Question 1

The mother of a preschooler tells the nurse that the child has started crying and resisting going to sleep at the scheduled bedtime.Which of the following actions should the nurse advise the parent to take?

Accepted Answer

Maintaining consistency in the same bedtime ritual can help establish a routine and signal to the child that it is time for bed. This can help decrease resistance to sleeping at bedtime. Offering a snack or allowing the child to sleep longer in the mornings may disrupt the child's circadian rhythms and make it more difficult to fall asleep at night. Eliminating a nap may make the child overtired and also make it more difficult to fall asleep at night.

Question 2

The nurse is completing an assessment on the patient's sleep patterns.Which of the following is a specific question that the nurse should ask to determine the potential presence of sleep apnea?

Accepted Answer

Snoring loudly is a common symptom of sleep apnea, as it occurs when the airway becomes partially or fully blocked during sleep. Headaches are also a potential symptom due to the decreased oxygen levels during apnea episodes. The other options are not specific to sleep apnea.

Question 3

The nurse is alert to patients who may be predisposed to obstructive sleep apnea.This includes which of the following individuals?

Accepted Answer

Individuals with heart disease may have sleep disorders.Women with heart disease have the majority of sleep disturbances,but not apnea in particular.Respiratory infections do not predispose a patient to obstructive sleep apnea.Structural abnormalities such as nasal polyps,certain jaw configurations,enlarged tonsils,or a deviated septum predispose a patient to obstructive sleep apnea.Obesity,smoking and alcohol use,and a history of obstructive sleep apnea greatly increase the risk of developing sleep apnea,but they do not necessarily predispose the person to sleep apnea.

Question 4

The parents of a newborn wonder when she should start to sleep through the night.The nurse's response should be that in infants,a nighttime pattern of sleep usually develops by which age?

Accepted Answer

By 3 months of age, most infants are capable of sleeping for a stretch of 6-8 hours at night without needing to feed or be changed. However, it is important to note that every baby is different and some may start to sleep through the night earlier or later than others. It is also important to establish healthy sleep habits and a consistent bedtime routine to encourage good sleep patterns.

Question 5

It is determined that the patient will need pharmacological treatment to assist with his sleep patterns.The nurse anticipates that treatment with an anxiety-reducing,relaxation-promoting medication will include the use of which one of the following?

Accepted Answer

Benzodiazepines are commonly prescribed for their anxiolytic and sedative effects. They work by enhancing the activity of the neurotransmitter gamma-aminobutyric acid (GABA), which reduces anxiety and promotes relaxation. Barbiturates are generally not used for sleep disorders due to their high risk of addiction, tolerance, and overdose. Amphetamines are stimulants and would worsen the patient's sleep problems. Tricyclic antidepressants may be used for depression and chronic pain, but are not typically prescribed as a first-line treatment for insomnia.

Question 6

In describing the sleep patterns of older adults,the nurse recognizes that which of the following statements is true?

Accepted Answer

Older adults have a decline in stage 4 sleep, which is the deepest stage of non-REM sleep. They also tend to have more difficulty staying asleep and experience more fragmented sleep patterns. While they may take less time to fall asleep, they may wake up more frequently during the night and wake up earlier in the morning. They also do not require more sleep than middle-aged adults, although individual sleep needs may vary. Additionally, older adults are typically easier to arouse than younger adults.

Question 7

The physiology of sleep is complex.Which of the following statements is the most appropriate one regarding this process?

Accepted Answer

The reticular activating system (located in the brainstem) plays a key role in the level of consciousness of a person. It is responsible for regulating sleep-wake transitions and filtering sensory information.

Option A is incorrect as circadian rhythms occur in a cycle of approximately 24 hours.

Option B is incorrect as high-stimulus environments typically lead to wakefulness, not NREM sleep.

Option D is incorrect as the bulbar synchronizing region is not responsible for REM sleep. The pontine tegmentum and other brain regions are involved in regulating REM sleep.

Question 8

An 11-year-old child in middle school is currently experiencing sleep-related fatigue during classes.Which of the following responses by the school nurse is the most appropriate one when counselling the child's parents regarding this assessment?

Accepted Answer

The most appropriate response would be to ask about the child's usual sleep patterns, as this can help to identify whether the child is experiencing a sleep deficit or other sleep-related issues. It is important to gather more information before jumping to conclusions or suggesting specific solutions.

Question 9

Which of the following instructions does the nurse give the patient in teaching methods to promote positive sleep habits at home?

