Question 1

The nurse is providing discharge instructions for the patient with sleep pattern disturbances. Which statement by the patient indicates a need for further education?

Accepted Answer

Use the bedroom for sleep and sex only; do not watch television, read, study, or eat in there. A consistent bedtime routine signals to the mind and body that it is time to go to sleep. Maintaining a regular sleep pattern helps maintain circadian rhythms. Continue the regular sleep pattern on weekends and on holidays. Getting out of bed if unable to sleep trains the mind to sleep when in bed. If unable to fall asleep within 20 minutes, get out of bed and engage in a relaxing activity such as reading or listening to music until sleepy.

Question 2

The nurse knows the following information about sudden infant death syndrome (SIDS): (Select all that apply.)

Accepted Answer

SIDS is the second most common cause of death among infants 1 to 12 months old. The most important modifiable SIDS risk factor appears to be prone sleeping. The etiology remains largely unknown. Risk factors include the infant's sleeping on the stomach and being exposed to cigarette smoke. SIDS was first formally defined in 1969 as the sudden unexpected death of an infant younger than 1 year that remains unexplained after a thorough postmortem investigation.

Question 3

Which of the following is inappropriate to delegate to the unlicensed assistive personnel (UAP)?

Accepted Answer

The nurse may not delegate assessment activities such as evaluating sleeping patterns. The nurse may delegate activities to help the patient prepare for sleep such as oral care and other bedtime routines. The UAP may document the hours slept.

Question 4

The nurse knows an appropriate goal for the nursing diagnosis Insomnia is:

Accepted Answer

The patient falling asleep within 15 minutes of going to bed is a goal for Insomnia. The patient reporting an ability to concentrate on tasks is a goal for Anxiety. The patient repeating medication instructions on discharge is an appropriate goal for Disturbed thought processes. The patient being able to sleep for at least 2 hours at a time is an appropriate goal for Disturbed sleep pattern during hospitalization.

Question 5

The nurse knows the reticular activating system (RAS):

Accepted Answer

The RAS receives sensory impulses from the spinal cord and relays motor impulses to the thalamus and all parts of the cerebral cortex. Polysomnography is the recording of brain waves and other physiologic variables, such as muscle activity and eye movements, during sleep. The circadian rhythms influence patterns of biological and behavioral functions, and the sleep-wake circadian rhythm is affected by the light-dark cycle.

Question 6

The nurse knows an appropriate goal for the nursing diagnosis Sleep deprivation is:

Accepted Answer

The patient remaining asleep for 6 to 7 hours consistently for 1 week is an appropriate goal for Sleep deprivation. The patient falling asleep within 15 minutes of going to bed is a goal for Insomnia. The patient reporting an ability to concentrate on tasks is a goal for Anxiety. The patient repeating medication instructions on discharge is an appropriate goal for Disturbed thought processes.

Question 7

The nurse knows that polysomnograpy is:

Accepted Answer

Polysomnography is the recording of brain waves and other physiologic variables, such as muscle activity and eye movements, during sleep. The reticular activating system (RAS) receives sensory impulses from the spinal cord and relays motor impulses to the thalamus. The circadian rhythms influence patterns of biological and behavioral functions. An electroencephalogram is used to record seizure activity in the brain.

Question 8

The nurse is performing an assessment of the patient's sleep patterns. Which question will elicit the best response?

Accepted Answer

When gathering information about the patient's sleep patterns, the best questions will be to ask if they awaken during the night. Asking the patient if they feel rested evaluates quality of sleep. Normal eating pattern and drinking beverages with caffeine establishes if they have any habits that might interfere with sleep.

Question 9

The nurse knows the following changes in sleep patterns occur in the older adult: (Select all that apply.)

Accepted Answer

The first REM stage is longer. Older adults sleep approximately 6 hours a night. Stage 4 sleep is decreased, resulting in less restorative sleep. A decline in health or the use of medications may interfere with sleep. Older adults awaken more at night and take longer to go back to sleep.

Question 10

The nurse knows that with the onset of darkness and in preparation for sleep:

Accepted Answer

Melatonin levels increase and core temperature and cortisol levels decrease with the onset of darkness. Cortisol levels peak at 6 A.M.

