A client has reported to the nurse that his sprained ankle resulted fr

A client has reported to the nurse that his sprained ankle resulted from “a careless accident. I seem so clumsy and unfocused lately.”

Which of the following assessment questions is most likely to reveal information regarding the cause of these symptoms?
1. “How many accidents have you had lately?”
2. “Have the accidents resulted in serious injuries?”
3. “Have there been any changes in your daily routine lately?”
4. “Do you have any idea what is responsible for this lack of focus?”

ANSWER

ANS: 4
A loss of REM sleep leads to feelings of confusion and suspicion. Various body functions (e.g., mood, motor performance, memory, and equilibrium) are altered when prolonged sleep loss oc-curs. Research estimates that traffic, home, and work-related accidents caused by falling asleep are often a result of sleep loss. This answer is the best question because it directly opens up the opportunity for the client to discuss possible sleep problems if they exist. The other questions are not inappropriate but are less likely to reveal the possible cause of the accidents.