Question 1

The parents of a 6-month-old tell the nurse that they are exhausted because their baby wakes up several times every night.What advice should the nurse give these parents?
A)Be certain that the baby is truly awake before picking him up for feeding.
B)Let the baby "cry it out" for a few nights until he can sleep through the night.
C)Continue to respond to the baby whenever he is restless during the night.
D)Bring the baby in for a possible sleep study to check for sleeping disorders.

Accepted Answer

It is important for parents to be sure the baby is truly awake before intervening. Sometimes babies may cry during their sleep but not actually be fully awake and in need of attention. By waiting a few minutes to assess the baby's level of wakefulness, parents may be able to avoid unnecessary feedings or disruptions to their own sleep.

Answer: C
 It is important for parents to respond to their baby's needs during the night, especially during the first year of life when babies are still developing their sleep patterns. Ignoring a crying baby and allowing them to "cry it out" can be stressful for both the baby and the parents, and may not ultimately result in better sleep. It is important for parents to provide comfort and reassurance to their baby as needed.

Therefore, the best choices for this situation are A and C.

Question 2

The nurse is developing a plan of care for a client diagnosed with narcolepsy.Which intervention should the nurse include in this plan of care?
A)Encourage the client to take an over-the-counter medication to improve nighttime sleep.
B)Be certain the client has the prescription for modafinil (Provigil)filled.
C)Have the client purchase sodium oxybate (Xyrem)over the counter to prevent daytime drowsiness.
D)Be certain the client obtains antihistamines to control nasal stuffiness.

Accepted Answer

Modafinil (Provigil) is a central nervous system stimulant that promotes wakefulness and is the primary medication used to manage narcolepsy. It should be obtained via prescription from a healthcare provider and included in the client's plan of care. None of the other options are appropriate interventions for managing narcolepsy.

Question 3

The nurse is planning interventions for a client who has difficulty falling asleep.Which intervention regarding sleep times would be most helpful?
A)Maintain a regular bedtime and wake-up time for all days of the week.
B)If bedtime is delayed on one night,go to bed that much earlier the next night.
C)If daytime drowsiness occurs,go to bed earlier that night.
D)Sleep at least 1 hour later on mornings you don't have to go to work.

Accepted Answer

Maintaining a regular bedtime and wake-up time for all days of the week helps to establish a consistent sleep schedule, which can improve sleep quality and make it easier to fall asleep. Inconsistent sleep schedules can disrupt the body's natural sleep-wake cycle and make it harder to fall asleep at night. Therefore, this intervention would be the most helpful in addressing the client's difficulty falling asleep. B, C, and D are not recommended because they involve changing the sleep schedule in response to specific events or circumstances, which can further disrupt the body's natural sleep-wake cycle.

Question 4

The nurse is completing the admission assessment on a client who has obstructive sleep apnea.Which findings should the nurse expect when assessing this client?
(Select all that apply)
A)Reddened uvula
B)Large soft palate
C)Obesity
D)Short neck
E)Deviated septum

Accepted Answer

The answer of The nurse is completing the admission assessment...

Question 5

A client s why a medication that is used to treat Parkinson's disease has been prescribed for the diagnosis of periodic limb movement disorder (PLMD).What should the nurse do?
A)Contact the physician.
B)Assure the client that medications used to treat Parkinson's disease are also used to treat PLMD.
C)Tell the client not to take the medication because there is most likely an error.
D)Check with the pharmacy to make sure the correct medication has been provided to the client

Accepted Answer

Medications used to treat Parkinson's disease, such as dopamine agonists, have also been found to be effective in treating PLMD. It is important for the nurse to educate the client about this and ensure they understand why the medication has been prescribed for them. If the nurse has concerns or questions, they can follow up with the physician for further clarification. Checking with the pharmacy is also a good idea, but it should not be the first step in this situation.

Question 6

The mother of a newborn tells the nurse,"I am concerned about my baby.When she first goes to sleep,her eyes dart around under her eyelids,she doesn't breathe regularly,and she sometimes twitches." What advice should the nurse give this mother?
A)Please bring your baby in immediately for a checkup.
B)These are common behaviors in newborns and are normal.
C)You should ask the physician about these symptoms at your next checkup.
D)If your baby does this again,take her to the emergency department.

