Deck 38: Sleep

Question 1

While doing an admission history on 30-year-old Mrs.Janeese,you learn that she has frequent sleepless nights and,as a result,has many questions about sleep."Some nights I don't feel like I have slept at all,even the slightest of noises will awaken me." What stage of sleep is Mrs.Janeese describing?

A)Rapid-eye-movement (REM)sleep
B)Non-rapid-eye-movement (NREM)sleep,stage I
C)Non-rapid-eye-movement (NREM)sleep,stage II
D)Non-rapid-eye-movement (NREM)sleep,stage III

Answer 1

Non-rapid-eye-movement (NREM)sleep,stage I

Question 2

Mrs.Andrea calls the pediatric clinic with concerns about her newborn.She states that when her baby first goes to sleep she can see her eyes dart around under her eyelids and she doesn't breathe regularly.What should the nurse's response to Mrs.Andrea be?

A)You should bring your baby in immediately for a checkup.
B)These are common behaviours in newborns and are normal.
C)Ask the physician about these symptoms at your next checkup.
D)If it happens again,take her to the emergency department.

Answer 2

These are common behaviours in newborns and are normal.

Question 3

Thirty-five-year-old Mr.Samson is being treated with a nasal continuous positive airway pressure device (CPAP)for sleep apnea.What finding would indicate to the nurse that this treatment has been effective for Mr.Samson?

A)Mr.Samson has lost 7 pounds since initiating treatment.
B)Mr.Samson sleeps so soundly that he snores.
C)Mr.Samson's diabetes is now under control.
D)Mr.Samson reports a decrease in morning headache.

Answer 3

Mr.Samson reports a decrease in morning headache.

Question 4

Mr.Bryant is a client being seen at the sleep clinic who is experiencing difficulty falling asleep.What suggestions regarding sleep times would the nurse make?

A)Maintain a regular bedtime and wake-up time for all days of the week.
B)If bedtime is delayed on one night,go to bed that much earlier the next night.
C)If daytime drowsiness occurs,go to bed earlier that night.
D)Sleep at least 1 hour later on mornings you don't have to go to work.

Question 5

Mrs.Hughes has brought her 2-month-old son in for his first vaccination.She asks the nurse how she can promote good sleep for her infant at night.How would the nurse respond?

A)At night,feed baby in a dimly lit room.
B)Try and keep baby awake during daylight.
C)Put baby to bed with a familiar blanket or stuffed toy.
D)Infants benefit from consistent bedtime rituals.

Question 6

Mrs.Hughes has brought her 2-month-old son in for his first vaccination.She asks the nurse why his sleep patterns are so sporadic.How would the nurse respond?

A)Once REM sleep develops,by 6-9 months of age,an infant's sleep pattern will regularize.
B)Sleep is partially regulated by circadian rhythms that are not developed until 3-6 months of age.
C)NREM sleep is not fully developed in infants,so they do not fall into the deepest stages (III and IV).
D)The activating system for melatonin release is not mature until 6-8 months of age.

Question 7

Mr.Bryant also reports awakening several times during the night.What intervention should the nurse recommend for Mr.Bryant when he is unable to sleep?

A)Get out of bed,go into another room,and pursue some relaxing activity until drowsy
B)Get out of bed,go into another room,and exercise until tired before trying to go back to sleep
C)Sit in bed and watch the bedroom television until drowsy
D)Stay in bed with eyes closed and do some mental arithmetic until sleepy

Question 8

Mr.Bryant,who reports having difficulty sleeping,asks if there are any environmental changes that he should make.Which recommendation would be appropriate?

A)Listen to story audiotapes
B)Keep a television on in the bedroom
C)Provide white noise with a fan
D)Play a talk radio station

Question 9

Mrs.Perry is teaching a class on the importance of sleep and rest to her first-year nursing students.How would she explain the purpose of the RAS system?

A)The RAS suppresses the brain centres.
B)The RAS controls the body biorhythm.
C)The RAS maintains wakefulness in the cerebral cortex.
D)The RAS sends stimuli from the cerebral cortex to the body.

Question 10

The nurse is working with Mr.Elinore,an air traffic controller.He states that he has significant life stressors at this time,is sleeping poorly,and it is affecting his ability to function.After developing a plan with Mr.Elinore that includes strategies to promote adequate rest and sleep,what would he and the nurse determine is an expected outcome?

A)Sleep at least 8 hours each night
B)List three positive coping mechanisms for anxiety relief
C)Report getting sufficient sleep to provide energy for daily activities
D)Manifest less anxiety after taking prescribed medications

Question 11

During a corporate health fair,Mr.Mitchell states that he "just can't stay awake" during the daytime,although he "sleeps just fine at night." What advice should the nurse offer Mr.Mitchell?

A)Go to your physician for a physical examination
B)Increase intake of caffeinated beverages in the daytime
C)Use an over-the-counter sleep aid to deepen nighttime sleep
D)Have a mental health screening for depression

Question 12

This is Mrs.Brophy's first night in hospital and she is having difficulty falling asleep.What is the first nursing intervention the nurse should use to help Mrs.Brophy sleep?

A)Give her the sleeping pill that has been ordered
B)Offer her a back massage and talk calmly with her
C)Offer her a cup of hot tea and a cookie
D)Open the curtains to allow street light to shine through

Question 13

What is sleep?

