Question 1

Which of the following is a common misconception about sleep in the older adult?&#10;A) Older adults need less sleep than middle-aged adults.&#10;B) Insomnia symptoms in the older adult frequently occur with depression.&#10;C) Older female adults report more trouble falling asleep than their male counterparts.&#10;D) Diabetes in the older adult can increase the prevalence of insomnia.

Accepted Answer

This is a common misconception, as older adults actually need the same amount of sleep as middle-aged adults, which is around 7-9 hours per night. In fact, some older adults may need additional napping during the day to compensate for poor sleep at night.

B, C, and D are all accurate statements about sleep in the older adult.

Question 2

Which of the following should the nurse teach a patient to assist him or her with a sleep disturbance?&#10;A) If you are not asleep within one hour of going to bed,get out of the bed.&#10;B) Exercise an hour before going to bed.&#10;C) Have a glass of wine or a beer just before bedtime.&#10;D) Avoid caffeine and alcohol for at least four hours before bedtime.

Accepted Answer

The nurse should teach the patient to avoid caffeine and alcohol for at least four hours before bedtime. Caffeine and alcohol interfere with the ability to fall and stay asleep, so avoiding them can help improve sleep patterns. A glass of wine or beer might make the patient feel drowsy initially, but it can cause interrupted sleep and will not help the patient stay asleep throughout the night. Exercising just before bedtime can make the patient feel more alert, so it is not recommended. If the patient is not asleep within one hour of going to bed, the nurse should teach the patient to engage in quiet activities, such as reading, until they feel sleepy again.

Question 3

Which of the following is a relatively noninvasive method of monitoring rest and activity cycles?&#10;A) Self-report&#10;B) Actigraphy&#10;C) Polysomnography&#10;D) Pittsburgh Sleep Quality Index

Accepted Answer

Actigraphy is a relatively noninvasive method of monitoring rest and activity cycles. It involves wearing a small, wristwatch-like device that tracks movement and can provide objective data on sleep patterns and circadian rhythms. Self-report and the Pittsburgh Sleep Quality Index rely on subjective reporting, while polysomnography involves more invasive monitoring of biological functions during sleep.

Question 4

Which instruction will the nurse include when teaching a patient with chronic insomnia about ways to improve sleep quality?&#10;A) Avoid aerobic exercise during the day.&#10;B) Read in bed for a few minutes each night.&#10;C) Keep the bedroom temperature slightly warm.&#10;D) Try to go to bed at the same time every evening.

Accepted Answer

Going to bed at the same time every evening helps regulate the body's internal clock and can improve sleep quality. Avoiding aerobic exercise during the day may actually be beneficial for promoting sleep, reading in bed can associate the bed with wakeful activities, and keeping the bedroom temperature slightly cool (around 65 degrees Fahrenheit) is recommended for optimal sleep. However, the instruction that will most improve sleep quality for a patient with chronic insomnia is establishing a consistent sleep schedule.

Question 5

Which information will the nurse plan to include when teaching a patient with narcolepsy about management of the disorder?&#10;A) Stimulant drugs should be used for only a short time because of the risk for abuse.&#10;B) Driving an automobile may be possible with appropriate treatment of narcolepsy.&#10;C) Changes in sleep hygiene are ineffective in improving sleep quality in narcolepsy.&#10;D) Antidepressant drugs are prescribed to treat the depression caused by the disorder.

Accepted Answer

The nurse should teach the patient with narcolepsy that driving an automobile may be possible with appropriate treatment, which may include medications, lifestyle changes, and/or behavioral therapy. Stimulant drugs are often used to treat daytime sleepiness, but should be used cautiously due to the risk of abuse. Improving sleep hygiene may also be helpful in managing symptoms. Antidepressant drugs may be prescribed to treat symptoms such as cataplexy and sleep paralysis, but are not used specifically to treat depression caused by narcolepsy.

Question 6

After the nurse has taught a patient about the use of extended-release Zopiclone (Imovane)for insomnia,which patient statement indicates a need for further teaching?&#10;A) &#34;I will take the medication an hour before bedtime.&#34;&#10;B) &#34;I should take the medication on an empty stomach.&#34;&#10;C) &#34;I should not take this medication unless I can sleep for at least six hours.&#34;&#10;D) &#34;I will schedule activities that require mental alertness for later in the day.&#34;

Accepted Answer

Extended-release Zopiclone (Imovane) should be taken right before bedtime, not an hour before, to ensure its effectiveness in inducing sleep.

Question 7

What should the nurse do,initially,to assist in determining whether a patient seen in the ambulatory care setting has chronic insomnia?&#10;A) Schedule a polysomnography (PSG)study.&#10;B) Arrange for the patient to have a sleep study.&#10;C) Ask the patient to keep a two-week sleep diary.&#10;D) Teach the patient about the use of an actigraph.

Accepted Answer

Asking the patient to keep a two-week sleep diary is a cost-effective and non-invasive method to track the patient's sleep patterns and assess for chronic insomnia. The diary can include information on the patient's bedtime routine, time it takes to fall asleep, number and duration of awakenings, and quality of sleep. This information can help the healthcare provider identify patterns and factors that may be contributing to the patient's insomnia. PSG and sleep studies are more invasive and expensive options that may be considered if the sleep diary does not provide enough information or if underlying medical conditions are suspected. Teaching the patient about the use of an actigraph may also be helpful in tracking their sleep patterns, but it is not the initial step in assessing for chronic insomnia.

Question 8

Which of the following is an arousal parasomnia that occurs during NREM sleep?&#10;A) Enuresis&#10;B) Hallucinations&#10;C) Sleepwalking&#10;D) Nightmares

Accepted Answer

Sleepwalking is an arousal parasomnia that occurs during NREM sleep. Enuresis (bedwetting) is also a parasomnia but occurs during REM sleep. Hallucinations and nightmares can occur during both REM and NREM sleep.

Question 9

Which action is best for the nurse to include in the plan of care in order to improve sleep quality for a critically ill patient in the critical care unit (CCU)?&#10;A) Ask all visitors to leave the CCU for the night.&#10;B) Lower the level of light from 2000 hours until 0700 hours.&#10;C) Avoid the use of opioids for pain relief during the evening hours.&#10;D) Schedule assessments to allow at least four hours of uninterrupted sleep.

Accepted Answer

The answer of Which action is best for the nurse...

Question 10

Healthy adults spend what percentage of sleep time in non-rapid eye movement (NREM)sleep?&#10;A) 20% to 25%&#10;B) 45% to 50%&#10;C) 75% to 80%&#10;D) 85% to 90%

Accepted Answer

Healthy adults spend 75% to 80% of sleep time in NREM sleep.

Deck 9: Sleep and Sleep Disorders