Answer: D Explanation: D) Comfort is the experience of having needs for relief and ease met in four contexts: physical, psychospiritual, sociocultural, and environmental. Sociocultural comfort is related to family and social relationships, which a personal support network would exemplify. Transcendence is not a context of holistic human experience. Question: The nurse provides an in-service to peers regarding situations that can affect the comfort level of the clients on the unit. Which client statement indicates that the client's sense of well-being is negatively impacted? A) "I feel like I have no energy today." B) "I don't feel any physical pain today." C) "I was able to sleep uninterrupted last night." D) "I am so glad that playing cards takes my mind off my worries." Answer: A Explanation: A) Fatigue is a lack of energy and motivation. A fatigued client is unable to focus on healing and lacks the ability to cope in stressful situations. Restful sleep, physical well-being without pain, and appropriate diversion all promote a sense of comfort for the client. Question: A client is experiencing sudden-onset severe pain in the left lower quadrant of the abdomen that is rated as a 10 on a pain scale of 0-10. The client is also experiencing nausea, vomiting, and restlessness. Based on this data, the nurse concludes that the client is experiencing which phenomenon? A) Acute pain B) Chronic pain C) End-of-life pain D) Fibromyalgia pain Answer: A Explanation: A) Duration establishes the difference between acute and chronic pain. Acute pain is defined as pain that lasts only through the expected recovery period, which is usually 30 days to 6 months. Acute pain typically has a sudden onset related to injury, surgery, or illness. Chronic pain outlasts the illness and extends beyond the recovery period. End-of-life and fibromyalgia would most likely involve chronic pain. Question: The nurse is preparing to assess a 1-year-old client for signs of discomfort. When conducting the assessment, which action by the nurse is the most appropriate? A) Asking the client to rate the pain on a scale of 0-10 during the assessment process B) Asking the parent to hold the client in the lap during the assessment process C) Reading a book to the client during the assessment process D) Recommending that the parent leave the room during the assessment process Answer: B Explanation: A) Children may be fearful of physical assessment. To promote comfort, allow the child to sit on the parent's or guardian's lap during the assessment process, rather than asking the parent to leave the room. A numeric pain scale is not appropriate until the client is older; a faces pain scale would be better. Reading a book during the assessment process is not age appropriate. Question: The nurse is caring for a pediatric client with a surgical wound. The wound is red with purulent drainage and is causing discomfort for the client. Which diagnostic test will determine if the discomfort of the wound is caused by an infection? A) White blood cell count B) Hematocrit measurement C) Urine analysis D) X-rays of the site Explanation: A) There are a few tests that can help the medical team determine the source of the client's discomfort. In this case, a white blood cell count will determine if the discomfort is being caused by an infection. An x-ray is useful for determining the existence of physical injuries, not the presence of infection. Urine analysis may indicate illness or malnutrition, whereas hematocrit measurement may identify iron deficiency anemia. Question: An 18-month-old toddler scheduled for routine vaccinations begins to cry when placed on the examination table. The parent attempts to comfort the toddler, but nothing is effective. Which action by the nurse is the most appropriate? A) Allow the toddler to sit on the parent's lap and begin the assessment. B) Allow the toddler to stand on the floor until the crying stops. C) Ask another nurse in the office to hold the toddler because the parent is not able to control the toddler's behavior. D) Instruct the parent to hold the toddler down tightly to complete the examination. Answer: A Explanation: A) Toddlers are most comfortable when sitting with the parents. Vaccinations can be administered in this way if the parent is taught proper therapeutic holding techniques to keep everyone safe for the procedure. Allowing the toddler to stand on the floor or holding the toddler down tightly are inappropriate. A nurse can assist if the parent is unable to hold the child during the vaccinations to prevent injury from movement. Question: The nurse is caring for a client who is experiencing acute chest pain that is rated as a 9 on a 0 to 10 pain scale. Based on this data, which medication does the nurse expect to administer? A) Acetaminophen B) Morphine C) Ibuprofen D) Naproxen Answer: B Explanation: A) Acute pain is often treated with an opioid such as morphine. Morphine is often used to treat chest pain that is associated with a myocardial infarction. Acetaminophen, ibuprofen, and naproxen are more appropriate for other types of pain, not acute chest pain. B) Acute pain is often treated with an opioid such as morphine. Morphine is often used to treat chest pain that is associated with a myocardial infarction. Acetaminophen, ibuprofen, and naproxen are more appropriate for other types of pain, not acute chest pain. Question: The nurse is designing a teaching plan for community members on ways to prevent chronic pain. Which information should the nurse include in this teaching plan? Select all that apply. A) Eating a healthy diet B) Obtaining adequate sleep C) Avoiding illicit drug use D) Limiting smoking to only before bedtime E) Avoiding repetitive movements Answer: A, B, C, E Explanation: A) Lifestyle habits that predispose individuals to chronic health alterations increase an individual's risk for experiencing discomfort. Eating a healthy diet and obtaining adequate sleep can prevent the development of chronic diseases that lead to symptoms of discomfort. Using illicit drugs and smoking can cause emotional and physical withdrawal symptoms when the drug is no longer used. It is wise to not engage in smoking or illicit drug use to prevent the onset of discomfort. Repetitive movements can increase the risk for injury and fatigue, leading to discomfort. Question: 9) Which client is most likely to reject attempts at comfort? A) An infant crying B) A school-age child with abdominal pain who is anxious about a procedure C) An adolescent with a sleep disorder who doesn't want his parents to be near him D) An older adult with end-stage renal disease Answer: C Explanation: A) Adolescents may respond to treatment and comfort better if you interact with them as adults rather than as children. Some adolescents may reject any offer of comfort, and an adolescent with a sleep disorder who has displayed antagonism toward his parents' presence is probably irritable from his condition and may immediately reject attempts at comfort, at least at first. An infant crying is verbalizing the need for comfort. A school-age child anxious about a medical procedure craves reassurance. An older adult with a terminal illness likely will welcome comfort measures even if she has accepted that she is going to die. Question: Which of the following is a pharmacologic therapy for acute pain? A) Antidepressants B) Muscle relaxants C) Opioid analgesics D) Stimulants Answer: C Explanation: A) Pharmacologic pain management for acute pain involves opioid analgesics, nonopioid analgesics, or nonsteroidal anti-inflammatory drugs (NSAIDs). It does not involve antidepressants, stimulants, or muscle relaxants. Question: Which of the following statements best describes the therapeutic approach to acute and chronic pain, fatigue, fibromyalgia, and sleep disorders? A) Therapy is