Porth's PrepU: Chapter 21- Sleep and Sleep Disorders

A nurse is discussing good sleep habits with an older adult. Which of the following statements made by the patient tells the nurse that further instruction is necessary?

"I will stay up later to make sure that I am very tired

A parent brings their 10-year-old child to the clinic because of sleepwalking at least two to three times per week. The parent is very concerned and asks the nurse what should be done when the child is found to be sleepwalking. Which of the following is the nurse's best response?

"Make sure the environment is safe and place bolts on doors and windows."

A patient informs the nurse that a friend recommended that the patient use melatonin because the patient is having difficulty sleeping. The patient asks the nurse what the medication does to help with sleep difficulty. Which of the following is the nurse's best response?

"Melatonin is a hormone produced by the pineal gland and helps regulate the sleep-wake cycle and possibly circadian rhythms."

A nurse is obtaining a patient's sleep history. The patient asks the nurse if taking melatonin is safe. Which of the following is the nurse's best response?

"Melatonin is thought to be safe for short-term use."

A client has been diagnosed with obstructive sleep apnea and is having a discussion about possible treatment options with the primary care provider. Which options will they discuss? Select all that apply.

-Weight loss -surgery - Positive airway pressure devices

The nurse is caring for a patient in the intensive care unit who has been unable to sleep well for days. Which of the following symptoms may be associated with sleep deprivation? Select all that apply.

-anxiety -irritability -inability to concentrate

A nurse is caring for a patient who is 2 days postpartum. The patient asks the nurse how many hours of the day she should expect her infant to sleep. Which of the following is the most appropriate answer?

16-20 hours

The nurse is caring for a group of clients in the hospital. Which of the following clients are at most risk for obstructive sleep apnea?

A male client with a neck circumference of 44 having a laparoscopic cholecystectomy

A patient who is hospitalized in the intensive care unit after having a myocardial infarction (MI) informs the nurse that he needs a sleeping pill because of the inability to sleep in that environment. The patient states that he has never had trouble sleeping before. Which type of insomnia does the nurse recognize the patient is having?

Acute insomnia

In what disease is often seen more frequent periods of nighttime awakening and daytime sleeping?

Alzheimer's disease

A nurse is caring for the following patients. Which of the following patients should the nurse evaluate first?

An 18-year-old male who appears to be sleepwalking in the hallway

The nurse is caring for a client who has been diagnosed with narcolepsy. The client reports hat his muscles become extremely weak when he becomes excited. The nurse understands that the client is describing which of the following?

Cataplexy

A nurse is obtaining a sleep history from a 19-year-old college student. The student states, "I sleep through my 8 AM class more often than not. I just can't seem to wake up at that early hour." The nurse suspects that the student is experiencing which of the following?

Delayed sleep phase syndrome(DSPS)

A parent informs the nurse that their family was on vacation, staying in a hotel, and woke up to the sound of a knock at the door. When they opened the door, their 8-year-old child was standing at the door not knowing where he was. This was not the first occurrence of sleepwalking for this child. Which of the following should be the priority concern?

Injury during the episode

The nurse is discussing a 6-year-old pediatric patient's sleep characteristics with the child's mother. The mother states that her child sometimes awakens her with fits of crying and appears to be very frightened. The mother asks the nurse what she should do when this happens. Which of the following is the most appropriate direction from the nurse?

Instruct the mother to help the child settle without trying to awaken the child

The nurse has a patient who appears to be sleepwalking. Which of the following interventions would be most appropriate for the nurse to do?

Lead the patient back to bed

What hormone does the pineal gland synthesize and release under the direct control of the suprachiasmatic nucleus (SCN)?

Melatonin

A nurse is caring for a patient who weighs 325 pounds. The client's wife reports that the patient snores loudly and stops breathing frequently when he sleeps. For which of the following possibly related symptoms will the nurse assess?

Morning headaches

A nurse has a patient who has an apnea-hypopnea index (AHI) of 7. Which of the following does the test result indicate that the patient has?

Obstructive sleep apnea

A patient with a history of snoring and tiredness in the morning would most likely be diagnosed with which type of apnea?

Obstructive sleep apnea

The nurse practitioner is examining a client who delivered a healthy baby 2 weeks prior to the visit. The client is complaining of severe mood swings, anxiety, and just feeling down overall. The nurse practitioner asks the client about frequency and duration of sleep disturbances in an effort to determine interruption in which of the following sleep stages?

REM

Which sleep stage is characterized by an increase in brain activity?

REM sleep

In which stage of sleep does dreaming occur most frequently?

Rapid eye movement sleep

In order to best treat transient insomnia, it is suggested that the client adopt which of the following sleep habits?

Setting up a normal bedtime and wake up time.

A nurse is caring for a patient who reports a terrifying experience of being unable to move, speak, or take a deep breath upon awakening. Which of the following has the patient likely experienced?

Sleep paralysis

The parents of a 3-year-old girl are speaking with the pediatrician during a regular checkup. The parents explain how most nights, the little girl will sit straight up in bed, scream and cry uncontrollably. They go in and do not feel that she is really awake, but they can comfort her and get her to go back to sleep very easily. What are they describing to the physician?

Sleep terrors

A nurse enters a patient's room to administer medications and finds the patient resting in bed with eyes closed. The nurse checks the patient's name bracelet and calls the patient by name. The patient arouses easily and states, "I must have dozed off." Which of the following stages of sleep does the nurse recognize this patient was in?

Stage 1

The nurse quietly enters a patient's room and checks the patient's intravenous infusion using a flashlight. In spite of the nurse being quiet and not turning on the lights, the client awakens easily. The patient was most likely to be in which of the following sleep cycles?

Stage 1

What body function is responsible for the control of the circadian clock with input of light-dark awareness?

Suprachiasmatic nucleus (SCN)

A nurse is teaching sleep-promoting strategies to a patient. Which of the following beverages would the nurse recommend to promote sleep?

Warm milk