Deck 33: Rest and Sleep

Question 1

A nurse is caring for a client who is sleeping for abnormally long periods of time. This condition may be caused by injury to which of the following body structures?

A) Spinal cord
B) Pancreas
C) Hypothalamus
D) Thyroid

Answer 1

Hypothalamus

Question 2

A nurse educates a young couple on putting their newborn on his back to sleep. What is the rationale for this information?

A) Prone position increases the risk for sudden infant death syndrome.
B) Prone position decreases the risk for sudden infant death syndrome.
C) Supine position may alter the size and shape of the infant's head.
D) Supine position makes changing diapers and feeding difficult.

Answer 2

Prone position increases the risk for sudden infant death syndrome.

Question 3

A client reports that her naps after lunch often stretch to three hours in length and that she has great difficulty rousing herself after a nap. This condition is best termed as which of the following?

A) Hypersomnia
B) Insomnia
C) Parasomnia
D) Sleep apnea

Answer 3

Hypersomnia

Question 4

A client's bed partner reports the client often has irregular snoring and silence followed by a snort. Does this warrant further assessment?

A) No, snoring has varied patterns
B) No, this is a description of normal snoring
C) Yes, this is an indicator of obstructive apnea
D) Yes, the bed partner is unable to sleep at night

Question 5

A client is diagnosed with narcolepsy. Which of the following is a characteristic of this disorder?

A) Waking during sleep
B) Restless leg syndrome
C) Uncontrollable desire to sleep
D) Decrease in the amount or quality of sleep

Question 6

What is the rationale for using CPAP to treat sleep apnea?

A) Positive air pressure holds the airway open.
B) Negative air pressure holds the airway closed.
C) Delivery of oxygen facilitates respiratory effort.
D) Alternating waves of air stimulate breathing.

Question 7

What name is given to the rhythmic biologic clock that exists in humans?

A) Sleep-wake cycle
B) Alert-unaware process
C) Circadian rhythm
D) Yo-yo theory

Question 8

Which natural chemical does the body produce at night to decrease wakefulness and promote sleep?

A) Melatonin
B) Serotonin
C) Endorphins
D) Dopamine

Question 9

Which group of terms best describes sleep?

A) Decreased state of activity, refreshed
B) Altered consciousness, relative inactivity
C) Comatose, immobility
D) Alert, responsive

Question 10

Which individual is likely to require more hours of sleep?

A) a person 75 years of age
B) a person 43 years of age
C) a person 25 years of age
D) a person 15 years of age

Question 11

Which of the following is the most common sleep disorder?

A) Hypersomnia
B) Parasomnia
C) Insomnia
D) Dyssomnia

Question 12

A client in his 40s has asked the nurse how much sleep he should be getting in order to maximize his health and well-being. How should the nurse respond?

A) "Most adults need between seven and nine hours, but everyone is different."
B) "It's important to get a minimum of eight hours sleep each night."
C) "More sleep equals better health, so the more sleep you can fit into your schedule, the better."
D) "Sleep needs depend a lot on age, and at your age, six to seven hours usually suffice."

Question 13

Based on the circadian cycle, the body prepares for sleep at night by decreasing the body temperature and releasing which chemical?

A) Neonephrine
B) Seratonin
C) Melatonin
D) Dopamine

Question 14

Which medication is least likely to affect sleep quality?

A) Diuretic
B) Steroid
C) Antidepressant
D) Ambien

Question 15

An individual awakens from a sound sleep in the middle of the night because of abdominal pain. Why does this happen?

A) Stimuli from peripheral organs to the RAS
B) Stimuli to the wake center in the cerebral cortex
C) Messages from chemoreceptors to the brain
D) Messages from baroreceptors to the spinal cord

Question 16

Which of the following clients likely faces a risk for the nursing diagnosis of Disturbed Sleep Pattern: Difficulty Remaining Asleep?

A) A client who receives IV antibiotics every three hours
B) A client whose opioid analgesics result in central nervous system depression
C) A client who is receiving corticosteroids that make her feel restless and agitated
D) A client whose physical therapy has been scheduled in the late evening

Question 17

A client who has a sleep disorder is trying stimulus control to improve amount and quality of sleep. What is recommended in this type of therapy?

A) Use the bedroom for sleep and sex only.
B) Use the bedroom for reading and eating.
C) Go to bed at the same time every night.
D) Sleep alone with minimal coverings.

Question 18

A client with a sleep disorder experiences cataplexy. Which is a feature of this condition?

A) Irresistible urge to sleep, regardless of the type of activity in which the client is engaged
B) Sudden loss of motor tone that may cause the person to fall asleep; usually experienced during a period of strong emotion
C) Nightmare or vivid hallucinations experienced during sleep time
D) Skeletal paralysis that occurs during the transition from wakefulness to sleep

Question 19

A middle-age adult man has just started an exercise program. What would the nurse teach him about timing of exercise and sleep?