primarily psychosocial in nature. B) Therapy involves both pharmacologic and nonpharmacologic approaches. C) Therapy is essentially physiologically focused. D) Therapy mostly involves the client avoiding risk behaviors. Answer: B Explanation: A) For all of these conditions, therapy involves both pharmacologic and nonpharmacologic approaches. Therapy for these conditions is both physiological and psychosocial, addressing all components of client's conditions. Therapy involves treatment of existing conditions, not just risk prevention measures on the client's part. Question: Which of the following best characterizes the sociocultural context of holistic human experience? A) Balance of physical processes B) Connection to a higher power C) Connection to others D) Equilibrium with external circumstances Answer: C Explanation: A) The sociocultural context of holistic human experience involves connection with others in society. Connection to a higher power is involved in the psychospiritual context. Homeostatic balance is involved in the physical context. Equilibrium with external circumstances is involved in the environmental context. Question: What is an example of chronic pain? A) Pain that precedes injury B) Pain that follows injury and ends when healing is complete C) Pain that is felt during injury and immediately after D) Pain that outlasts the healing process Answer: D Explanation: A) Chronic pain is pain that lasts beyond the expected time of healing, usually for at least 6 months; it does not always have a known cause. Pain can range from mild to severe, and autonomic responses decrease over time as the body adapts to the persistent pain impulses. Chronic pain does not precede injury, nor does it subside immediately after injury, and it may not be related to an injury. It does not end when healing is complete. Question: 2) What is the relationship between a full opioid agonist and the ceiling effect? A) A full opioid agonist produces few withdrawal symptoms when the drug's effects plateau and the client begins easing off the drug. B) A client may use a full opioid agonist as much or as little as necessary to control chronic pain with no ill effects. C) Side effects may limit a full opioid agonist's use but not a plateau in the beneficial effects it produces. D) At some point, a full opioid agonist's side effects cease to increase in potency, but the pain-relieving effect continues to increase. Answer: C Explanation: A) Full opioid agonists do not have a ceiling effect. Therefore, full opioid agonists can be given in increasing doses until pain is relieved or side effects become intolerable. Question: A client who has been undergoing treatment for chronic back pain has been considering various over-the-counter nonopioids to manage the pain. The nurse has assessed the client's needs and discussed the use of available methods with the client. Which client statement indicates the need for further instruction? A) "Nonopioid pain medications can have serious side effects I need to consider and watch for carefully." B) "I should not take a higher than recommended dose because the beneficial effect isn't likely to be higher with a higher dose." C) "I may use these medications for as long as I think they are necessary." D) "I may use both opioid and nonopioid medications together, especially to relieve severe pain." Answer: C Explanation: A) Over-the-counter (OTC) nonopioids are associated with severe side effects, especially when taken long term. NSAIDs can produce gastrointestinal (GI) toxicity and prolong bleeding times, and acetaminophen can produce liver and kidney toxicity. Nonopioids have a ceiling effect, so taking a higher dose will not produce a greater analgesic effect. While nonopioids are rarely effective alone for severe pain, they may produce a synergistic effect to relieve pain when combined with an opioid. Question: A toddler being prepared for a lumbar puncture begins to cry when carried into the treatment room by the mother. Which nursing diagnosis is most appropriate for the client at this time? A) Knowledge Deficient of the procedure B) Anxiety related to anticipated painful procedure C) Fear related to the unfamiliar environment D) Ineffective Coping related to an invasive procedure Answer: B Explanation: A) The child associates the treatment room with a painful procedure, and the reaction to entering the treatment room is based on anticipation of repeat discomfort. The child's behavior is appropriate for coping in a child of this age. This child is not old enough to understand the need for a lumbar puncture. The child's fear is related not to the unfamiliar environment but to the anticipated pain associated with the treatment room from having undergone painful procedures there. Question: The nurse is creating a pain management plan using the three-step approach for a client with intractable pain. Which interventions should the nurse include in this plan? Select all that apply. A) Administer a nonopioid analgesic first. B) Administer an opioid analgesic first. C) Administer a nonopioid with an opioid second. D) Administer an opioid analgesic last. E) Administer analgesics upon client request. Answer: A, C, D Explanation: A) The first step in the three-step approach to pain management involves administering a nonopioid drug first. If pain is not adequately controlled with this mild intervention, clients should advance to step 2 and receive a mild opioid in combination with the same or a new nonopioid drug. If the client is still experiencing pain, the mild opioid should be replaced with a stronger opioid in step 3. Pain-relieving drugs should be given "by the clock" (every 3-6 hours) rather than on demand to maintain freedom from pain. Question: Which of the following statements best characterizes risk for injury as it relates to pain? A) Risk for injury is an external risk factor for pain. B) It is difficult to predict what might pose a risk for injury. C) Risk for injury can be decreased by living a healthy lifestyle. D) Precautions against risk for injury are rarely successful in preventing injury. Answer: A Explanation: A) External risk factors for pain, such as the risk for injury, can be decreased by safety precautions such as wearing a seat belt or helmet. Similarly, internal risk factors for pain, such as the risk for developing a chronic disease, can be decreased by living a healthy lifestyle. It is not difficult to anticipate what might pose a risk for injury. Question: The nurse is reviewing the admission orders for an older adult client who is being admitted for a hysterectomy. The client, who has been diagnosed as having uterine cancer, has chronic pain caused by arthritis. The healthcare provider has prescribed long-acting oral narcotic medication to be administered every 4 hours. What should the nurse do when providing the medication to the client? A) Administer the medication if the client requests it. B) Administer the medication every 4 hours around the clock. C) Consult the provider to order intravenous pain medication. D) Administer the medication sparingly to avoid narcotic addiction. Answer: B Explanation: A) Administer analgesics as prescribed. Analgesics should be administered around the clock or by self-administration with a patient-controlled analgesic (PCA) pump to keep the pain from becoming severe. In this case, the nurse should follow the prescribed administration plan of every 4 hours around the clock. The client shouldn't need to request the medication, the medication should be administered around the clock as prescribed rather than sparingly, and the nurse should administer the medication orally as prescribed rather than consult the provider for intravenous medication. Question: A preschool-age client's IV has infiltrated and must be restarted immediately for medication administration. There