A)Sleep is unconsciousness with perception of strong stimuli only.
B)Sleep is unconsciousness with heightened perception of external stimuli.
C)Sleep is a state with no response to stimuli.
D)Sleep is an altered state of consciousness with decreased responses to stimuli.

Question 14

Mr.Bryan requests a bedtime snack.Which food should the nurse offer Mr.Bryan?

A)Hot chocolate
B)Tea and crackers
C)Cereal with milk
D)Chips and salsa

Question 15

A student in Mrs.Perry's class asks her when in the sleep cycle dreaming occurs.What is the correct answer?

A)During REM sleep
B)In all stages of sleep
C)During stage I REM sleep
D)Within 10 minutes of falling asleep

Question 16

Seventy-year-old Mr.Markson tells the nurse,"I can go to sleep without a problem,but then I wake up in a couple of hours and can't go back to sleep." What nursing action would help promote rest and sleep in this client?

A)Have Mr.Markson develop a bedtime ritual of quiet music and a glass of wine
B)Encourage Mr.Markson to avoid taking pain medication prior to sleep
C)Evaluate if Mr.Markson perceives sleeplessness to be a serious problem
D)Have Mr.Markson perform moderate exercises before bedtime

Question 17

The parents of 6-month-old Timmy tell the nurse that they are exhausted because their baby wakes up several times every night.What advice should the nurse give these parents?

A)Be certain that the baby is truly awake before picking him up for feeding
B)Let the baby "cry it out" for a few nights until he can sleep through the night
C)Continue to respond to the baby anytime he is restless during the night
D)Bring the baby in for a sleep study to check for possible sleeping disorders

Question 18

Cohen,a 6-year-old,has enlarged tonsils from frequent streptococcal infections.How might these enlarged tonsils affect his sleep?

A)Cause sleep apnea
B)Increase REM sleep
C)Precipitate narcolepsy
D)Decrease stage IV NREM sleep

Question 19

Jamie,a 5-year-old,has recurrent night terrors.What nursing intervention would the nurse plan to help alleviate this problem?

A)Walk Jamie around in the room when the night terrors occur
B)Briefly wake and resettle Jamie 15 to 20 minutes before usual onset
C)Give Jamie a cup of hot chocolate before bedtime
D)Have Jamie empty his bladder prior to going to bed

Question 20

Mrs.Janeese sleeps poorly during the 6 days she is hospitalized.After being discharged,she is very tired on her first night home.How would you to expect this to affect her sleep cycle?

A)Dreams will be prolonged.
B)REM sleep will predominate.
C)Stage IV NREM sleep will last 30 minutes during each cycle.
D)REM sleep cycles will be shorter than usual.

Question 21

Mrs.Flacco takes the occasional sleeping aid to help her get the rest she needs.She has taken something twice in the last month.Which of the following should Mrs.Flacco consider before taking a sleeping aid tonight?

A)She is driving a school bus first thing in the morning.
B)She is at risk for developing dependence on the drug.
C)She is at risk for rebound insomnia.
D)She will dream more when taking these sleep aids.

Question 22

Mrs.Blakely is an occupational health nurse who is employed by the local health authority.She is heading a special project on reducing environmental stimuli in hospitals to promote rest and sleep for patients.She is visiting all the hospitals to check on the progress policy changes have made.Which of the following findings would indicate to Mrs.Blakely that an organization may need further guidance on policy changes?

A)Overhead lighting evident in all corridors and rooms
B)Volume on paging system decreased after 9 pm
C)All staff required to wear rubber soled shoes
D)Shift report should be away from nursing stations

Question 23

Mr.Jose is admitted for back surgery and brings his CPAP unit with him.What should the nurse's response be?

A)Assist him to use it as he would at home
B)Have his wife take it home so it won't get lost
C)Explain that he can't use it in the hospital because of safety regulations
D)Tell him that he won't need it because the physician will order him a sleeping pill

Question 24

Ms.Ayres is attending a sleep clinic for the first time.She has complaints of fatigue and inability to sleep at night.Which of the following tools would be used early in the assessment of Ms.Ayres sleep and rest patterns?

A)Electrooculogram
B)Sleep diary
C)Polysomnography
D)Electroencephalogram

Question 25

Mrs.Ellen has begun a fitness program in an effort to lose weight and achieve a healthier lifestyle.Since doing so,she has had difficulty falling asleep.What suggestions could the nurse offer Mrs.Ellen that may improve her sleep and rest patterns?

A)Wear dark,wrap-around sunglasses when she exercises
B)Have a small glass of wine and some cheese before bed
C)Exercise moderately in the morning or early afternoon
D)Exercise vigorously late in the evening

Question 26

During her sleep diagnostics,Ms.Ayres was noted to have two periods of apnea within the first hour,lasting around 10 seconds.Based on this finding,what would the nurse's actions include?

A)Initiate CPAP treatment
B)Prepare her for a polysomnography
C)Have emergency airway equipment on standby
D)Continue to monitor her

Question 27

Mr.Wesley has been receiving morphine around the clock for post-operative pain.What is the effect of opioids on sleep?

A)They increase REM sleep.
B)They increase NREM sleep.
C)They decrease REM sleep.
D)They decrease NREM sleep.

Question 28

Ms.Ayres is to have some diagnostic tests related to sleep.Which diagnostic test will provide the health care team with the best information?

A)Multiple Sleep Latency Test
B)Accelerometer
C)Electrocardiogram (ECG)
D)Polysomnography