Foundation Exam #5 Summer 2025 at Denver College of Nursing

C. "Staying out late with coworkers during the week could affect my sleep.": Irregular sleep schedules and staying out late can disrupt the body’s circadian rhythm, making it harder to fall asleep or maintain restful sleep. Consistency in bedtime routines supports better sleep quality. D. "Drinking caffeinated coffee at 7 pm could affect my sleep.": Caffeine is a stimulant that can remain active in the body for several hours, delaying sleep onset and reducing overall sleep time and quality, especially when consumed in the evening.

Demonstration of glucometer use reflects that the client has understood and applied self-management teaching for diabetes care. This skill is essential for monitoring blood glucose levels, adjusting diet, activity, or medication, and preventing complications like hypoglycemia or hyperglycemia. When the client can correctly perform this task, it indicates effective learning and achievement of a key educational goal.

A. Changing the time of day that I eat dinner can disrupt sleep: Irregular eating patterns, especially eating heavy meals late at night, can cause indigestion or discomfort, making it harder to fall asleep or stay asleep. C. Exercising 2 hours before bedtime can decrease relaxation: Vigorous physical activity close to bedtime stimulates the body and raises core temperature, making it more difficult to relax and initiate sleep. Exercise should be completed at least several hours before bedtime. D. Worrying about work can disrupt my sleep: Stress, anxiety, and overthinking activate the sympathetic nervous system, keeping the mind alert and interfering with the ability to relax and fall asleep. E. Staying up late for a party can interrupt sleep patterns: Irregular sleep schedules and staying up late can disturb circadian rhythms, leading to difficulty falling asleep and reduced sleep quality. F. Drinking coffee at 7 PM could interrupt my sleep: Caffeine is a central nervous system stimulant that can remain in the body for several hours, delaying sleep onset and reducing total sleep time.

A. Delayed wound healing: This client has type 2 diabetes and smokes heavily, both of which impair circulation and oxygenation to tissues, resulting in delayed wound healing and increased risk for infection after surgery. B. Obesity: The client’s extreme obesity (400 lbs, 5'2") increases the risk for respiratory compromise, wound dehiscence, poor circulation, and difficulty with anesthesia and postoperative mobility, making recovery more challenging. E. Age: At 80 years old, the client’s decreased physiological reserve, slower metabolism, and reduced organ function increase the likelihood of postoperative complications such as pneumonia, infection, or delayed healing.

Caffeine is a stimulant that interferes with the ability to fall asleep and maintain restful sleep. Adolescents often consume caffeinated sodas, energy drinks, or chocolate, which can delay sleep onset. The nurse should educate the client to avoid caffeine several hours before bedtime to promote healthy sleep hygiene. This intervention directly addresses the cause of difficulty falling asleep.

A. A well-lit space: A well-lit environment helps the client clearly see teaching materials, written instructions, and demonstrations. Proper lighting enhances concentration and prevents visual strain, allowing the client to engage fully in the teaching session. It is especially important for older adults or clients with impaired vision to ensure they can read handouts and observe procedures accurately. B. An area free of distractions: A quiet, private space minimizes interruptions and noise that can interfere with comprehension and retention. Teaching in a distraction-free area helps the client focus entirely on the information being shared, improving understanding and recall. It also promotes open communication, allowing the client to ask questions without embarrassment or external pressure.

A potassium level of 2.9 mEq/L indicates hypokalemia, which is a critical electrolyte imbalance. Potassium is essential for cardiac electrical conduction and muscle contraction. Low levels can cause life-threatening arrhythmias, muscle weakness, and respiratory compromise. This finding must be reported immediately, and the nurse should have the provider repeat back the value to confirm understanding and ensure prompt intervention, such as potassium replacement and cardiac monitoring.

Many herbal supplements can interact with prescription or over-the-counter medications, altering their effectiveness or causing harmful side effects. For example, St. John’s Wort can reduce the effectiveness of antidepressants and oral contraceptives, while Ginkgo biloba can increase bleeding risk when taken with anticoagulants. Older adults are especially vulnerable due to polypharmacy. Nurses should emphasize discussing all supplements with healthcare providers before use.

A return demonstration allows the nurse to assess the client’s understanding and technique in performing deep breathing and coughing exercises, which are essential to prevent postoperative complications such as atelectasis and pneumonia. This method ensures that the client can perform the skill correctly and safely while giving the nurse an opportunity to correct any mistakes immediately.