Accepted Answer

These are common behaviors in newborns and are normal. This is called Rapid Eye Movement (REM) sleep and is a normal part of newborn sleep patterns. It is important to educate the mother about normal newborn behaviors to reduce anxiety and promote appropriate newborn care. If the mother has any further concerns or questions, she should contact her healthcare provider.

Question 7

The client who has obstructive sleep apnea is being treated with a nasal continuous positive airway pressure (CPAP)device,but has just been prescribed modafinil (Provigil).What client statement indicates that teaching about these therapies has been effective?
A)"I am so glad that I won't have to sleep in this machine anymore."
B)"Once I get regulated on the Provigil,I will wean myself off the CPAP."
C)"I will continue using my CPAP machine at night."
D)"I can turn down the pressure on my CPAP machine in about 1 week."

Accepted Answer

The client's statement that they will continue using their CPAP machine indicates that they understand the importance of using both therapies together to manage their obstructive sleep apnea. The other options either indicate a misunderstanding of the therapies or a desire to discontinue the use of the CPAP machine, which is not appropriate for effective management of this condition.

Question 8

The hospitalized client requests a bedtime snack.Which food should the nurse offer this client?
A)Hot chocolate
B)Tea and crackers
C)Cereal with milk
D)Chips and salsa

Accepted Answer

Cereal with milk is a good option for a bedtime snack as it is easy to digest and provides carbohydrates that can promote sleep. It is also a better option compared to hot chocolate, tea and crackers, and chips and salsa as these foods may contain caffeine or high levels of sugar and sodium that can disrupt sleep and/or exacerbate underlying health conditions.

Question 9

The client has been prescribed zolpidem (Ambien)for the short-term management of insomnia.What information should the nurse include when teaching the client about this medication?
A)For best results,take the medication just prior to bedtime.
B)Take the medication at dinnertime to avoid gastric upset.
C)Do not take the medication with any liquid that contains calcium.
D)Drink an entire glass of water with the dose to avoid kidney stones.

Accepted Answer

Zolpidem (Ambien) should be taken just prior to bedtime, as it is a short-acting medication that induces sleep quickly. Taking it at dinnertime may lead to daytime drowsiness and decreased alertness, which can be dangerous.

B, C, and D are incorrect choices. There is no evidence that taking zolpidem with or without food affects gastric upset, and there is no interaction with calcium-containing liquids. Drinking water is always recommended with medications, but there is no specific concern for kidney stones with zolpidem.

Question 10

A 5-year-old client has recurrent night terrors.What nursing intervention should the nurse use to help alleviate this problem?
A)Have the child walk around in the room when night terrors occur.
B)The next morning,ask the child to describe the event.
C)Have the child empty the bladder prior to going to bed.
D)Use an additional pillow behind the child's head at night.

Accepted Answer

Night terrors can be associated with full bladder, so having the child empty the bladder prior to going to bed may help alleviate the problem. Options A and D are not supported by evidence and may potentially worsen the night terrors. Option B may also not be helpful as the child may not remember the event due to the nature of night terrors.

Question 11

A client tells the nurse that because of work and life responsibilities,sleep has "become optional." What is the best response the nurse should make to this client?
A)"Be sure to get extra sleep when you can."
B)"A lack of sleep can affect hormone levels and bodily functions."
C)"Everyone has different needs for sleep to in order to function."
D)"You must be very productive."

Accepted Answer

Option B is the best response because it provides factual information about the consequences of not getting enough sleep, including potential impacts on hormones and bodily functions. It also helps the client understand the importance of prioritizing sleep, even if they have work and life responsibilities. The other options either offer insufficient advice or make light of the client's concerns.

Question 12

The client who has sleep apnea reports falling asleep while driving,almost being involved in an accident,and frequent episodes of sleepwalking.What nursing diagnosis should be a priority for this client?
A)Disturbed Sleep Pattern related to difficulty staying asleep
B)Risk for Impaired Gas Exchange related to sleep apnea
C)Disturbed Thought Processes related to chronic insomnia
D)Risk for Injury related to somnambulism

Accepted Answer

The client's report of sleepwalking and falling asleep while driving indicate a high risk for injury, making the nursing diagnosis of Risk for Injury related to somnambulism a priority. The other options may also be relevant, but do not address the immediate safety concern.