A) Exercising immediately before bedtime enhances ability to sleep
B) Exercising within two hours of bedtime can hinder ability to sleep
C) The time of day does not matter; exercise facilitates sleep
D) The fatigue from exercise may be a hindrance to sleep

Question 20

A nurse working the night shift assesses a client's vital signs at 4 a.m. (0340). What would be the expected findings, based on knowledge of NREM sleep?

A) Decreased TPR and BP
B) Increased TPR and BP
C) No change from daytime readings
D) Highly individualized, cannot predict

Question 21

Which expected outcome demonstrates the effectiveness of a plan of care to promote rest and sleep?

A) Verbalizes inability to sleep without medications
B) Continues to read in bed for hours each night
C) Identifies factors that interfere with normal sleep pattern
D) Reports minimal improvement in quality of rest and sleep

Question 22

The client is a male who states his wife complains that his snoring awakens her at night. The spouse is present. To obtain further data, the nurse asks the spouse what?

A) "How loud is his snoring?"
B) "Is there silence after snoring which then is followed with a snort?"
C) "How long does he snore each night?"
D) "How often are you awakened at night due to his loud snoring?"

Question 23

A nurse is caring for a client who complains about sleep apnea. Which of the following delivery devices should the nurse use to administer oxygen to this client?

A) Nasal catheter
B) Oxygen tent
C) Transtracheal oxygen
D) CPAP mask

Question 24

A new mother is discussing her 6-month-old infant's sleep habits and expresses concern about the infant obtaining too much sleep. The mother reports the infant's circadian cycle as:

The best statement by the nurse is:

A) "Your infant requires more time asleep during the day hours."
B) "You need to awaken your infant during the 2400 to 0600 time period."
C) "Your infant is obtaining the average hours of sleep per day for an infant."
D) "Your infant is actually obtaining too little sleep for one day."

Question 25

What condition have studies confirmed occurs when adults and children do not get recommended hours of sleep at night?

A) Obesity
B) Anxiety
C) Diabetes
D) Hypertension

Question 26

A nurse is caring for a client diagnosed with sleep apnea. What should the nurse do in order to promote sleep in the client?

A) Encourage the client to lose weight.
B) Avoid sedatives for sleeping.
C) Encourage deep breathing exercises.
D) Provide good ventilation in the room.

Question 27

Which drug normalizes sleep cycles by enabling the body's supply of melatonin to naturally promote sleep?

A) Flurazepam (Dalmane)
B) Temazepam (Restoril)
C) Eszopiclone (Lunesta)
D) Ramelteon (Rozerem)

Question 28

The parents of a boy 10 years of age are worried about his sleepwalking (somnambulism). What topic should the nurse discuss with the parents?

A) Sleep deprivation
B) Privacy
C) Schoolwork
D) Safety

Question 29

A nurse is caring for a client who has been diagnosed with insomnia. What nursing intervention would help the nurse relieve the client's condition?

A) Maintain a calm and quiet environment free from noise.
B) Administer sedatives as prescribed by the physician.
C) Motivate the client to sleep because it may affect his health.
D) Engage the client in some diversional activities.

Question 30

Which of the following guidelines does the nurse apply to discussion of sleep patterns with older adult clients?

A) Circadian rhythms become more prominent as clients age.
B) The amount of stage 4 sleep increases as clients age.
C) Total sleep time decreases as the clients age.
D) Older clients fall asleep more quickly than younger ones.

Question 31

The nurse manager in an acute care facility has received client evaluations in which the clients have complained about excessive noise that interfered with their rest. The nurse manager and nursing staff plan to do the following. Which activity will most assist clients in obtaining rest?

A) Post signs for quiet and turn down hall lights during formal quiet times.
B) Ensure clients are offered prescribed sleeping medications at bedtime.
C) Provide a small carbohydrate snack or juice prior to hours of sleep.
D) Adjust the temperature of the room to 74 degrees and provide a blanket.

Question 32

What is the most common method for ordering sleep medications?

A) Stat
B) p.r.n
C) Single order
D) Daily dose

Question 33

A client has sought care because of insomnia that has been increasing in severity and frequency in recent months. What questions should the nurse include in an assessment of this client's health problem? Select all that apply.

A) "Do you have a family history of sleep disturbances?"
B) "Do you smoke?"
C) "What medications are you currently taking?"
D) "Do you have a consistent routine around getting ready for bed and going to bed?"
E) "How would you characterize your mood lately?"

Question 34

A sedative-hypnotic has been prescribed to help a client sleep. What should the nurse teach the client about this medication?

A) It should be taken every night for several months
B) It is useful for sleep but is better taken with alcohol
C) It loses its effectiveness after one or two weeks
D) It should be taken in the morning for long-term effects

Question 35

What independent nursing action can be used to facilitate sleep in hospitalized clients who are on bedrest?

A) Administering prescribed sleep medications
B) Changing the bed with fresh linens
C) Encouraging naps during the daytime
D) Giving a back massage