Question 1

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use.
-Narcolepsy
A)Use continuous positive airway pressure.
B)Offer a small meal several hours before bedtime.
C)Administer antidepressants.
D)Administer modafinil (Provigel).
E)Do not startle.
F)Administer benzodiazepine-like drugs.

Accepted Answer

Modafinil (Provigil) is a stimulant medication that helps reduce excessive sleepiness in patients with narcolepsy.

Answer: E
 Patients with narcolepsy may experience sudden episodes of falling asleep, so the nurse should avoid startling the patient as this can trigger an episode.

Answer: F
 Benzodiazepine-like drugs can help patients with sleep disruptions, but they are not typically used to treat narcolepsy.

A, B, and C are not appropriate interventions for narcolepsy.

Therefore, the best choices are D and E.

Question 2

The nurse is evaluating outcomes for the patient with insomnia. Which key principle will the nurse consider during this process?
A) The patient is the best evaluator of sleep.
B) The nurse is the best evaluator of sleep.
C) Effective interventions are the best evaluators of sleep.
D) Observations of the patient are the best evaluators of sleep.

Accepted Answer

With regard to problems with sleep, the patient is the source for evaluating outcomes. The patient is the only one who knows whether sleep problems have improved and what has been successful. Interventions are not the best indicator; achievement of goals according to the patient is the best. Observations do provide needed data, but in the case of insomnia, the patient is the source for evaluating the restfulness of sleep.

Question 3

An older-adult patient is visiting the clinic after a fall during the night. The nurse obtains information on what medications the patient takes. Which medication most likely contributed to the patient's fall?
A) Melatonin
B) L-tryptophan
C) Benzodiazepine
D) Iron supplement

Accepted Answer

The most likely cause is a benzodiazepine. If older patients who were recently continent, ambulatory, and alert become incontinent or confused and/or demonstrate impaired mobility, the use of benzodiazepines needs to be considered as a possible cause. This can contribute to a fall in an older adult. Short-term use of melatonin has been found to be safe, with mild side effects of nausea, headache, and dizziness being infrequent. Iron supplements may be given to patients with restless legs syndrome. Some substances such as L-tryptophan, a natural protein found in foods such as milk, cheese, and meats, promote sleep; while it does promote sleep, it is not the most likely to cause mobility problems.

Question 4

A community health nurse is providing an educational session at the senior center on how to promote sleep. Which practices should the nurse recommend? (Select all that apply.)
A) Take a nap in the afternoon.
B) Sleep where you sleep best.
C) Use sedatives as a last resort.
D) Watch television right before sleep.
E) Decrease fluids 2 to 4 hours before sleep.
F) Get up if unable to fall asleep in 15 to 30 minutes.

Accepted Answer

The nurse should instruct the patient to sleep where he or she sleeps best, to use sedatives as a last resort, to decrease fluid intake to cut down on bathroom trips, and, if unable to sleep in 15 to 30 minutes, to get up out of bed. Naps should be eliminated if they are not part of the individual's routine schedule, and if naps are taken, they should be limited to 20 minutes or less a day. Television can stimulate and disrupt sleep patterns.

Question 5

The patient and the nurse discuss the need for sleep. After the discussion, the patient is able to state factors that hinder sleep. Which statements indicate the patient has a good understanding of the teaching? (Select all that apply.)
A) "Drinking coffee at 7 PM could interrupt my sleep."
B) "Staying up late for a party can interrupt sleep patterns."
C) "Exercising 2 hours before bedtime can decrease relaxation."
D) "Changing the time of day that I eat dinner can disrupt sleep."
E) "Worrying about work can disrupt my sleep."
F) "Taking an antacid can decrease sleep."

Accepted Answer

Caffeine, alcohol, and nicotine consumed late in the evening produce insomnia. Worry over personal problems or situations frequently disrupts sleep. Alterations in routines, including changing mealtimes and staying up late at night for social activities, can disrupt sleep. Exercising 2 hours before bedtime actually increases a sense of fatigue and promotes relaxation. Taking an antacid does not decrease sleep.

Question 6

A patient has sleep deprivation. Which statement by the patient will indicate to the nurse that outcomes are being met?
A) "I wake up only once a night to go to the bathroom."
B) "I feel rested when I wake up in the morning."
C) "I go to sleep within 30 minutes of lying down."
D) "I only take a 20-minute nap during the day."

Accepted Answer

Being able to sleep and feeling rested would indicate that outcomes are being met for sleep deprivation. Limiting a nap to 20 minutes is an intervention to promote sleep. Going to sleep within 30 minutes indicates a goal for insomnia. Waking up only once may indicate nocturia is improving but does not relate to sleep deprivation.

Question 7

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use.
-Obstructive sleep apnea
A)Use continuous positive airway pressure.
B)Offer a small meal several hours before bedtime.
C)Administer antidepressants.
D)Administer modafinil (Provigel).
E)Do not startle.
F)Administer benzodiazepine-like drugs.