is no time for placing local anesthetic cream on the skin to decrease the pain associated with the procedure. Which complementary therapy would be most helpful when placing the IV for this pediatric client? A) Moderate sedation B) Restraint using a "mummy wrap" C) Anesthesia D) Distraction using bubbles Answer: D Explanation: A) Complementary therapies—especially guided imagery, relaxation techniques, and distraction—can reduce the anxiety associated with the anticipation of the procedure. Playing games such as blowing bubbles would provide distraction for this pediatric client and be a valid nursing intervention. All the other choices are not considered complementary therapies and are inappropriate for the situation. Question: Which of the following triggers pain? A) The central nervous system B) The peripheral nervous system C) The musculoskeletal system D) The cardiovascular system Answer: B Explanation:A) Pain is triggered by the peripheral nervous system, which lies outside the brain and spinal cord of the central nervous system and does not involve the musculoskeletal or cardiovascular systems. Question: Which of the following statements best describes the body's adaptation to pain? A) The worse pain becomes, the more obvious it is. B) Once the body adapts to pain, its detrimental effects cease. C) The observation of pain's effects may become more difficult. D) The body's sympathetic response increases. Answer: C Explanation:A) As the body adapts to pain, visible and physiological symptoms of pain may be harder to detect. The sympathetic response returns to baseline levels unless the client experiences breakthrough pain, and some visible signs of pain, such as crying, cease. Pain fibers may become sensitized so that the intensity and perception of pain increase over time. Question: Which of the following statements describes all pain? A) Pain is the result of tissue damage. B) Pain's effects are primarily physiological, not mental or emotional. C) Pain can be localized to a particular area of the body. D) Pain's effects can be verbalized. Answer: D Explanation: A) Pain can be described by the client, and so all pain can be verbalized. It may be the result of tissue damage or a warning of the potential for damage. Pain is both a physical and an emotional experience. Pain may not be localized in its effects. Question: The nurse is taking care of a client with terminal lung cancer who is showing signs of imminent death. What change should the nurse most expect the client to exhibit first? A) Decreased blood pressure B) Blurry vision C) Confusion D) Irregular pulse rate Answer: A Explanation: A) Low blood pressure, or hypotension, occurs as a client's body begins to near death. This is often accompanied by cool skin and an irregular pulse rate. Hypotension can lead to blurry vision, as well as confusion and dizziness; however, etiologies other than low blood pressure may also be the source of these symptoms. The nurse should most expect hypotension, potentially presenting with the other signs and symptoms. Question: A competent older adult client has a living will that expresses the client's desire to avoid resuscitation and heroic life support measures. The family members are not supportive of this directive and plan to contest the living will. Which nursing action is the most appropriate? A) Place the document on the chart. B) Contact the Social Services department. C) Explain to the client that the conflict could invalidate the document. D) Notify the hospital attorney. Answer: A Explanation: A) The client is competent. The wishes of the client must take priority. The document should first be placed on the chart and the provider notified. If there are concerns about the authenticity of the document, the Social Services department or the unit supervisor will need to be contacted. There is no need to notify the hospital attorney at this time. A lack of support by the family, or a plan to contest, does not invalidate the document legally. Question: The nurse is caring for a client who has suffered a massive cerebral hemorrhage and is not expected to survive. The client's mother indicates the client is Catholic. Which intervention is most appropriate? A) If the nurse is not Catholic, then finding a Catholic nurse to continue care for the client is necessary. B) The nurse should contact a priest and ask him what must be done for the client. C) The nurse should assume the client's desires based on the nurse's existing understanding of the Catholic faith. D) The nurse should ask the client or the client's family what they want in terms of religious rituals. Answer: D Explanation: A) Cultural and religious beliefs and traditions are often of paramount importance for end-of-life clients and their families. Nurses should work to facilitate requests to every extent possible. Contacting a priest may be necessary for the client to receive the Anointing of the Sick, but the nurse should follow the client's or family's request in this matter. The nurse doesn't need to find a Catholic nurse to continue care and should not simply assume what the client wants in this regard. Question: The nurse is caring for the family of a terminally ill client. The family members have been tearful and sad since the diagnosis was given. What is the best nursing diagnosis for this family? A) Grieving B) Hopelessness C) Compromised Family Coping D) Caregiver Role Strain Answer: A Explanation: A) Grieving prior to the actual loss is termed anticipatory grieving. There are no assessment findings that indicate compromised family coping or hopelessness. This reaction is typical of family members, so there is no indication that the family is exhibiting caregiver role strain. Question: An older adult client with terminal lung cancer is not breathing well and has cold and mottled skin. The client has a living will and requests comfort measures only. What should the nurse do to help this client? A) Ask the family what they want to be done for the client. B) Withhold all care until the client dies. C) Contact the provider for orders to control the client's breathing. D) Provide the client with pain medication as ordered. Answer: D Explanation: A) "Comfort measures only" indicates that the client does not want extraordinary measures to sustain life. This does not mean that nursing care ceases but that nursing care to provide client comfort is intensified and maintained through the end stages of the client's life. Clients with a CMO order should receive effective pain and symptom management, spiritual care, food and fluids as the client is able, and hygiene care. Asking the family what they want to be done is inappropriate when a client has written a living will. Contacting the provider to intervene to control respiration is considered adding extraordinary measures and is inappropriate, as is going against the client's written wishes when a living will is present and in force. Question: The nurse is caring for a dying child. Which nursing action supports the primary goal for a dying child? A) Keep the child entertained so she does not think about dying. B) Ensure that a good relationship is maintained with the family. C) Administer pain medication as ordered. D) Maintain a busy schedule for child and family members. Answer: C Explanation: A) Children with life-limiting conditions should receive palliative care in much the same way it is provided to adults. The major goal for the dying child is to promote comfort and keep the child pain-free by providing analgesia to promote optimal pain relief. Maintaining a good relationship is important but not a major goal for the child's care. Keeping the child entertained is good, but the client needs to voice her feelings about death and dying. A dying child does not have the energy to maintain a busy schedule. Question: