Deck 7: Risks Related to Sleep Alterations

Question 1

A patient in the clinic tells the nurse that she has difficulty sleeping at night. When developing a plan of care for this patient, which of the following would the nurse consider?

A) Melatonin is released in response to darkness.
B) Sunlight reduces the release of melatonin.
C) Melatonin is released in the late afternoon.
D) Melatonin secretion stops about 2 a.m.

Answer 1

Sunlight reduces the release of melatonin.

Question 2

Which assessment by the nurse indicates that a patient who has just fallen to sleep is in stage 1 of sleep?

A) Slow rolling eye movements
B) Breathing slows down
C) Rapid eye movement
D) Drop in blood pressure

Answer 2

Slow rolling eye movements

Question 3

When assessing a patient's sleep-wake pattern, the nurse keeps in mind circadian body patterns. Which assessment data would indicate that the client follows normal circadian sleep-wake patterns?

A) Highest level of alertness at 4 p.m. (1600 hours)
B) Best coordination at 2:30 p.m. (1430 hours)
C) Fastest reaction time at 10:00 a.m. (1000 hours)
D) Greatest muscle strength at 12 noon (1200 hours)

Answer 3

Best coordination at 2:30 p.m. (1430 hours)

Question 4

When taking a healthy patient's vital signs, the nurse would expect the highest body temperature to occur at what time of day?

A) 6 a.m. (0600 hours)
B) 12 noon (1200 hours)
C) 7 p.m. (1900 hours)
D) 2 a.m. (0200 hours)

Question 5

A gerontology nurse is speaking to adults in a senior center about healthy sleep patterns. Which sleep pattern does the nurse describe as normal for this age group?

A) Taking a shorter time to fall asleep
B) Having longer sleep cycles
C) Taking more naps
D) Spending more time in REM sleep

Question 6

When assessing a patient with sleep deprivation, the nurse would expect the patient to report:

A) weight loss.
B) reduced peripheral vision.
C) slow speech.
D) irritability.

Question 7

Which statement by a patient undergoing polysomnography indicates that more teaching is needed?

A) "An EEG is performed during the sleep study in order to detect any seizure activity."
B) "An EMG is performed during the sleep study to record muscle tension and relaxation."
C) "An EOG is performed during the sleep study to record eye movements."
D) "A nasal thermistor is used during the sleep study to measure nasal air flow."

Question 8

To reduce jet lag in a patient traveling from the United States to Europe, what recommendation should the nurse make?

A) Spend time outside during daylight at the destination.
B) Take melatonin in the morning until adjusted to time.
C) Drink caffeinated coffee in the early evening to overcome tiredness.
D) Take a long-acting hypnotic at bedtime.

Question 9

Which assessment data is a precipitating factor for insomnia?

A) Frequent worrying
B) Loss of a job
C) Inadequate coping skills
D) Hyperarousal

Question 10

A patient is being seen in the clinic for insomnia. The nurse explains that the best diagnostic indicator of insomnia is:

A) the patient's report of insomnia.
B) results of polysomnography.
C) completing the Pittsburgh Sleep Quality Index.
D) results of actigraphy.

Question 11

During sleep apnea, the nurse can anticipate which laboratory values?

A) A rise in blood CO_2, a drop in blood O₂
B) A rise in blood CO_2, a rise in blood O₂
C) A drop in blood CO_2, a rise in blood O₂
D) A drop in blood CO_2, a drop in blood O₂

Question 12

The nurse is counseling a pregnant woman with sleep obstructive sleep apnea (OSA). Which statement by the woman indicates that she does not understand what the nurse has taught?

A) "My baby may have poor fetal growth due to OSA."
B) "OSA may lead to a small placenta."
C) "My baby may be small for gestational age at birth."
D) "OSA will not affect my baby."

Question 13

When observing a patient with central sleep apnea during sleep, the nurse is most likely to observe:

A) respiratory efforts seen during periods with no airflow.
B) absence of respiratory efforts during periods of no airflow.
C) paradoxical chest and abdomen movements during desaturation.
D) absence of desaturation.

Question 14

Which statement is typical of a patient who is newly diagnosed with narcolepsy?

A) "I gradually drift off to sleep during the day."
B) "I sleep well at night."
C) "I have periods where I collapse."
D) "I have daytime sleepiness and fatigue."

Question 15

When developing a care plan for a patient with narcolepsy, the nursing diagnosis with the highest priority is:

A) risk for injury.
B) insomnia.
C) deficient knowledge.
D) disturbed body image.

Question 16

When evaluating the effectiveness of the stimulant drug methylphenidate in the patient with narcolepsy, the nurse should expect the patient to have:

A) less attacks of sleep paralysis.
B) less cataplexy attacks.
C) reduced daytime sleepiness.
D) uninterrupted nighttime sleep.

Question 17

Which patient statement is typical of data collected from patients with a diagnosis of restless leg syndrome?

A) "The urge to move my legs subsides when resting."
B) "My leg restless subsides with movement."
C) "The restlessness subsides in the evening."
D) "My symptoms get better at night."

Question 18

Which instruction should the nurse give to a patient undergoing a Suggested Immobility Test for possible restless leg syndrome?

A) "You will be asked to lie quietly in bed."
B) "This test takes place at night."
C) "Do not fall asleep."
D) "You may move around if your legs feel restless."

Question 19

A parent tells the nurse that her child woke up terrified, with eyes opened and cried out. The child did not recall the event in the morning. The nurse explains that this event is called:

A) night terrors.
B) somnambulism.
C) enuresis.
D) bruxism.

Question 20

Which nursing diagnosis has the highest priority in the patient with somnambulism?

A) Risk for injury
B) Insomnia
C) Deficient knowledge
D) Disturbed body image