Accepted Answer

Using the bedroom only for sleep or sexual activity helps to associate the bedroom with rest and relaxation, promoting better sleep habits. Eating a large meal before bedtime, exercising vigorously before bedtime, and staying in bed if sleep does not come after 30 minutes can all interfere with sleep and should be avoided.

Question 10

Which of the following is a determinant of dreams?

Accepted Answer

Age is a determinant of dreams,along with personality,physiological conditions,psychological conditions,pharmacological therapies,and situational factors.Height,weight,and gender are not identified determinants of dreams.

Question 11

A patient who is currently taking a diuretic should be informed by the nurse that he or she may experience which of the following effects?

Accepted Answer

Diuretics increase urine production, which can lead to nocturia (waking up at night to urinate). The other options are not associated with diuretic use.

Question 12

Which of the following information provided by the patient's bed partner is most associated with sleep apnea?

Accepted Answer

Excessive snoring is the most common symptom associated with sleep apnea, as it is caused by the partial obstruction of the airway during sleep, leading to loud and frequent snoring. Restlessness, talking during sleep, and sleepwalking may be associated with other sleep disorders or general sleep disturbances, but are not specific to sleep apnea.

Question 13

The nurse is discussing sleep habits with the patient in the sleep assessment clinic.Of the following activities performed before sleeping,the nurse informs the patient that which one of the following can potentially interfere with the patient's sleep?

Accepted Answer

Finishing office work before sleeping can potentially stimulate the brain and cause difficulty in falling asleep. It is recommended to avoid work-related activities before sleeping and instead engage in calming activities to promote better sleep. Listening to music, reading novels, and drinking warm milk are relaxing activities that can help promote sleep.

Question 14

Which of the following sleep disorders is a parasomnia disorder of arousal?

Accepted Answer

Sleepwalking is a parasomnia disorder of arousal where individuals engage in complex behaviors while in a state of deep sleep. The other options, sleep apnea and narcolepsy, are sleep disorders that involve disruptions in the sleep-wake cycle, but they are not classified as parasomnia disorders of arousal. Early-morning awakening, while it can be a symptom of certain sleep disorders, is not a sleep disorder in and of itself.

Question 15

When a patient is deprived of sleep,the nurse might assess which of the following symptoms?

Accepted Answer

When a patient is deprived of sleep, they may experience symptoms such as confusion and irritability. Elevated blood pressure, inappropriateness, rapid respirations, decreased temperature, and talkativeness are not commonly associated with sleep deprivation.

Question 16

Which stage of sleep accounts for the greatest proportion of total sleep time in adults?

Accepted Answer

Stage 2 sleep accounts for about 45-55% of total sleep time in adults, making it the stage that accounts for the greatest proportion of total sleep time. Stage 1 sleep accounts for about 5% of total sleep time, while stages 3 and 4 (also known as slow wave or delta sleep) together account for only about 15-20% of total sleep time. REM sleep accounts for about 20-25% of total sleep time.

Question 17

Which of the following is an effective brief method for assessing sleep quality?

Accepted Answer

Visual analogue scale (VAS) is an effective brief method for assessing sleep quality. It measures subjective experiences of sleep quality, with a single-item rating scale ranging from 0 to 100 mm, allowing individuals to rate their overall sleep quality by choosing a point along a continuum from "very poor" to "excellent." It is easy to administer, requires minimal time commitment, and has been shown to be a valid and reliable measure of sleep quality. Sleep history, sleep monitor, and sleep questionnaire diary may provide more detailed information about sleep, but they are not as brief and efficient as VAS.

Question 18

As a result of recent studies regarding infant safety during sleep,which of the following instructions does the nurse give the parents?

Accepted Answer

Recent studies have shown that the safest sleep position for infants is on their back, which reduces the risk of Sudden Infant Death Syndrome (SIDS). Therefore, the nurse should instruct the parents to place the infant on his or her back during sleep. Choices A, B, and D are not recommended as they increase the risk of suffocation and SIDS. Stuffed toys, loose-fitting plastic covers, and small pillows can pose a suffocation hazard to the infant.

Question 19

Which sleep stage begins the initial period of deep sleep?

Accepted Answer

Stage 3, also known as slow-wave sleep, is the initial period of deep sleep characterized by low-frequency, high-amplitude delta waves.

Question 20

A 74-year-old patient reports having sleeping difficulties.To have a better idea of the patient's problem,how should the nurse respond?

Accepted Answer

Asking the patient about their routine before bed can provide insight into any behaviors that may be contributing to their sleep difficulties. This can include factors such as caffeine or alcohol consumption, screen time before bed, or irregular sleep schedules.

Quiz 40: Sleep