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 an outcome if the resident continues with this pattern of sleep?
Safety issues with an unsupervised resident in the lounge area
Onset of cardiac dysfunction
Onset of new underdiagnosed health problems
The ability to function during the day may be hindered by these episodes.
The Correct Answer is D
A) Safety issues with an unsupervised resident in the lounge area: While there could be safety concerns related to a resident being in a common area at night, the primary outcome expected from continued insomnia would more directly relate to the individual's functioning rather than immediate safety issues.
B) Onset of cardiac dysfunction: While chronic sleep disturbances can contribute to various health problems, including cardiovascular issues, the immediate outcome of insomnia is more likely to be seen in daily functioning rather than a direct onset of cardiac dysfunction.
C) Onset of new underdiagnosed health problems: While ongoing insomnia may exacerbate existing health issues or lead to new ones over time, the most immediate and observable outcome of insomnia would relate to how it affects daily functioning rather than the development of new health problems.
D) The ability to function during the day may be hindered by these episodes: Insomnia typically leads to increased fatigue, decreased alertness, and impaired cognitive function during the day. As a result, the resident's overall ability to engage in daily activities and interact socially may be significantly hindered by their lack of restorative sleep.
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Correct Answer is C
Explanation
A) Motor component of IV (Trochlear): The trochlear nerve primarily controls the superior oblique muscle of the eye, which is responsible for downward and lateral eye movements. The findings described do not relate to eye movement and therefore do not indicate dysfunction of this nerve.
B) Motor and sensory components of XI (Accessory): The accessory nerve innervates the sternocleidomastoid and trapezius muscles, primarily affecting head rotation and shoulder elevation. The symptoms noted in the assessment do not pertain to these muscle functions, so this option is not correct.
C) Motor component of VII (Facial): The signs of asymmetry in frowning, uneven eyebrow lifting, sagging eyelids, and air escaping when puffing the cheeks are characteristic of dysfunction in the facial nerve (cranial nerve VII). This nerve controls the muscles of facial expression, and impairment would lead to the described asymmetrical movements.
D) Motor component of X (Vagus) and sensory component of XII (Hypoglossal): The vagus nerve affects autonomic functions and some swallowing muscles, while the hypoglossal nerve controls tongue movements. Neither nerve is primarily responsible for the facial expressions described in the assessment findings, making this option incorrect.
Correct Answer is D
Explanation
A) The patient has asthma: While asthma can lead to respiratory symptoms and issues, it is not typically associated with clubbing of the fingernails. Asthma primarily affects airway constriction and inflammation, rather than causing the long-term changes in nail morphology seen with clubbing.
B) The patient has cardiovascular disease: Although some cardiovascular conditions can lead to clubbing, it is more commonly associated with chronic lung diseases. Cardiovascular disease might cause other signs or symptoms, but clubbing alone is not a definitive indicator of this condition.
C) The patient has emphysema: Emphysema, a type of chronic obstructive pulmonary disease (COPD), is characterized by the destruction of lung tissue and impaired airflow. While it can contribute to hypoxemia, clubbing is not a common finding specifically associated with emphysema.
D) The patient has chronic hypoxemia: Clubbing of the fingernails is a classic sign of chronic hypoxemia, often resulting from long-term respiratory conditions like COPD, interstitial lung disease, or lung cancer. It indicates a prolonged lack of oxygen in the blood, leading to changes in the nail bed and digit shape. Given the patient's long smoking history, chronic hypoxemia is the most likely explanation for this finding.