Question 13

The client reports difficulty sleeping.Which environmental intervention should the nurse recommend?
A)Play soft music throughout the night.
B)Keep a television on in the bedroom.
C)Provide white noise with a fan.
D)Play a talk radio station.

Accepted Answer

Providing white noise with a fan can help mask other noises and create a consistent background sound that can promote sleep. Soft music or a talk radio station may be too stimulating and keep the client awake. Keeping a television on in the bedroom can also be too stimulating and interfere with sleep.

Question 14

The client is being treated with a nasal continuous positive airway pressure device (CPAP)for sleep apnea.What finding indicates that this treatment has been helpful to the client?
A)The client has lost 7 pounds since treatment began.
B)The client sleeps so soundly that he snores.
C)The client's diabetes is now under control.
D)The client reports a decrease in morning headache.

Accepted Answer

A decrease in morning headache is a common symptom improvement that is seen in clients with sleep apnea who are being successfully treated with CPAP. The other options do not directly indicate improvement in sleep apnea symptoms.

Question 15

The nurse is admitting a critically ill client to the intensive care unit.What should the nurse ask regarding this client's sleep history?
A)No questions should be asked.
B)"When do you usually go to sleep?"
C)"Do you have any problems with sleeping?"
D)"What are your bedtime rituals?"

Accepted Answer

The answer of The nurse is admitting a critically ill...

Question 16

The 70-year-old client tells the nurse,"I can go to sleep without a problem,but then I wake up in a couple of hours and can't go back to sleep." What nursing action would help promote rest and sleep in this client?
A)Have the client develop a bedtime ritual of quiet music and a glass of wine.
B)Encourage the client to avoid taking pain medication prior to sleep.
C)Evaluate if the client perceives sleeplessness to be a serious problem.
D)Have the client perform moderate exercises before bedtime.

Accepted Answer

Evaluating the client's perception of their sleeplessness is important as it can provide insight into the severity of the problem and any possible underlying causes. It can also help the nurse determine the best course of action to promote restful sleep. The other options have potential drawbacks such as dependence on alcohol for sleep (option A) and the potential for stimulating effects of exercise before bedtime (option D). Option B may not be applicable if the client requires pain medication for other reasons.

Question 17

The nurse is working with a client to develop an expected outcome for the nursing diagnosis Disturbed Sleep Pattern,difficulty staying asleep related to anxiety secondary to multiple life stressors.Which expected outcome would be most applicable to this client's situation?
A)The client will sleep at least 8 hours each night.
B)The client will list three positive coping mechanisms for anxiety relief.
C)The client will report getting sufficient sleep to provide energy for daily activities.
D)The client will manifest less anxiety after taking prescribed medications.

Accepted Answer

The most applicable expected outcome for the nursing diagnosis of Disturbed Sleep Pattern related to anxiety is that the client will report getting sufficient sleep to provide energy for daily activities. This outcome is more focused on addressing the root cause of the problem, which is the anxiety secondary to multiple life stressors. Options A and D are not specific enough, while option B is not directly related to the nursing diagnosis.

Question 18

A client complains of not being able to stay awake during the day even after sleeping throughout the night.What should the nurse suggestion to this client?
A)Go to your physician for a physical examination.
B)Go to a mental health professional for evaluation of possible depression.
C)Purchase an over-the-counter sleep aid to deepen nighttime sleep.
D)Drink more caffeinated beverages in the daytime to stay awake.

Accepted Answer

The client's complaint may be indicative of an underlying medical condition, such as sleep apnea, that requires a physical examination and further evaluation by a healthcare provider. It is important to rule out any possible medical causes before suggesting other interventions.

Question 19

The client reports difficulty sleeping and awakening several times during the night.What intervention should the nurse recommend for the client when unable to sleep?
A)Get out of bed,go into another room,and pursue some relaxing activity until drowsy.
B)Get out of bed,go into another room,and exercise until tired before trying to go back to sleep.
C)Sit in bed and watch the bedroom television until drowsy.
D)Stay in bed with eyes closed and do some mental arithmetic until sleepy.

