CH 33 - Sleep

Which stage of the non-rapid eye movement (NREM) sleep cycle is associated with snoring? 1 2 3 4

2 Snoring is a condition characterized by noisy breathing during the second stage of NREM sleep. As the physiological functions become slower in this stage, sleep becomes deeper and snoring occurs. Snoring does not occur in the other stages of sleep. Drowsiness occurs in the NREM 1 stage. Vital signs decrease and muscles relax in the NREM 3 stage. Somnambulism and nocturnal enuresis may occur in the NREM 3 stage. There is not an NREM 4 stage.

While reviewing a patient's polysomnography results, the nurse finds that the patient has severe obstructive sleep apnea (OSA). Which assessment finding led the nurse to suspect this condition? Four apneic or hypopneic episodes per hour 10 apneic or hypopneic episodes per hour 20 apneic or hypopneic episodes per hour 35 apneic or hypopneic episodes per hour

35 apneic or hypopneic episodes per hour Polysomnography is a diagnostic test used to confirm OSA. It includes the number of apneic or hypopneic episodes per hour. The absence of breathing indicates apnea. If the patient experiences more than 30 apneic or hypopneic episodes per hour, it indicates severe OSA. Because the patient is experiencing 35 apneic episodes per hour, the nurse concludes that the patient has severe OSA. If the patient experiences four or fewer apneic or hypopneic episodes per hour, it indicates that the patient is normal. If the patient experiences five to 15 apneic or hypopneic episodes per hour, it indicates mild OSA. If the patient experiences 15 to 30 apneic or hypopneic episodes per hour, it indicates moderate OSA.

At which age is a patient most likely to have nocturnal emissions? Infants Toddlers Adolescents Older adults

Adolescents A nocturnal emission (a "wet dream") is the discharge of semen from the penis during sleep. In women, the vagina lubricates during wet dreams. This may occur due to the appearance of sexual images in dreams. Adolescence is the time during which the body begins to secrete larger amounts of sexual hormones; therefore wet dreams are common in adolescents. Infants and toddlers do not have wet dreams. Testosterone levels are lower in older adults; thus wet dreams are less likely in older adults.

The nurse is caring for a patient who reports chronic insomnia. Which drug does the nurse expect to be prescribed to the patient? Zaleplon Zolpidem Modafinil Eszopiclone

Eszopiclone Insomnia for a month or longer is known as chronic insomnia. Eszopiclone is useful for the long-term treatment of insomnia. Zaleplon and zolpidem are short-term medications that are useful in inducing sleep. Modafinil is useful in treating narcolepsy.

The nurse is caring for a patient with depression and improper sleep patterns. Which medication does the nurse expect to be prescribed to the patient? Zaleplon Doxepin Zolpidem Modafinil

Doxepin Sleep disorders are common in patients with depression. Depressive thoughts in the daytime build up stress and cause emotional arousal during rapid eye movement sleep, thus affecting the patient's sleep patterns. A tricyclic antidepressant such as doxepin elevates the mood of a depressed person by increasing the levels of neurotransmitters such as serotonin, norepinephrine, acetylcholine, and histamine, thereby inducing sleep. Zaleplon induces sleep but may also arouse suicidal thoughts in patients with depression. Zolpidem may cause depression and thus is contraindicated. Modafinil is a wake-promoting drug that is used in the treatment of narcolepsy.

An obese patient is diagnosed with obstructive sleep apnea. Which conservative approaches are included in the treatment plan of the patient? Select all that apply. Limiting alcohol consumption Motivating the patient to lose weight Recommending that the patient take sedatives Recommending that the patient take herbal medicines Avoiding the consumption of stimulants before going to bed

Limiting alcohol consumption Motivating the patient to lose weight Avoiding the consumption of stimulants before going to bed In obstructive sleep apnea, the upper airways become partially or completely blocked, diminishing nasal airflow or stopping it for as long as 30 seconds. Consumption of alcohol interferes with the quality of sleep; therefore decreasing alcohol use is recommended. Weight reduction is helpful for decreasing sleep apnea, as it helps reduce the obstruction of the airway and promotes lung expansion. Consumption of stimulants causes sleeplessness; therefore they should be avoided. Sedatives should only be prescribed by the health care provider. Herbal medicines may produce side effects or interact with other medications the patient is already taking.

The nurse is caring for a patient with narcolepsy. Which medication does the nurse expect to be prescribed to the patient? Zaleplon Zolpidem Modafinil Eszopiclone

Modafinil Narcolepsy is an uncontrollable excess sleep disorder caused by decreased hypocretin levels in the body. Modafinil is a wake-promoting drug that increases hypocretin levels in the body and is thus useful in the treatment of narcolepsy. Zaleplon and zolpidem are short-term medications that are useful in inducing sleep. Eszopiclone is useful in the long-term treatment of insomnia.

Which stage of sleep is associated with somnambulism? Non-rapid eye movement (NREM) 1 NREM 2 NREM 3 NREM 4

NREM 3 Somnambulism, also called sleepwalking, occurs in the NREM 3 stage of sleep, which is the deepest stage of sleep, in which vital signs are decreased. Drowsiness occurs in the NREM 1 stage. Sleep becomes deeper and snoring occurs during NREM stage 2. Vital signs decrease and the muscles relax in the NREM 3 stage. There is not an NREM 4 stage of sleep.

Which condition can be diagnosed with multiple sleep latency tests? Bruxism Narcolepsy Somnambulism Obstructive sleep apnea

Narcolepsy Narcolepsy is the lack of control over sleep and prolonged uncontrollable sleep. The multiple sleep latency test monitors brain waves, heartbeat, and eye movement during several 20-minute naps over the course of a day and is used for patients in whom narcolepsy is suspected. Bruxism is diagnosed by observing dental abnormalities such as broken teeth, teeth alignment, and tenderness of the jaw muscles. Polysomnography is used to diagnose somnambulism and obstructive sleep apnea.

Which medications affect a patient's rapid eye movement (REM) sleep leading to frequent waking at night and sleepiness during the day? Narcotics Beta blockers Decongestants Benzodiazepines

Narcotics Narcotics act as central nervous stimulants. These stimulants cause disruption in rapid eye movement (REM) sleep by their effects on the central nervous system, causing a loss of total sleep time and time in REM sleep. Decreased REM sleep can lead to a feeling of increased daytime sleepiness. The other classes of drugs do not specifically affect REM sleep. Beta blockers may cause insomnia and nightmares. Decongestants affect the patient's sleep patterns. Benzodiazepines facilitate the action of the neurons in the central nervous system that suppress responsiveness to stimulation and promote sleep.

The nurse is caring for a patient who has restless leg syndrome. Which medication does the nurse expect in the patient's prescription? Zaleplon Modafinil Ropinirole Eszopiclone

Ropinirole Restless leg syndrome is a neurologic disorder characterized by tingling and crawling sensations in the legs and an urge to move them. This sensation is uncomfortable and disturbs sleep. Ropinirole restores the imbalance in the dopamine levels in the brain; it may improve sleep by decreasing these unpleasant feelings in the legs. Zaleplon is a short-term medication for insomnia. Modafinil is useful in treating narcolepsy. Eszopiclone is useful for the long-term treatment of insomnia.

In which stage of non-rapid eye movement (NREM) sleep does enuresis occur? Stage 1 Stage 2 Stage 3 Stage 4

Stage 3 NREM sleep has four stages. Enuresis occurs in stage 3 of NREM of the sleep cycle. Stage 3 lasts for approximately 15 to 30 minutes. It is the deepest stage of sleep. Enuresis does not occur in stages 1 or 2. There is not a Stage 4 of NREM.