Question 1

The nurse is performing an assessment of the patient's sleep patterns. Which question by the nurse will elicit the best response?&#10;A) &#34;Do you feel rested when you awaken?&#34;&#10;B) &#34;What is your normal eating pattern?&#34;&#10;C) &#34;Do you awaken during the night?&#34;&#10;D) &#34;Do you drink beverages with caffeine?&#34;

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 2

Which task is inappropriate for the nurse to delegate to the unlicensed assistive personnel (UAP)?&#10;A) Providing oral care&#10;B) Evaluating sleep patterns&#10;C) Providing bedtime routines&#10;D) Documenting sleep hours

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 3

When the nurse is explaining cataplexy to the patient, which description should be included?&#10;A) It is an uncontrolled desire to sleep.&#10;B) It is falling asleep for several minutes.&#10;C) It is loss of voluntary muscle tone.&#10;D) It is a sleep cycle that begins with NREM.

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 4

The nurse knows that during rapid eye movement (REM) sleep, which activities occur?&#10;A) Memories are stored&#10;B) Increase in cerebral blood flow&#10;C) Slow rhythmic scanning eye movements&#10;D) Release of epinephrine&#10;E) Repair of brain cells

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 5

The nurse is providing discharge instructions to a patient who has had sleep alterations. Which statement by the patient indicates further education is needed?&#10;A) &#34;I should avoid drinking caffeine too close to bedtime.&#34;&#10;B) &#34;I should not eat anything too close to bedtime.&#34;&#10;C) &#34;I should exercise regularly to help with sleeping.&#34;&#10;D) &#34;I can gain weight if I don't sleep enough.&#34;

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 6

The nurse is educating a patient about taking measures to help avoid disruption to the circadian rhythm. Which statement by the patient indicates a need for further education?&#10;A) &#34;I know the circadian rhythm influences biological functions.&#34;&#10;B) &#34;I know the circadian rhythm exists only in humans.&#34;&#10;C) &#34;I know the sleep-wake circadian rhythm is impacted by the light-dark cycle.&#34;&#10;D) &#34;The most familiar circadian rhythm is the day-night 24-hour cycle.&#34;

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 7

The nurse teaches the patient what information about polysomnograpy?&#10;A) This is the recording of brain waves and other variables.&#10;B) This is the relay of motor impulse to the hypothalamus.&#10;C) This is the patterns of biological functioning.&#10;D) This is the recording of seizure activity in the brain.

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 providing community education on sudden infant death syndrome (SIDS). What information does the nurse include?&#10;A) SIDS is the second most common cause of death among infants (1 to 12 months).&#10;B) The etiology remains largely unknown.&#10;C) The most modifiable risk factor is sleeping supine.&#10;D) Risk factors include being exposed to cigarette smoke.&#10;E) It is defined as sudden unexpected death.

Accepted Answer

SIDS is the leading cause of death among infants 1 to 12 months of age. The etiology remains largely unknown. The most important modifiable SIDS risk factor appears to be prone sleeping. Risk factors include the infant's being exposed to cigarette smoke. Sudden infant death syndrome (SIDS) is defined as the sudden unexpected death of an infant younger than 1 year of age that remains unexplained after a thorough postmortem investigation.

Question 9

The nurse recognizes which changes in sleep patterns occur in the older adult?&#10;A) Sleep increases to approximately 8 to 10 hours a night.&#10;B) REM sleep is shorter.&#10;C) Stage 4 NREM is decreased.&#10;D) The use of medication may interfere with sleep.&#10;E) Older adults awaken more at night.

Accepted Answer

Older adults sleep approximately 7 to 8 hours a night. The first REM stage is longer. There is no stage 4 REM. Deeper stages of sleep are shortened, 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 wants to help a hospitalized patient get more sleep. What intervention will be most helpful?&#10;A) Allow the patient an hour nap during the day shift.&#10;B) Administer sleeping medication if the patient can't go to sleep after an hour.&#10;C) Place a &#34;do not disturb&#34; sign on the door for the duration of the night shift.&#10;D) Cluster cares so the patient gets at least 90 minutes of uninterrupted sleep at night.

Accepted Answer

Being able to sleep for at least 90 minutes without interruption will best help this patient as the normal sleep cycle is approximately 90 minutes long. An hour nap is probably too long even in the hospital. Administering sleeping pills is an alternative if the patient truly can't sleep while hospitalized, but this is not the preferred solution. Not disturbing a hospitalized patient for an entire night shift is unrealistic.

Question 11

The nurse is providing discharge instructions for the patient with sleep pattern disturbances. Which statement by the patient indicates a need for further education?&#10;A) &#34;It is a good idea to have a bedtime routine.&#34;&#10;B) &#34;My bedtime routine can include watching TV in bed until I fall asleep.&#34;&#10;C) &#34;I will keep my regular sleep pattern on the weekend.&#34;&#10;D) &#34;If I can't fall asleep, I will get out of bed and do something relaxing.&#34;

Accepted Answer

The answer of The nurse is providing discharge instructions for...

Question 12

The nurse identifies what physiological response occurs with the onset of darkness and in preparation for sleep?&#10;A) Cortisol levels peak&#10;B) Cortisol levels increase&#10;C) Core body temperature increases&#10;D) Melatonin levels increase

Accepted Answer

The answer of The nurse identifies what physiological response occurs...