The parents of a child with terminal cancer ask the nurse that the child not be told that he will not recover. The nurse anticipates that the child might ask the nurse if he is dying. What would be most appropriate for the nurse to do? A) Suggest a meeting with the healthcare team and the parents. B) If the child asks about death, offer to bring in the child life therapist to help explain the situation. C) Tell the child he is dying if the child asks and offer to stay with him. D) Prepare to ignore the child's question if the child asks it and change the subject. Answer: A Explanation: A) Offering to set up a meeting with the healthcare team to discuss the parents' fears and concerns about telling their child the truth is the best action by the nurse. Telling the child he is dying would be going against the parents' wishes. Avoiding the subject is not an option. Changing the subject or ignoring the child is not appropriate, and the nurse should not simply pass the issue off to a therapist. Question: An older school-age child is brought to the emergency department after a car accident. The parents witness and stare at the resuscitation scene unfolding before them. The child is not responding to the resuscitative efforts after 30 minutes. Which is the best communication strategy for the nurse to use in this situation? A) Ask the parents whether they would like resuscitative efforts to be continued at this point. B) Ask the parents to stand at the foot of the cart to watch. C) Inform the parents that resuscitative efforts have not been effective and are not beneficial to the child. D) Ask the parents to leave until the child has stabilized. Answer: C Explanation: A) Care must be used in how the parents are asked to withdraw therapies. An effective communication strategy is to inform the parents that an intervention was initiated to give the child the best chance of recovery, but it has not been effective and is not beneficial to the child. When asking to withhold therapy such as cardiopulmonary resuscitation, it is helpful to indicate that the therapy is not effective in reversing overwhelming illness or brain damage. All other interventions mentioned are not effective communication strategies in this situation. Question: The wife of a patient with end-stage chronic obstructive pulmonary disease (COPD) tells the nurse that she wishes her husband were eligible for hospice care but she thinks that hospice is only available for cancer patients. She is also concerned that, even if he were eligible for hospice care, they couldn't afford it, they'd have medical personnel constantly underfoot, and her husband would have to switch healthcare providers. Which responses by the nurse are appropriate? Select all that apply. A) Inform her that a diagnosis of cancer is not required for hospice care. B) Inform her that hospice care is very expensive. C) Tell her that hospice care is intended to ease the burden of primary caregivers, not add to it by being in the way. D) Tell her that, even though her husband has end-stage COPD, he is not eligible for hospice care. E) Inform her that all hospice programs are provided 24/7 in long-term care facilities. Answer: A, C Explanation: A) In addition to clients who are diagnosed with cancer, a variety of clients qualify for hospice care. To be eligible for hospice care, clients need to be diagnosed by a physician as having 6 months or less to live. Hospice care supports the involvement of family in clients' care and is available to help ease the burden of primary caregivers. In many cases, hospice is provided by the individual's health insurance or Medicare policy. Hospice care can take place in the client's home or in hospice centers, hospitals, nursing homes, and other long-term care facilities. Question: An adolescent client with terminal cancer tells the nurse that she does not want any more treatment, even though her parents are planning for her to participate in a study trial that involves aggressive chemotherapy. Which action by the nurse is the most appropriate? A) Tell the client that the decision is her parents' and she has to participate in the study. B) Tell her that, at 16, she can make her own decisions no matter what her parents want. C) Request that the parents and daughter meet together with the healthcare team to discuss options and the implications of various choices. D) Tell her not to worry because her parents want the best for her. Answer: C Explanation: A) Adolescents with a serious medical condition are more capable of making treatment decisions than most teenagers. However, the Patient Self- Determination Act of 1990 limits the legal rights of individuals younger than 18 to make their own healthcare decisions. If the adolescent states a desire to withdraw from or refuse treatment, her parents and healthcare team should discuss the reasons for her decision and help her understand the implications of her decision and any treatment alternatives that may influence her choice. Telling her not to worry does not address the problem. Question: If nutrients and hydration are provided artificially for a client at the end of life because of the client's diminished muscle control, then what is another therapy that is likely to accompany this therapy? A) Provide oral care regularly. B) Provide mechanical ventilation. C) Gently massage extremities. D) Maintain client safety. Answer: A Explanation: A) A client with diminished muscle control might have decreased food and fluid intake resulting from difficulty swallowing and decreased gastrointestinal activity. In addition to providing nutrients and hydration to this client artificially, other clinical therapies might be to provide regular oral care and to provide hygiene care as needed. Mechanical ventilation is therapy for a respiration etiology, gentle massage is therapy for a circulation etiology, and maintaining client safety is therapy for a sensation etiology. Question: What best explains the reason that a nurse should be responsible for communicating any changes in the condition of a client at the end of life that would warrant a change in the care plan? A) Nurses typically are responsible for definitively diagnosing patient conditions. B) Nurses are the healthcare providers who tend to have the greatest amount of contact with clients at the end of life. C) Clients typically do not prefer to talk to physicians about problems. D) It is legally mandated that nurses are solely responsible for communicating this information. Answer: B Explanation: A) Collaboration between healthcare providers is essential to providing quality care at the end of life. Nurses interact with clients most frequently, so they are responsible for communicating any changes in the client's condition that would warrant a change in the care plan, but they don't definitively diagnose patient condition, and they are not the only legally mandated people who may communicate changes in a client's condition. Clients often talk to physicians about problems. Question: What word best describes the pain a client experiences at the end of life? A) Unmanageable B) Unpredictable C) Inevitable D) Acute Answer: C Explanation: A) The most common symptom at the end of life is pain, so end-of-life care must include pain management. Client pain will likely be chronic with acute episodes, and it won't necessarily be unmanageable or unpredictable. Question: A client reports feeling tired and not refreshed after sleeping. The client also tells the nurse that family members have been making comments about the client's loud snoring at night. What should the nurse suspect as being the cause of this client's fatigue? A) Insomnia B) Depression C) Thyroid disorder D) Sleep apnea Answer: D Explanation: A) The client is snoring at home, which could indicate obstructive sleep apnea. Insomnia is the