Accepted Answer

Continuous positive airway pressure (CPAP) is the gold standard treatment for obstructive sleep apnea. It helps keep the airway open during sleep and promotes better breathing.

Answer: B 
 Offering a small meal several hours before bedtime can help regulate blood sugar levels and prevent hunger-induced awakenings during the night. It can also promote better sleep quality and reduce the risk of insomnia.

Answer: D 
 Modafinil (Provigil) is a medication that promotes wakefulness and alertness. It may be used to treat conditions like narcolepsy, a sleep disorder characterized by excessive daytime sleepiness.

Answer: E 
 In patients with sleeping disruptions, it is important to avoid startling or alarming situations as they can disrupt the sleep cycle and lead to awakenings. This may involve using earplugs, avoiding loud noises, or minimizing light exposure.

Answer: F 
 Benzodiazepine-like drugs are a class of medications that are often used to treat anxiety and insomnia. They work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which can promote relaxation and drowsiness. However, these drugs may have side effects like dizziness, confusion, and dependence, and should be used with caution. Antidepressants, on the other hand, are typically not used for the primary treatment of sleeping disorders, but may be useful in patients with comorbid depression or anxiety.

Question 8

The nurse is caring for a patient who has not been able to sleep well while in the hospital, leading to a disrupted sleep-wake cycle. Which assessment findings will the nurse monitor for in this patient? (Select all that apply.)
A) Changes in physiological function such as temperature
B) Decreased appetite and weight loss
C) Anxiety, irritability, and restlessness
D) Shortness of breath and chest pain
E) Nausea, vomiting, and diarrhea
F) Impaired judgment

Accepted Answer

The biological rhythm of sleep frequently becomes synchronized with other body functions. Changes in body temperature correlate with sleep pattern. When the sleep-wake cycle becomes disrupted, changes in physiological function such as temperature can occur. Patients can experience decreased appetite, loss of weight, anxiety, restlessness, irritability, and impaired judgment. Gastrointestinal and respiratory/cardiovascular symptoms such as shortness of breath and chest pain are not symptoms of a disrupted sleep cycle.

Question 9

The nurse is caring for a patient in the intensive care unit who is having trouble sleeping. The nurse explains the purpose of sleep and its benefits. Which information will the nurse include in the teaching session? (Select all that apply.)
A) NREM sleep contributes to body tissue restoration.
B) During NREM sleep, biological functions increase.
C) Restful sleep preserves cardiac function.
D) Sleep contributes to cognitive restoration.
E) REM sleep decreases cortical activity.

Accepted Answer

Sleep contributes to physiological and psychological restoration. NREM sleep contributes to body tissue restoration. It allows the body to rest and conserve energy. This benefits the cardiac system by allowing the heart to beat fewer times each minute. During stage 4, the body releases growth hormone for renewal and repair of specialized cells such as the brain. During NREM sleep, biological functions slow. REM sleep is necessary for brain tissue restoration and cognitive restoration and is associated with a change in cerebral blood flow and increased cortical activity.

Question 10

The nurse is caring for a patient on the medical-surgical unit who is experiencing an exacerbation of asthma. Which intervention will be most appropriate to help this patient sleep?
A) Place bed in semi-Fowler's position.
B) Offer iron-rich foods for meals.
C) Provide a snack before bedtime.
D) Encourage the patient to read.

Accepted Answer

Placing the patient in a semi-Fowler's position eases the work of breathing. Respiratory disease often interferes with sleep. Patients with chronic lung disease such as emphysema or asthma are short of breath and frequently cannot sleep without two or three pillows to raise their heads. Iron-rich food may help a patient with restless legs syndrome. Providing a snack and encouraging the patient to read may be good interventions for patients, but the most appropriate would be raising the head of the bed.

Question 11

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use.
-Hiatal hernia
A)Use continuous positive airway pressure.
B)Offer a small meal several hours before bedtime.
C)Administer antidepressants.
D)Administer modafinil (Provigel).
E)Do not startle.
F)Administer benzodiazepine-like drugs.

Accepted Answer

For patients with hiatal hernia, offering a small meal several hours before bedtime can help alleviate sleeping disruptions. Continuous positive airway pressure (CPAP), antidepressants, modafinil, and benzodiazepine-like drugs are not relevant interventions for this condition. Do not startle is a general intervention for any patient experiencing sleeping disruptions but is not specific to hiatal hernia.

Question 12

The nurse is preparing an older-adult patient's evening medications. Which treatment will the nurse recognize as relatively safe for difficulty sleeping in older adults?
A) Ramelteon (Rozerem)
B) Benzodiazepine
C) Antihistamine
D) Kava

Accepted Answer

Ramelteon (Rozerem), a melatonin receptor agonist, is well tolerated and appears to be effective in improving sleep by improving the circadian rhythm and shortening time to sleep onset. It is safe for long- and short-term use particularly in older adults. The use of benzodiazepines in older adults is potentially dangerous because of the tendency of the drugs to remain active in the body for a longer time. As a result, they also cause respiratory depression, next-day sedation, amnesia, rebound insomnia, and impaired motor functioning and coordination, which leads to increased risk of falls. Caution older adults about using over-the-counter antihistamines because their long duration of action can cause confusion, constipation, and urinary retention. Kava promotes sleep in patients with anxiety; it should be used cautiously because of its potential toxic effects on the liver.