Accepted Answer

Getting out of bed and engaging in a relaxing activity until feeling drowsy is a good intervention for insomnia. This can help break the cycle of anxiety and negative thoughts associated with being awake in bed, allowing the client to associate the bed with sleep once again. Engaging in exercise before bedtime can have a stimulating effect, making it difficult to sleep. Watching television in bed can also be counterproductive to sleep, as the blue light emitted by the screen can interfere with the secretion of melatonin, a hormone involved in regulating sleep cycles. Mental arithmetic can be mentally taxing, and may also interfere with the client's ability to relax and fall asleep.

Question 20

The client has complained of stiffness and muscle tension in his back.The nurse suggests a back rub,but the client declines the offer.What action should the nurse take?
A)Encourage the client to accept the back rub,saying how much it will relax the back muscles.
B)Document that the client is noncompliant with the nursing plan of care.
C)Accept the declination but tell the client to call if he changes his mind.
D)Instruct the UAP to rub the client's back while assisting him to change into a clean gown.

Accepted Answer

The client has the right to decline any treatment or intervention, and it is the nurse’s duty to respect the client’s decision. The nurse should explain to the client that the offer is always open and the client can call anytime they feel like receiving a back rub. Documenting noncompliance is not the appropriate course of action, as the back rub is not a mandatory treatment intervention. Instructing the UAP to provide a back rub is not within the scope of their responsibilities without supervision and authorization of the nurse. Encouraging the client may not be respectful of their autonomy and may make them feel uncomfortable.

Quiz 45: Sleep

The parents of a 6-month-old tell the nurse that they are exhausted because their baby wakes up several times every night.What advice should the nurse give these parents?

The nurse is developing a plan of care for a client diagnosed with narcolepsy.Which intervention should the nurse include in this plan of care?

The nurse is planning interventions for a client who has difficulty falling asleep.Which intervention regarding sleep times would be most helpful?

The nurse is completing the admission assessment on a client who has obstructive sleep apnea.Which findings should the nurse expect when assessing this client? (Select all that apply)

A client s why a medication that is used to treat Parkinson's disease has been prescribed for the diagnosis of periodic limb movement disorder (PLMD) .What should the nurse do?

The mother of a newborn tells the nurse,"I am concerned about my baby.When she first goes to sleep,her eyes dart around under her eyelids,she doesn't breathe regularly,and she sometimes twitches." What advice should the nurse give this mother?

The client who has obstructive sleep apnea is being treated with a nasal continuous positive airway pressure (CPAP) device,but has just been prescribed modafinil (Provigil) .What client statement indicates that teaching about these therapies has been effective?

The hospitalized client requests a bedtime snack.Which food should the nurse offer this client?

The client has been prescribed zolpidem (Ambien) for the short-term management of insomnia.What information should the nurse include when teaching the client about this medication?

A 5-year-old client has recurrent night terrors.What nursing intervention should the nurse use to help alleviate this problem?

A client tells the nurse that because of work and life responsibilities,sleep has "become optional." What is the best response the nurse should make to this client?

The client who has sleep apnea reports falling asleep while driving,almost being involved in an accident,and frequent episodes of sleepwalking.What nursing diagnosis should be a priority for this client?

The client reports difficulty sleeping.Which environmental intervention should the nurse recommend?

The client is being treated with a nasal continuous positive airway pressure device (CPAP) for sleep apnea.What finding indicates that this treatment has been helpful to the client?

The nurse is admitting a critically ill client to the intensive care unit.What should the nurse ask regarding this client's sleep history?

The 70-year-old client tells the nurse,"I can go to sleep without a problem,but then I wake up in a couple of hours and can't go back to sleep." What nursing action would help promote rest and sleep in this client?

The nurse is working with a client to develop an expected outcome for the nursing diagnosis Disturbed Sleep Pattern,difficulty staying asleep related to anxiety secondary to multiple life stressors.Which expected outcome would be most applicable to this client's situation?

A client complains of not being able to stay awake during the day even after sleeping throughout the night.What should the nurse suggestion to this client?

The client reports difficulty sleeping and awakening several times during the night.What intervention should the nurse recommend for the client when unable to sleep?

The client has complained of stiffness and muscle tension in his back.The nurse suggests a back rub,but the client declines the offer.What action should the nurse take?