absence of sleep. There is not enough information to determine if the client is depressed or has a thyroid disorder. Question: A participant in a seminar given by a nurse asks for information about lifestyle situations that might contribute to chronic fatigue. Which examples might the nurse identify in response to this request? Select all that apply. A) Thyroid problems B) Chronic back pain C) Marijuana use D) Vigorous exercise three times a week E) Swimming after a meal Answer: A, B, C Explanation: A) Fatigue is a symptom that needs investigating. Some risk factors for fatigue are hyper- or hypothyroidism, use of illicit drugs such as marijuana, and chronic pain. Swimming and vigorous exercise will energize, not produce fatigue. Question: During an assessment, an adolescent reports: "I get up at 6 a.m., I attend early-morning band classes three times each week, I play sports for 2 hours each day after school, and homework takes me 3 hours each night. I always feel tired." Based on these data, which question will the nurse ask while continuing the client's history? A) "Do you think you are involved in too many activities?" B) "Do you consume foods high in iron such as red meat and green, leafy vegetables?" C) "How many hours of sleep do you get each night?" D) "Have you considered talking with your teachers about decreasing your homework?" Answer: C Explanation: A) The data in this scenario reveal very little time for sleep; therefore, the history should focus on sleep patterns, not diet. Asking if the client thinks the number of activities or homework should be reduced does not directly address the number of hours of sleep the client is getting. An 8-year-old female client complains of chronic fatigue that has persisted for several months despite an adequate amount of sleep each night. The nurse plans the care based on a nursing diagnosis of Fatigue. What intervention is the nurse most likely to try first? A) Recommend a sleep study. B) Recommend a healthy and well-balanced diet with adequate water intake. C) Recommend that the client's parents keep a journal of her activities and sleep patterns. D) Recommend cognitive-behavioral therapy. Answer: B Explanation: A) If the client appears to be getting an adequate amount of sleep each night, then ensuring the client is eating a proper diet would be the first response to fatigue. A sleep study is not indicated for a client who is getting adequate sleep, and keeping a journal of the client's behavior is a step that would follow dietary recommendations if those don't address the fatigue. Cognitive-behavioral therapy is an approach that would follow other, less intensive approaches should they fail to address the fatigue. Question: During a home visit with new parents, the nurse learns that a new mother is fatigued because the baby is not sleeping well. Which suggestion could the nurse make that would most help decrease this client's fatigue? A) Advise the client to alternate night feedings with the baby's father to allow each parent to rest. B) Suggest that the client ask the neighbors to babysit one night a week. C) Ask the physician for medication to restore energy. D) Increase exercise time each week to promote energy. Answer: A Explanation: A) Getting up with the newborn causes fatigue over time. If the parents take turns getting up, each parent will get a full night of rest every other day, which should help with fatigue. Medications to restore energy are not appropriate in this case. Asking someone to babysit once a week will not significantly increase rest time and depends on the sustained commitment of neighbors to giving up a night out of every week. These parents need sleep, and increasing exercise is not a long-term solution for sleep deprivation. Question: What most determines the effectiveness of pharmacologic therapy for fatigue? A) The patient's attitude toward taking medication B) The length of time the patient has been fatigued C) The appropriateness to the patient's condition D) The patient's commitment to complementary therapies Answer: C Explanation: A) Pharmacologic therapy depends on the cause of fatigue. To be effective, the pharmacologic therapy must be tailored to the client's specific condition. The length of the patient's condition isn't a factor, and neither is the patient's commitment to complementary therapies. The patient certainly must be willing to take medication, but if the medication isn't appropriate in the first place, the patient's willingness doesn't matter. Question: The nurse is caring for a client who is experiencing chronic fatigue related to medication being taken for seasonal allergies. What should the nurse anticipate would most likely help this client? A) A medication change to treat seasonal allergies B) Physical therapy to promote exercise C) Acupuncture and massage D) Sleep medication to increase rest time Answer: A Explanation: A) The nurse might expect the provider to try different dosages or different medications to try to relieve the symptoms. Because the fatigue is due to medication side effects, other strategies will not be effective while the client is on the medication. Therapies such as acupuncture and massage are not consistently supported by clinical studies as effective interventions for fatigue. Question: A client has been prescribed iron supplements to treat fatigue and a hemoglobin level of 9. What additional information should the nurse suggest to the client to help reduce feelings of fatigue associated with a low red blood cell count? Select all that apply. A) Increasing intake of ice cream B) Drinking a glass of orange juice each day C) Increasing intake of red meat D) Increasing intake of wax beans E) Increasing intake of green, leafy vegetables Answer: B, C, E Explanation: A) Iron is absorbed better when accompanied with vitamin C in foods such as orange juice. Green, leafy vegetables and red meat are good sources of iron that the client can consume in a healthy diet. Ice cream and wax beans are not sources of dietary iron and do not enhance the absorption of iron. Question: A client who has multiple sclerosis is complaining of fatigue. In recommending an exercise program to this client, what is the most likely factor the nurse will need to consider other than physician approval? A) Complementary dietary recommendations B) The intensity of the workout C) Complementary therapy recommendations D) Pharmacologic therapy Answer: B Explanation: A) Clients who report persistent fatigue should be encouraged to begin a physician-approved mild to moderate exercise regimen. Higher intensity exercise does not appear to produce a greater reduction in fatigue, so clients should be instructed to avoid intense workouts that may increase feelings of fatigue. Exercise reduces fatigue in chronic conditions such as multiple sclerosis. Question: An adult female client is diagnosed with chronic fatigue syndrome. What statement best accompanies the diagnosis? A) Continued bed rest will relieve the condition. B) The client's physician has ruled out an obvious cause for the fatigue. C) The client is suffering complications from a severe stress reaction. D) The client needs a rigorous exercise regimen. Answer: B Explanation: A) Chronic fatigue syndrome occurs when an individual experiences severe tiredness that lasts more than 6 months, is not caused by a primary condition, and is not relieved by stress reduction. Because this syndrome is not caused by a primary condition and lasts for at least half a year before it is diagnosed, the physician will have ruled out an obvious cause for the fatigue by this point. Bed rest will not relieve the condition, and exercise therapy has produced conflicting results in patients with chronic fatigue syndrome and so should be approached with caution. Question: A pregnant client experiencing fatigue