Question 11

The nurse is providing discharge education for a patient with restless leg syndrome. The following statement by the patient indicates a need for further education:

Accepted Answer

Decreasing caffeine is helpful but does not need to be eliminated. Massaging the legs, walking, or doing deep knee bends may temporarily relieve symptoms. Supplements to correct deficiencies in iron, folate, and magnesium may be helpful.

Question 12

The nurse is educating a patient about taking measures to help avoid disruption to the circadian rhythm. The following statement by the patient indicates a need for further education:

Accepted Answer

Biological rhythms exist in plants, animals, and humans. In humans, these biorhythms, along with internal and external factors, affect sleep. The most familiar rhythm is the day-night, 24-hour circadian rhythm cycle. Circadian rhythms influence patterns of biological and behavioral functions. Some creatures are diurnal, or primarily active during the day, whereas others are nocturnal, with most of their activity during the night.

Question 13

The nurse is providing discharge instructions to the parents of a toddler about sleeping habits. Which of the following statements indicates further education is needed?

Accepted Answer

The regular bedtime routine should be consistently followed. Children need 10 to 12 hours of sleep a day, and toddlers and preschoolers may exhibit resistance to going to bed. Sleep needs fluctuate with growth spurts.

Question 14

The nurse knows that during non-rapid eye movement (NREM) sleep, the following occur: (Select all that apply.)

Accepted Answer

During NREM sleep, the phases of sleep in which REM sleep does not occur, growth hormone is released to repair epithelial and brain cells, cell division for skin and bone marrow renewal occurs, and energy is conserved. Slow scanning eye movements do not occur in either REM or NREM. Dreaming occurs in REM.

Question 15

The nurse knows an appropriate goal for the nursing diagnosis Disturbed sleep pattern during hospitalization is:

Accepted Answer

The patient being able to sleep for at least 2 hours at a time is an appropriate goal for Disturbed sleep pattern during hospitalization. The patient falling asleep within 15 minutes of going to bed is a goal for Insomnia. The patient reporting an ability to concentrate on tasks is a goal for Anxiety. The patient repeating medication instructions on discharge is an appropriate goal for Disturbed thought processes.

Question 16

The nurse is providing discharge instructions to a patient who has had sleep alterations. The following statements by the patient indicate further education is needed.

Accepted Answer

Going to bed hungry or eating a large, heavy, or spicy meal just before going to bed can interfere with sleep. Bedtime snacks that contain complex carbohydrates are recommended to promote calmness and relaxation. Highly caffeinated substances such as coffee, cola, and chocolate are central nervous system stimulants that can disrupt the sleep cycle. Exercise can assist with weight-loss efforts and promote fatigue and relaxation, but excessive exercise, especially in the evening, interferes with sleep. Both children and adults who sleep less than the recommended number of hours each night are more likely to be overweight.

Question 17

The nurse knows that during rapid eye movement (REM) sleep, the following occur: (Select all that apply.)

Accepted Answer

Rapid eye movement (REM) sleep occurs during deep sleep and is manifested by quick scanning movements of the eyes that are associated with dreaming. REM sleep is associated with memory storage, learning, increased cerebral blood flow, and epinephrine release. Repair of brain cells occurs during non-REM sleep.

Question 18

The nurse knows that cataplexy includes:

Accepted Answer

Cataplexy is characterized by the sudden loss of voluntary muscle tone; vivid hallucinations during sleep onset or on awakening; and brief episodes of total paralysis at the beginning or end of sleep. An uncontrolled desire to sleep and falling asleep for several minutes define narcolepsy. Narcolepsy begins with REM sleep.

Question 19

The nurse is providing discharge education for a patient with narcolepsy. The following statement by the patient indicates a need for further education:

Accepted Answer

There is no cure currently for narcolepsy. Treatment includes a regular exercise routine, a regular sleep routine, daytime naps if possible, light meals high in protein to maintain alertness, and vitamins. Avoiding alcohol, heavy meals, long-distance driving, and long periods of sitting is helpful.

Question 20

The nurse knows the usual progression of sleep is:

Accepted Answer

The usual sleep sequence for a person is a fairly rapid progression through NREM 1 through 4, back through NREM 3 and 2, and then into REM sleep.

Quiz 33: Sleep