Question 1

Which form of delirium occurs most frequently as a disruption in a patient's circadian rhythm?&#10;A)Altered mental status&#10;B)Organic brain syndrome&#10;C)ICU psychosis&#10;D)Sundowning

Accepted Answer

Sundowning, also known as late-day confusion, is a form of delirium that occurs most frequently as a disruption in a patient's circadian rhythm. It typically occurs in the late afternoon or evening and can be exacerbated by fatigue, low light, and shadows. Patients with sundowning may experience agitation, confusion, and restlessness, and may have difficulty sleeping at night.

Question 2

The most effective treatment for delirium is:&#10;A)emphasis on mobility activities.&#10;B)encouraging family visits.&#10;C)prevention.&#10;D)nonpharmacologic sleep protocols.

Accepted Answer

Prevention is the most effective treatment for delirium, as it reduces the chances of it occurring in the first place. This involves identifying and addressing risk factors that can contribute to delirium, such as dehydration, malnutrition, medication side effects, infection, and sensory deprivation. Once delirium is present, it can be difficult to fully treat or reverse. However, nonpharmacologic sleep protocols may be helpful in managing symptoms and preventing further progression, and mobility activities and family visits may still be beneficial for overall well-being.

Question 3

A person who is morbidly obese has a body mass index (BMI) of:&#10;A)25.&#10;B)30.&#10;C)35.&#10;D)40.

Accepted Answer

A person with a BMI of 40 or above is considered morbidly obese, indicating a severe level of obesity that can lead to serious health complications. Therefore, option D is the correct answer. Options A, B, and C represent lower levels of obesity.

Question 4

Older adults have increased sleep latency. This means :&#10;A)they sleep longer.&#10;B)they take longer to fall asleep.&#10;C)they have trouble staying asleep.&#10;D)they have trouble waking up.

Accepted Answer

Increased sleep latency means that it takes longer for older adults to fall asleep, so choice B is the best answer. None of the other choices accurately reflect what increased sleep latency means.

Question 5

In obese patients, if neck circumference is more than 16 inches, it is an indicator that the patient may have which condition?&#10;A)Cushing's syndrome&#10;B)Hypothyroidism&#10;C)Insulinoma&#10;D)Obstructive sleep apnea

Accepted Answer

An increased neck circumference in obese patients is a common indicator of obstructive sleep apnea, a potentially serious sleep disorder where the muscles in the throat intermittently relax and block the airway during sleep.

Question 6

The focus of treating delirium is:&#10;A)calming and quieting the environment.&#10;B)discontinuing medications.&#10;C)restraining the patient.&#10;D)reversal of the cause.

Accepted Answer

The best way to treat delirium is by identifying the underlying cause and reversing it. Calming and quieting the environment can help manage symptoms, but it does not treat the root cause. Discontinuing medications that may be contributing to the delirium can also be helpful, but it may not be enough if there is an underlying medical condition or infection causing the delirium. Restraint should only be used as a last resort to ensure patient safety.

Question 7

Which of the following is considered to be a major cause of patient insomnia during hospitalization?&#10;A)Bright lights&#10;B)Noise of hospital work&#10;C)Televisions&#10;D)Visitors

Accepted Answer

Noise from hospital work, such as staff activities and equipment, is a major cause of patient insomnia during hospitalization.

Question 8

Which of the following is not mistaken for delirium?&#10;A)Depression&#10;B)Mania&#10;C)Old age&#10;D)Schizophrenia

Accepted Answer

Depression, mania, and old age can sometimes be mistaken for delirium due to similar symptoms such as confusion and agitation. Schizophrenia, however, is a distinct disorder characterized by symptoms such as hallucinations and delusions and is not commonly mistaken for delirium.

Question 9

The National Highway Traffic Safety Administration estimates which number of automobile accidents are caused by drowsiness each year?&#10;A)50,000&#10;B)100,000&#10;C)150,000&#10;D)200,00

Accepted Answer

The National Highway Traffic Safety Administration estimates that 100,000 automobile accidents each year are caused by drowsiness.

Question 10

Which sleep medication has been associated with some high-profile sleep-walking and sleep-driving incidents?&#10;A)Ambien&#10;B)Lunesta&#10;C)Restoril&#10;D)Sonata

Accepted Answer

Ambien (zolpidem) has been associated with high-profile incidents of sleep-walking and sleep-driving, as well as other sleep-related behaviors such as sleep-eating and sleep-sex. It has a relatively short half-life, meaning it can leave the body quickly, which may contribute to these incidents.

Question 11

Antidepressants that have shown promise prescribed off-label for obesity include Prozac and:&#10;A)Adapin.&#10;B)Effexor.&#10;C)Paxil.&#10;D)Wellbutrin.

Accepted Answer

The answer of Antidepressants that have shown promise prescribed off-label...

Question 12

Muscle mass can decrease by what percentage per week of absolute bedrest?&#10;A)5%&#10;B)7%&#10;C)9%&#10;D)11%

Accepted Answer

The answer of Muscle mass can decrease by what percentage...

Question 13

Which percentage of sleep times in young adults is deep sleep?&#10;A)10%&#10;B)20%&#10;C)30%&#10;D)40%

Accepted Answer

The answer of Which percentage of sleep times in young...

Question 14

Which type of delirium is often associated with alcohol withdrawal?&#10;A)Hyperactive delirium&#10;B)Hypoactive delirium&#10;C)Mixed delirium&#10;D)Subdued delirium

Accepted Answer

The answer of Which type of delirium is often associated...

Question 15

Zeglin describes five phases of becoming bedridden. Which phase occurs when there is a fall and/or a hospital stay?&#10;A)Phase I&#10;B)Phase II&#10;C)Phase III&#10;D)Phase IV

Accepted Answer

The answer of Zeglin describes five phases of becoming bedridden....

Question 16

The medication risperidone has a black box warning for patients with dementia-related psychosis because:&#10;A)it causes worsening motor function.&#10;B)it carries a high risk for death.&#10;C)it may cause renal failure.&#10;D)it may aggravate Parkinson's symptoms.

Accepted Answer

The answer of The medication risperidone has a black box...

Question 17

Cardiovascular complications associated with obesity include:&#10;A)coronary artery disease.&#10;B)obstructive sleep apnea.&#10;C)stroke.&#10;D)all of the above

Accepted Answer

The answer of Cardiovascular complications associated with obesity include:&#10;A)coronary artery...

Question 18

Which class of analgesics is associated with increased time awake?&#10;A)Benzodiazepines&#10;B)Beta blockers&#10;C)NSAIDS&#10;D)Opioids

Accepted Answer

The answer of Which class of analgesics is associated with...

Deck 2: Phenomena of Concern to the Clinical Nurse Specialist