describes her typical diet as consisting of fast food such as burgers and fries for lunch, takeout from Chinese or Mexican restaurants for dinner, and orange juice or a fruit smoothie in the morning. What is the problem with this diet? A) The fast food because it's likely high in fat. B) The takeout food might be saucy and heavy. C) The burgers contain red meat. D) The fruit smoothies are processed. Answer: A Explanation: A) Fatigue in expectant mothers is often caused by iron-deficiency anemia. Expectant mothers should be encouraged to eat more protein, including lean meats and beans, and to take an iron supplement. Vitamin C increases iron absorption, so pregnant women should be encouraged to eat fruits and vegetables that contain high amounts of vitamin C. The fast food would be a problem because it's fatty, not because of the red meat content. The Chinese or Mexican food might be fatty as well, but that depends on what it is, which isn't clear from this information. The fruit smoothies would likely be high in vitamin C and therefore good for this client. Question: What is a lifestyle risk factor for fatigue? A) Chemotherapy B) Stress C) Surgery D) Inactivity Answer: D Explanation: A) Inactivity is a lifestyle risk factor for fatigue. Stress is a mood disorder that is a risk factor for fatigue. Surgery and chemotherapy are medical procedures that are risk factors for fatigue. Question: What word best describes fatigue from culture shock? A) Linguistic B) Temporary C) Geographical D) Mild Answer: B Explanation: A) Culture shock involves adjustment to changes in culture, and so should be temporary in most cases. Differences between cultures may include a number of small changes, which build over time to cause physical and mental fatigue that should decrease the longer the individual lives within the new culture. Culture shock may involve a reaction to changes in geography or language, but not necessarily, and it may be mild or more severe. Question: The nurse is caring for a client who is diagnosed with fibromyalgia. Based on this diagnosis, which clinical manifestations might the nurse anticipate for this client? Select all that apply. A) Weakness B) Exhaustion C) Pain in the calves of the leg D) Nausea and vomiting E) Anxiety Answer: A, B, E Explanation:A) The client with fibromyalgia may experience weakness from fatigue; exhaustion from nonrestorative sleep, waking up too early, or poor sleep quality; and anxiety and other mood disorders. There is no evidence that pain in the calves, nausea, or vomiting are symptoms of fibromyalgia The son of a client with fibromyalgia asks the nurse if he will also experience the health problem. Which responses by the nurse are appropriate for this situation? Select all that apply. A) If your diet is high in fatty foods, you have a greater chance of developing fibromyalgia. B) Having a family member with fibromyalgia increases the risk for developing it. C) If you exercise often enough you'll be fine. D) Only people aged 20-50 develop fibromyalgia. E) Fibromyalgia is more prominent in women. Answer: B, E Explanation:A) There are many theories about the causes and risk factors about fibromyalgia. It is generally conceded that it is more of a problem for women aged 20—50 than for men. Having a family member with the disease also increases the risk for development. The disease has not been linked to lack of exercise. Diets have been suggested as possible treatment but are not thought to cause the disease. A man brings his wife to the clinic and states, "I want you to fix my wife and tell her that there is nothing wrong with her." The client has symptoms of pain, sleep disorders, and stiffness. Which would be most appropriate for the nurse to include in a plan of care for this family? A) Medications used to treat fibromyalgia B) An exercise program to increase energy C) Information and literature on fibromyalgia D) Suggested dietary changes to help with the pain Answer: C Explanation: A) Accepting a disease like fibromyalgia may be difficult due to the vagueness of the disease. Information and written literature may help the family understand that the disease is real. The physician orders medication and diets. There is no proof that exercise, or lack thereof, causes fibromyalgia. The nurse identifies the nursing diagnosis of Chronic Pain as being appropriate for a client with fibromyalgia. Which manifestation did the client most likely report that caused the nurse to select this diagnosis? A) Pain from eyestrain B) Pain from a severe skin rash C) Acute chest pain D) Tender points in the knees Answer: D Explanation: A) Clients with fibromyalgia typically complain of multiple tender points generally including the neck, spine, and knees. Acute chest pain, pain from a rash, and muscle strain of the eye are not reported symptoms. During a home visit, the family of a client with fibromyalgia asks the nurse what they can do to help the client with painful episodes. What should the nurse suggest to the client and family? A) Protect the client from injury. B) Plan a family reunion or vacation. C) Divide household chores among each member of the family. D) Keep the client in bed. Answer: C Explanation: A) Although the causes and treatments are not all known, there is general agreement that reducing stress may help lessen the effects of fibromyalgia. The nurse could help the family by suggesting ways to decrease stress on the client by having the family pitch in on responsibilities. A family reunion or vacation might cause more stress to the client, who would more than likely be planning and packing for such an event. Keeping the client in bed would not be therapeutic. There is no reason to believe that this client is at higher risk for injury than another member of the family. The nurse is discussing goals to relieve pain and fatigue with a client newly diagnosed with fibromyalgia. Which goal statement would be realistic for this client to achieve within 30 days? A) Cook dinner five nights a week. B) Join an exercise group to meet five nights a week. C) Walk her son to school daily. D) Get a job outside the home. Answer: A Explanation:A) Fibromyalgia reduces the client's energy. The client might set as an initial goal to be able to perform daily tasks for the family such as cooking and doing the laundry. Walking her son to school daily is a bit ambitious to start, as are joining an exercise group and getting a job outside the home The nurse is caring for a client who has recently been diagnosed with fibromyalgia. The client has complained of pain, fatigue, and sleep disruptions. Which medication should the nurse anticipate will most likely be prescribed as part of the client's treatment plan? A) Duloxetine B) Milnacipran C) Pregabalin D) Acetaminophen Answer: B Explanation: A) Milnacipran is a clinical pharmacologic therapy for pain, fatigue, and sleep disruptions for fibromyalgia. Duloxetine and pregabalin are not prescribed for fatigue, and acetaminophen can be used for pain but will not assist with the sleep disturbances. The mother of three teenagers is diagnosed with fibromyalgia and asks the nurse to how to keep up with all of the children's activities. Which suggestion by the nurse is the most appropriate? A) Attempt to attend all the functions of the children. B) Negotiate with the children to alternate attendance of their functions. C) Avoid attending any afterschool functions for the children. D) Ask the children to limit their activities. Answer: B Explanation: A) Because it is too difficult to attend all of the children's functions, the nurse suggests alternating attendance of the children's functions. In this manner, the client feels that she is partially meeting the needs of each child. Not attending any functions will only add to the client's stress and may worsen symptoms. It is not reasonable