Ch 45 Test

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

Maintain a regular bedtime and wake-up time for all days of the week.

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

No questions should be asked.

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

Provide white noise with a fan.

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?

Reddened uvula Large soft palate Obesity

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?

Risk for Injury related to somnambulism

A client who smokes cigarettes tells the nurse that sleep is light, and that he awakens easily. What should the nurse suggest to help this client with sleep?

Smoke no cigarettes after the evening meal.

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

Cereal with milk

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 lack of sleep can affect hormone levels and bodily functions.

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 client reports a decrease in morning headache.

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?

Accept the declination but tell the client to call if he changes his mind.

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

Assure the client that medications used to treat Parkinsons disease are also used to treat PLMD.

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?

Be certain that the baby is truly awake before picking him up for feeding.

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?

Be certain the client has the prescription for modafinil (Provigil) filled.

A client is working two jobs, caring for aged parents, and maintaining a household for the family. The nurse realizes that this emotional stress will have what impact on the clients sleep?

Less deep sleep and more awakenings during the night

The parent of a preschool-age child asks the nurse what can be done to reduce the number of nightmares the child experiences. What should the nurse suggest to this parent?

Limit or eliminate television.

A client has not had uninterrupted sleep for several nights, and is irritable. What other assessment findings should the nurse associate with the clients lack of REM sleep?

Depression Confusion Disorientation Impaired memory

A client with diabetes asks the nurse why his blood glucose level is higher on days when he sleeps less. What should the nurse explain to the client?

During sleep, the hormone cortisol is inhibited. If sleep is interrupted, cortisol levels will remain elevated, impacting blood glucose.

The nurse suspects that an adult is not getting an adequate amount of nightly sleep. What information caused the nurse to have this suspicion

Enrolled in online classes Raising two children ages 4 and 8 Experiences chronic pain from sciatica Works one job steady night turn and another part-time late afternoon

The nurse is working on a hospital committee tasked with reducing environmental distractions to sleep within the hospital. Which recommendations by the committee would be helpful?

Establish a time at which radios and televisions should be turned off or down. Discontinue use of the paging system after 2100.

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 cant go back to sleep. What nursing action would help promote rest and sleep in this client?

Evaluate if the client perceives sleeplessness to be a serious problem.

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?

For best results, take the medication just prior to bedtime.

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?

Get out of bed, go into another room, and pursue some relaxing activity until drowsy.

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?

Go to your physician for a physical examination.

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

Have the child empty the bladder prior to going to bed.

A client tells the nurse about having problems falling and staying asleep. What should the nurse ask the client to gain more information about this client problem?

How often does this happen? How much coffee do you drink each day? What have you done to deal with this sleeping problem?

The nurse, seeing a client asleep, turns off the television in the room. The client opens her eyes and says I was watching that. I wasnt sleeping. The nurse realizes that the client was demonstrating which stage of NREM sleep?

I

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?

I will continue using my CPAP machine at night.

A client reports the need to urinate during the night and then not being able to fall back asleep. The nurse should document this assessment finding as which factor that influences sleep?

Illness

A hospitalized client is being woken up every hour during the night for care and procedures. The nurse realizes that the lack of NREM sleep can have which physiological effect?

Increase susceptibility to infection

After an assessment, the nurse is concerned that an older client is experiencing changes in sleep. What findings did the nurse use to make this clinical decision?

Is wide awake around 3 am Takes a nap after lunch every day Goes to sleep before 9 pm most evenings Wakes up and looks at the clock every hour

The nurse is assessing a client in the intensive care unit who is asleep. What physiological changes will the nurse observe in this client?

Lower blood pressure Lower heart rate

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 clients situation?

The client will report getting sufficient sleep to provide energy for daily activities.

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 doesnt breathe regularly, and she sometimes twitches. What advice should the nurse give this mother?

These are common behaviors in newborns and are normal.