Chapter 43: Sleep Review Questions

The nurse incorporates which priority nursing intervention into a plan of care to promote sleep for a hospitalized patient?

1. Have patient follow hospital routines. 2. Avoid waking patient for nonessential tasks. 3. Give prescribed sleeping medications at dinner. 4. Turn television on low to late-night programming. 2

The nurse is administering a benzodiazepine sleep aid to an older adult. What should be the priority assessment for the patient?

1. Incontinence. 2. Nausea and vomiting. 3. Bradycardia. 4. Respiratory depression. 4

The school nurse is teaching health-promoting behaviors that improve sleep to a group of high-school students. Which points should be included in the education? (Select all that apply).

1. Go to bed at the same time each night. 2. Study in your bedroom to have a quiet place. 3. Turn on the television to help you fall asleep. 4. Avoid drinking coffee or soda before bedtime. 5. Turn off your cell phone at bedtime. 1, 4, and 5

A 72-year-old patient asks the nurse about using an over-the-counter antihistamine as a sleeping pill to help her get to sleep. What is the nurse's best response?

1. "Antihistamines are better than prescription medications because these can cause a lot of problems." 2. "Antihistamines should not be used because they can cause confusion and increase your risk of falls." 3. "Antihistamines are effective sleep aids because they do not have many side effects." 4. "Over-the-counter medications when combined with sleep-hygiene measures are a good plan for sleep." 2

Which statement made by the parent of a school-age child requires follow-up by the nurse?

1. "I encourage evening exercise about an hour before bedtime." 2. "I offer my daughter a glass of warm milk before bedtime." 3. "I make sure that the room is dark and quiet at bedtime." 4. "We use quiet activities such as reading a book before bedtime." 1

The nurse is taking a sleep history from a patient. Which statement made by the patient needs further follow-up?

1. "I feel refreshed when I wake up in the morning." 2. "I use soft music at night to help me relax." 3. "It takes me about 45 to 60 minutes to fall asleep." 4. "I take the pain medication for my leg pain about 30 minutes before I go to bed." 3

Which statement made by a mother being discharged to home with her newborn infant indicates that she understands the discharge teaching related to best sleep practices?

1. "I'll give the baby a bottle to help her fall asleep." 2. "We'll place the baby on her back to sleep." 3. "We put the baby's stuffed animals in the crib to make her feel safe." 4. "I know the baby will not need to be fed until morning." 2

Which statement made by an older adult best demonstrates understanding of taking a sleep medication?

1. "I'll take the sleep medicine for 4 or 5 weeks until my sleep problems disappear." 2. "Sleep medicines won't cause any sleep problems once I stop taking them." 3. I'll talk to my health care provider before I use an over-the-counter sleep medication." 4. "I'll contact my health care provider if I feel extremely sleepy in the mornings." 3

Which statement made by the patient indicates a need for further teaching on sleep hygiene?

1. "I'm going to do my exercises before I eat dinner." 2. "I'm going to go to bed every night at about the same time." 3. "I set my alarm to get up at the same time every morning." 4. "I moved my computer to the bedroom so I could work before I go to sleep." 4

The nurse is providing health teaching for a patient using herbal compounds such as kava for sleep. Which points need to be included? (Select all that apply).

1. Can cause urinary retention. 2. Should not be used indefinitely. 3. May have toxic effects on the liver. 4. May cause diarrhea and anxiety. 5. Are not regulated by the U.S. Food and Drug Administration (FDA). 2, 3, and 5

Which sleep-hygiene actions at bedtime can the nurse delegate to the nursing assistant? (Select all that apply).

1. Giving the patient a back rub. 2. Turning on quiet music. 3. Dimming the lights in the patient's room. 4. Giving a patient a cup of coffee. 5. Monitoring for the effect of the sleeping medication that was given. 1, 2, and 3

The nurse is developing a plan of care for a patient experiencing obstructive sleep apnea (OSA). Which intervention is appropriate to include on the plan?

1. Instruct the patient to sleep in a supine position. 2. Have patient limit fluid intake 2 hours before bedtime. 3. Elevate head of bed and assume a side or prone position. 4. Encourage patient to take an over-the-counter sleep aid. 3

The nurse is contacting the health care provider about a patient's sleep problem. Place the steps of the SBAR (situation, background, assessment, recommendation) in the correct order.

1. Mrs. Dodd, 46 years old, was admitted 3 days ago following a motor vehicle accident. She is in balanced skeletal traction for a fractured left femur. She is having difficulty falling asleep. 2. "Dr. Smithson, this is Pam, the nurse caring for Mrs. Dodd. I'm calling because Mrs. Dodd is having difficulty sleeping." 3. "I'm calling to ask if you would order a hypnotic such as zolpidem (Ambien) to use on a prn basis." 4. Mrs. Dodd is taking her pain medication every 4 hours as ordered and rates her pain as a 2 out of 10. Last night she was still awake at 0100. She states that she is comfortable but just can't fall asleep. Her vital signs are BP 124/76, P 78, R 12 and T 37.1 C (98.8 F). 2, 1, 4, and 3

The patient reports episodes of sleepwalking to the nurse. Through understanding of the sleep cycle, the nurse recognizes that sleepwalking occurs during which sleep phase?

1. Rapid eye movement (REM) sleep. 2. Stage 1 nonrapid eye movement (NREM) sleep. 3. Stage 4 NREM sleep. 4. Transition period from NREM to REM sleep 3

The nurse is developing a plan for a patient who was diagnosed with narcolepsy. Which interventions should the nurse include on the plan? (Select all that apply).

1. Take brief, 20-minute naps no more than twice a day. 2. Drink a glass of wine with dinner. 3. Eat the large meal at lunch rather than dinner. 4. Establish a regular exercise program. 5. Teach the patient about the side effects of modafinil (Provigil). 1, 4, and 5