for a client with fibromyalgia to try to run the home and attend all of the functions of each child. The children should not have to limit their activities because of the client's illness. An adult client is diagnosed with fibromyalgia. The client asks the nurse whether a recent of infection with the Coxsackie B virus could have caused fibromyalgia. Which response by the nurse is the most appropriate? A) The Coxsackie B virus has nothing to do with fibromyalgia. B) The Coxsackie B virus may have triggered the fibromyalgia. C) The Coxsackie B virus definitely caused the fibromyalgia. D) The Coxsackie B virus probably caused the fibromyalgia. Answer: B Explanation: A) The exact cause of fibromyalgia is unknown. Infections such as hepatitis C virus (HCV), HIV, Coxsackie B, and parvovirus may trigger fibromyalgia. However, over 70% of clients have no precipitating factor for the disease. The best response to this client is simply that the Coxsackie B virus may have triggered the fibromyalgia without speculating as to the likelihood of the infection being the cause. The nurse is counseling an adult client with fibromyalgia. What are some elements of counseling that can help this client develop effective coping skills? Select all that apply. A) Ask the client about specific stressors in the client's life and how the client handles them. B) Inform the client about what to do as the disease worsens. C) Ask the client about sources of support that the client may be able to rely on. D) Advise the client that a dimension of self-efficacy is independently developing a response to the problems of fibromyalgia. E) Suggest to the client that some symptoms may be psychosomatic. Answer: A, C Explanation: A) It helps to identify stressors that make pain and fatigue worse, and then develop strategies to avoid those stressors or to minimize symptoms when those stressors occur. Fibromyalgia is not a progressive disease. Getting appropriate help is important in managing fibromyalgia. Clients should be encouraged to see a fibromyalgia specialist, and self-efficacy means engaging in health-promoting behavior to influence the course of the disease, not developing a treatment plan alone. It is important to validate the client's perceptions. A 13-year-old female client is diagnosed with juvenile primary fibromyalgia syndrome. What should the nurse expect regarding this client? A) The nurse will treat the client in much the same way as an adult with fibromyalgia. B) Chronic fatigue can be ruled out as a likely clinical manifestation. C) The client's pain will likely have lasted no more than 3 months. D) The client's WPI score will be no greater than 7. Answer: A Explanation: A) JPFS is most commonly diagnosed in girls between the ages of 13 and 15. Triggers and symptoms of JPFS are similar to those of adult fibromyalgia, and so the nurse's interventions with this client are likely to pertain to pain management, fatigue reduction, and increased activity tolerance, just as they would for an adult patient. Because this client's symptoms are likely to be the same as those of an adult with fibromyalgia, the client is likely to experience chronic fatigue, pain lasting more than 3 months, and a WPI score of at least 7. A 15-year-old female client diagnosed with juvenile primary fibromyalgia syndrome asks the nurse whether the fibromyalgia can be cured so that she won't have to deal with it as an adult. Which of the following is the best response the nurse could make to this question? A) The fibromyalgia likely can be cured with proper sleep hygiene, exercise, and pharmacologic management. B) Fibromyalgia can be difficult to treat effectively, but the symptoms are unlikely to persist into adulthood. C) It is likely that the fibromyalgia will persist into adulthood, and there is no cure, but the symptoms can be treated and the condition is not life-threatening. D) The client will suffer from persistent fibromyalgia for the remainder of her life unless a cure can be found. Answer: C Explanation: A) More than 80% of children who have JPFS will have fibromyalgia that persists into adulthood. It is not certain that this client's fibromyalgia will persist into adulthood, but it is likely. There is no cure for fibromyalgia, but it can be treated symptomatically and it is not progressive or life-threatening. Fibromyalgia is a disorder that involves which of the following? A) Muscle strength B) Respiratory control C) Heat regulation D) Pain Processing Answer: D Explanation: A) Fibromyalgia is a disorder of pain processing, not a disorder of muscle strength, respiratory control, or heat regulation. Pain associated with fibromyalgia results from central amplification of pain signals, including spontaneous nerve activity, enlarged receptive fields, and abnormal levels of neurotransmitters. Which statement best exemplifies the etiology of fibromyalgia? A) Stress and poor sleep hygiene are the main precipitating factors for fibromyalgia. B) No exact cause is known, but some clients with fibromyalgia may have precipitating factors. C) The primary cause for fibromyalgia in nearly all clients who have it is infection. D) Precipitating factors for fibromyalgia are primarily physiological. Answer: B Explanation: A) The exact cause of fibromyalgia is unknown; over 70% of clients with fibromyalgia have no precipitating factor for the disease. Infections, physical trauma, psychosocial stressors, vaccinations, and chemical substances all might be causative factors for fibromyalgia in some patients. Which is a characteristic of fibromyalgia? A) Difficult to treat B) Definite as to cause C) Easy to prevent D) Brief in its effects Answer: A Explanation: A) Fibromyalgia is difficult to treat. a combination of pharmacologic and nonpharmacologic therapies is needed to control pain and fatigue. Individuals with fibromyalgia are often referred to a rheumatologist for specialty care. No exact cause for fibromyalgia is known, and it may present without precipitating factors. No means of preventing fibromyalgia is known, and it may only be diagnosed if the pain has lasted at least 3 months. Which client is exhibiting hypersomnia? A) The client only gets about 5 or 6 hours of sleep each night. B) The client gets roughly 8 hours of sleep each night but can't stay awake during the day. C) The client consistently has trouble getting to sleep and often lies awake for hours after bedtime. D) The client experiences repetitive involuntary leg movements that interfere with sleep. Answer: B Explanation: A) Hypersomnia is a condition of getting enough sleep at night but still exhibiting daytime drowsiness. A client getting 5 or 6 hours of sleep each night is experiencing sleep loss. Difficulty falling asleep is insomnia. Repetitive involuntary leg movements is restless leg syndrome. What primarily differentiates lack of sleep due to a sleep disorder from lack of sleep due to another developing condition? A) The length of sleep B) The quality of sleep C) The symptoms of lack of sleep D) The cause for the lack of sleep Answer: D Explanation: A) The etiology, or cause, of the lack of sleep will differ depending on whether the condition is because of a sleep disorder or another developing condition. However, the length of sleep, quality of sleep, and symptoms related to the lack of sleep may not differ. An older adult client is talking with the nurse about sleep problems. Which fact regarding sleep should the nurse teach this client? A) All elderly individuals experience disrupted sleep and depression. B) The need for sleep decreases with age. C) Sleep problems signal the onset of other developing medical conditions. D) The elderly do not experience as much deep sleep as a younger person. Answer: D Explanation: A) Starting at age 20, there is a reduction in stages 3 and 4 NREM sleep and in REM sleep, which is