Question 13

The nurse is providing discharge education for a patient with narcolepsy. Which statement by the patient indicates a need for further education?&#10;A) &#34;Daytime naps are helpful.&#34;&#10;B) &#34;Taking the medication will cure it.&#34;&#10;C) &#34;High protein meals are helpful.&#34;&#10;D) &#34;I need to avoid alcohol.&#34;

Accepted Answer

The answer of The nurse is providing discharge education for...

Question 14

The nurse is providing discharge instructions to the parents of a toddler about sleeping habits. Which statement indicates further education is needed?&#10;A) &#34;Sleep needs may change during growth spurts.&#34;&#10;B) &#34;Children sleep 12 hours a day.&#34;&#10;C) &#34;Toddlers will often resist going to bed.&#34;&#10;D) &#34;The bedtime routine can vary.&#34;

Accepted Answer

The answer of The nurse is providing discharge instructions to...

Question 15

The nurse is providing discharge education for a patient with restless leg syndrome. Which statement by the patient indicates a need for further instruction?&#10;A) &#34;I should avoid all caffeine.&#34;&#10;B) &#34;I can do leg massage and knee bends.&#34;&#10;C) &#34;Taking magnesium supplements may be helpful.&#34;&#10;D) &#34;Taking a walk regularly may be helpful.&#34;

Accepted Answer

The answer of The nurse is providing discharge education for...

Question 16

The nurse recognizes what function of the reticular activating system (RAS)?&#10;A) Records brain waves and other variables.&#10;B) Relays motor impulse to the hypothalamus.&#10;C) Influences patterns of biological functioning.&#10;D) Is affected by the light-dark cycle.

Accepted Answer

The answer of The nurse recognizes what function of the...

Question 17

A patient has Sleep deprivation. What finding by the nurse best indicates goal achievement?&#10;A) Remains asleep for 6 to 7 hours consistently for 1 week.&#10;B) Falls asleep within 15 minutes of going to bed.&#10;C) Reports an ability to concentrate on tasks.&#10;D) Verbalizes understanding of medication instructions.

Accepted Answer

The answer of A patient has Sleep deprivation. What finding...

Question 18

The nurse identifies which sequence to be the usual progression of sleep?&#10;A) NREM 1-3 then REM, then back through NREM 1 and 2&#10;B) REM then NREM 1-4, then back through NREM 2 and 3&#10;C) NREM 1-3 then back through NREM 3 and 2 then REM&#10;D) REM then NREM 1-4 then back through NREM 3

Accepted Answer

The answer of The nurse identifies which sequence to be...

Question 19

The nurse is working with a patient who has been advised to take 2 20-minute naps during the day for fatigue. After a week, the patient states the naps have not helped. What response by the nurse is best?

A) "Maybe that is too much sleep for you during the day."
B) "Why don't you try one 40-minute nap instead?"
C) "Let's explore some sleeping medications for you to try."
D) "It often takes a few weeks for napping to help."

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Accepted Answer

The answer of The nurse is working with a patient...

Question 20

The student nurse learns that during non-rapid eye movement (NREM) sleep, which activities occur?&#10;A) Brain waves slow&#10;B) Slow rhythmic scanning eye movements&#10;C) Dreaming&#10;D) Drop in blood pressure&#10;E) Conservation of energy

Accepted Answer

The answer of The student nurse learns that during non-rapid...

Question 21

The nurse is admitting a patient to the general medical-surgical unit. What should the nurse assess as part of a routine sleep assessment?&#10;A) Usual sleeping and waking times&#10;B) Bedtime routines&#10;C) Sleeping environment preferences&#10;D) Medications used for sleep&#10;E) Any current life events&#10;F) None of above

Accepted Answer

The answer of The nurse is admitting a patient to...

Question 22

The nurse recognizes which sleeping conditions are identified as dyssomnias?&#10;A) Difficultly getting to sleep&#10;B) Nocturnal enuresis&#10;C) Inability staying asleep&#10;D) Being excessively sleepy&#10;E) Falling asleep during the day

Accepted Answer

The answer of The nurse recognizes which sleeping conditions are...

Question 23

The nurse conducting a sleep workshop in the community would identify which patients to be at risk for obstructive sleep apnea (OSA)?&#10;A) Deviated septum&#10;B) Recessed chin&#10;C) Alcohol use&#10;D) Large neck&#10;E) Recent tonsillectomy

Accepted Answer

The answer of The nurse conducting a sleep workshop in...

Question 24

The nurse will include which interventions to help improve sleep quality during hospitalization on all patients' care plans?&#10;A) Maintaining sleep routines&#10;B) Minimizing disruptions&#10;C) Providing light snacks&#10;D) Using sleep medications&#10;E) Using relaxation measures

Accepted Answer

The answer of The nurse will include which interventions to...

Question 25

The nurse manager is concerned about nursing staff who are working the night shift. What interventions can the manager suggest to help the nurses overcome shift-related sleep disturbances?&#10;A) Power nap before leaving for the first night shift.&#10;B) Get a minimum of 4 hours of sleep.&#10;C) Wear dark glasses when driving home from work.&#10;D) Seek exposure to bright light when waking.&#10;E) Maintain a regular sleeping schedule when working and on nights off.

Accepted Answer

The answer of The nurse manager is concerned about nursing...

Deck 33: Sleep