RN Nursing · Rest and Sleep · Practice question
A nurse is caring for a hospitalized client who has a fractured leg and reports difficulty sleeping due to discomfort. Considering the physiological and psychological needs related to rest and sleep, which nursing intervention should the nurse prioritize to promote the client's restful sleep?
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Administer prescribed analgesia before the client’s usual sleep time and provide pillows for support to ease discomfort.
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Limit fluid intake before bedtime to prevent nighttime awakenings due to urination.
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Encourage the client to engage in stimulating activities before bedtime to distract from pain.
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Keep the room brightly lit and maintain a moderate noise level to keep the client alert and oriented.
Answer & explanation
Correct: Administer prescribed analgesia before the client’s usual sleep time and provide pillows for support to ease discomfort.
Pain is the primary barrier to sleep for a client with a fractured leg, so addressing it directly is the highest priority intervention. Administering prescribed analgesia before the client's usual sleep time targets the physiological cause of the sleep disturbance, while providing supportive pillows reduces mechanical discomfort by offloading pressure on the injured limb. Together, these measures create the physical comfort necessary for sleep onset and maintenance, fulfilling both physiological and psychological needs simultaneously. Pain relief also reduces anxiety about nighttime discomfort, further supporting restful sleep. Limiting fluid intake before bedtime is a secondary comfort measure that may reduce nocturnal awakenings from urination, but it does not address the client's stated primary issue of pain, making it insufficient as a priority. Encouraging stimulating activities before bedtime is counterproductive because mental stimulation raises arousal levels and delays sleep onset, which worsens insomnia. Keeping the room brightly lit and maintaining moderate noise further disrupts the sleep environment by suppressing melatonin production and increasing sensory stimulation, both of which are known to fragment sleep architecture. Evidence-based sleep hygiene supports a dark, quiet, cool environment; therefore, this option is directly contraindicated for promoting rest.
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