the deepest sleep. This reduction in deep sleep progresses with aging. Sleep problems may be from a sleep disorder as the primary condition and not another developing medical condition. Generally, the amount of sleep needed is about the same for the youth, middle-aged, and older adult. Not all elderly people experience depression and sleep disturbances. An older adult client recovering from prostate surgery is waking up frequently during the night. Which client statement supports the nursing diagnosis Disturbed Sleep Pattern? A) "The pain in my hips is unbearable at times." B) "I walk for half an hour after I eat breakfast." C) "I take my Zoloft as soon as I get up in the morning." D) "I have one cup of regular coffee in the morning." Answer: A Explanation: A) Physical discomfort or pain, especially from osteoarthritis and focused in the hips, often disrupts the sleep of older persons. The client is taking his prescribed antidepressant medication Zoloft (sertraline hydrochloride) appropriately because it has a stimulant effect and should be taken in the morning. A short walk in the morning is an appropriate type and timed exercise. Caffeine intake of one morning cup of coffee should have little interference with sleeping during the night. A client with clinical depression asks the nurse for suggestions on how to improve the quality of sleep. The client often drinks a glass of wine before bedtime to help sleep. The client falls asleep quickly but then wakes up an hour or so later and often feels anxious. A period of wakefulness follows, often lasting several hours. Which of the following planning goals would be least appropriate for this client? A) Avoid the use of alcohol late in the evening. B) Reduce or remove environmental distractions from the bedroom. C) Maintain a consistent bedtime. D) Report decreased snoring. Answer: D Explanation: A) For this client, avoiding the use of alcohol late in the evening would definitely be a worthwhile goal, as well as ensuring an environment and a routine conducive to sleep. However, the client's history does not indicate that snoring or apnea is a problem, so a goal related to decreasing snoring is probably least appropriate for this client unless there is reason to suspect this as a problem. A resident in an assisted-living facility is restless most nights and sits in the lounge area reading. When questioned, the resident reports suffering from insomnia. What should the nurse expect as a likely outcome if the resident continues with this pattern of sleep? A) Sleep paralysis B) Onset of cardiac dysfunction C) Onset of new underdiagnosed health problems D) The client's activities during the day may be hindered by these episodes. Answer: D Explanation: A) Insomnia is defined as an inability to fall asleep or stay asleep on most nights for over a month. The individual experiencing insomnia is at risk for daytime drowsiness and may experience cognitive deficits, fatigue, and irritability, all of which can hinder the client's activities during the day. Sleep paralysis is a clinical manifestation of narcolepsy, not insomnia. There is no evidence that insomnia leads to cardiac problems. There is no evidence that the resident client is demonstrating underlying problems. A client with a history of insomnia is scheduled for a polysomnogram that requires an overnight stay in a sleep laboratory. The test will not include audio and video equipment. It will monitor the client's blood oxygen levels, heart rate, breathing, and eye and leg movements, and it will use an electroencephalogram to monitor brain waves. What disorder is least likely to be identified in this test? A) Periodic limb movement disorder B) Sleep apnea C) Sleep talking D) Restless leg syndrome Answer: C Explanation: A) Heart rate, breathing, and blood oxygen levels as well as audio monitoring can detect snoring and breathing changes that suggest sleep apnea. The monitoring of leg movements detects periodic limb movement disorder and restless leg syndrome. Audio and video equipment can also detect parasomnias such as sleep talking, but because such equipment is not being used in this case, the study is least likely to identify this disorder. The nurse is assessing a client for a sleep-rest disorder. Which client behavior is most indicative of such a disorder? A) The client answers history questions in detail. B) The client expresses impatience after two or three questions and insists that the nurse hurry up and finish. C) The client expresses a concern about the privacy of the information he reveals. D) The client cannot answer definitely whether he sleeps in strange positions. Answer: B Explanation: A) Observation can indicate the presence of fatigue, decreased cognitive functioning and coordination, dark circles under the eyes, and irritability. Expressing impatience after just two or three questions is indicative of irritability, which could be a sign of sleep deprivation from a sleep-rest disorder. Answering history questions in detail does not demonstrate decreased cognitive functioning, a concern about privacy is a normal concern, and the client may not be able to answer about strange sleep positions because he may simply not know. The nurse is conducting a clinic visit with a mother and an adolescent client. Both the mother and the adolescent report that the adolescent is not able to sleep until late at night and then wakes up too late in the morning. This has caused the adolescent to be late for school several times. The mother states, "I don't know what to do." Which response by the nurse is the most appropriate? A) Inform her that several techniques can potentially help correct this problem. B) Recommend a polysomnography (PSG). C) Indicate that this is simply a normal change of the body's internal clock associated with puberty, and it will work itself out. D) Ask about other medical conditions because the adolescent's sleep patterns indicate the onset of a chronic illness. Answer: A Explanation: A) Adolescents experience changes in the body's internal clock associated with puberty that in some adolescents cause a delay in melatonin release each night; the result is delayed sleep phase syndrome. Signs of delayed sleep phase syndrome include an inability to fall asleep and wake up at the desired time. The use of sleep hygiene, sleep restriction therapy, and relaxation techniques can be beneficial in the treatment of this syndrome. A sleep study would only be indicated if the adolescent were experiencing other sleep disturbance symptoms. This isn't a sign of another illness but shouldn't be ignored either. An adult client diagnosed with sleep apnea has been prescribed a continuous positive airway pressure (CPAP) machine as treatment. The nurse is instructing the client on how to use the machine. Which instruction least relates to ensuring the patient's comfort with the device? A) Use a properly sized mask with the straps tight. B) Instruct the client to wear the mask with air pressure while sleeping. C) Show how to adjust the pressure to reduce difficulty exhaling. D) Demonstrate relaxation techniques to reduce a claustrophobic feeling when wearing the mask. Answer: B Explanation: A) Wearing the right size mask and keeping the straps tight, doing relaxation exercises to reduce the claustrophobic feelings caused by wearing the mask, reducing the difficulty of exhalation by properly adjusting pressure may all help safeguard the patient's comfort with the CPAP device, but wearing the mask with air pressure while sleeping is simply the general way the device should be used and doesn't make any special allowances for the comfort of the patient. Sleep disorders mainly do what with respect to the activities of daily living? A) Interfere B) Decrease C) Change D) Increase Answer: A Explanation: A) Sleep disorders can lead to disrupted ac