Question 13

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use.
-Sleepwalking
A)Use continuous positive airway pressure.
B)Offer a small meal several hours before bedtime.
C)Administer antidepressants.
D)Administer modafinil (Provigel).
E)Do not startle.
F)Administer benzodiazepine-like drugs.

Accepted Answer

The nurse should avoid startling the patient who sleepwalks to prevent any harm or injury.

Answer: F
 Administering benzodiazepine-like drugs can help treat sleepwalking by calming the patient and reducing their likelihood of sleepwalking.

Note: Options A, B, C, and D are not appropriate for treating sleepwalking. Continuous positive airway pressure is used to treat sleep apnea, offering a small meal several hours before bedtime is not relevant to sleepwalking, administering antidepressants is not relevant to sleepwalking, and administering modafinil (Provigil) is a medication used to treat narcolepsy or other sleep disorders, but not sleepwalking.

Question 14

A young mother has been hospitalized for an irregular heartbeat (dysrhythmia). The night nurse makes rounds and finds the patient awake. Which action by the nurse is most appropriate?
A) Inform the patient that it is late and time to go to sleep.
B) Ask the patient if she would like medication for sleep.
C) Recommend a good movie that is on television tonight.
D) Take time to sit and talk with the patient about her inability to sleep.

Accepted Answer

A nurse on the night shift needs to take time to sit and talk with patients unable to sleep. This helps to determine the factors keeping patients awake. Assessment is the first step of the nursing process; therefore assessment needs to be done first and involves ascertaining the cause of the patient's inability to sleep. Patients who are admitted to the hospital for uncertain diagnoses can be stressed and worried about the testing and outcomes. In addition, a young mother can be worried about the care of her children and those caring for the children. This uncertainty and change in routine can cause difficulty in resting or falling asleep. A distraction such as a television may or may not work for the patient. After assessment is completed, a sedative may or may not be in order. Telling the patient that it is late and time to go to sleep is not a therapeutic response for an adult who is under stress.

Question 15

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use.
-Insomnia
A)Use continuous positive airway pressure.
B)Offer a small meal several hours before bedtime.
C)Administer antidepressants.
D)Administer modafinil (Provigel).
E)Do not startle.
F)Administer benzodiazepine-like drugs.

Accepted Answer

For insomnia, administering benzodiazepine-like drugs is a common intervention. These drugs help to induce sleep by enhancing the effect of the neurotransmitter GABA, which has a calming effect on the brain.

Question 16

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use.
-Cataplexy
A)Use continuous positive airway pressure.
B)Offer a small meal several hours before bedtime.
C)Administer antidepressants.
D)Administer modafinil (Provigel).
E)Do not startle.
F)Administer benzodiazepine-like drugs.

Accepted Answer

The answer of The nurse is caring for a group...

Quiz 43: Sleep

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use. -Narcolepsy

The nurse is evaluating outcomes for the patient with insomnia. Which key principle will the nurse consider during this process?

An older-adult patient is visiting the clinic after a fall during the night. The nurse obtains information on what medications the patient takes. Which medication most likely contributed to the patient's fall?

A community health nurse is providing an educational session at the senior center on how to promote sleep. Which practices should the nurse recommend? (Select all that apply.)

The patient and the nurse discuss the need for sleep. After the discussion, the patient is able to state factors that hinder sleep. Which statements indicate the patient has a good understanding of the teaching? (Select all that apply.)

A patient has sleep deprivation. Which statement by the patient will indicate to the nurse that outcomes are being met?

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use. -Obstructive sleep apnea

The nurse is caring for a patient who has not been able to sleep well while in the hospital, leading to a disrupted sleep-wake cycle. Which assessment findings will the nurse monitor for in this patient? (Select all that apply.)

The nurse is caring for a patient in the intensive care unit who is having trouble sleeping. The nurse explains the purpose of sleep and its benefits. Which information will the nurse include in the teaching session? (Select all that apply.)

The nurse is caring for a patient on the medical-surgical unit who is experiencing an exacerbation of asthma. Which intervention will be most appropriate to help this patient sleep?

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use. -Hiatal hernia

The nurse is preparing an older-adult patient's evening medications. Which treatment will the nurse recognize as relatively safe for difficulty sleeping in older adults?

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use. -Sleepwalking

A young mother has been hospitalized for an irregular heartbeat (dysrhythmia) . The night nurse makes rounds and finds the patient awake. Which action by the nurse is most appropriate?

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use. -Insomnia

The nurse is caring for a group of patients who have sleeping disruptions. Match the condition to the intervention the nurse will use. -Cataplexy