Chapter 43: Sleep

The nurse is caring for a patient who has been in holding in the emergency department for 24 hours. The nurse is concerned about the patient's experiencing sleep deprivation. Which action will be best for the nurse to take? 1. Expedite the process of obtaining a medical-surgical room for the patient. 2. Pull the curtains shut, dim the lights, and decrease the number of visitors. 3. Obtain an order for hypnotic medication to help the patient sleep. 4. Ask everyone in the unit to try to be quiet so the patient can sleep.

1

The nurse is completing a sleep assessment on a patient. Which tool will the nurse use to complete the assessment? 1. Visual analog scale 2. Cataplexy scale 3. Polysomnogram 4. RAS scale

1

The nurse is completing an assessment on an older-adult patient who is having difficulty falling asleep. Which condition will the nurse further assess for in this patient? 1. Depression 2. Mild fatigue 3. Hypertension 4. Hypothyroidism

1

The nurse is discussing lack of sleep with a middle-aged adult. Which area should the nurse most likely assess to determine a possible cause of the lack of sleep? 1. Anxiety 2. Loud teenagers 3. Caring for pets 4. Late night television

1

The nurse is providing an educational session on sleep regulation for new nurses in the Sleep Disorder Treatment Center. Which statement by the nurses will best indicate that the teaching is effective? 1. "If the patient has a disease process in the central nervous system, it can influence the functions of sleep." 2. "If the patient has a disease process in the cranial nerves, it can influence the functions of sleep." 3. "If the patient has an interruption in the urinary pathways, it can influence the functions of sleep." 4. "If the patient has an interruption in the spinal reflexes, it can influence the functions of sleep."

1

Which nursing observation of the patient in intensive care indicates the patient is sleeping comfortably during NREM sleep? 1. Eyes closed, lying quietly, respirations 12, heart 60 2. Eyes closed, tossing in bed, respirations 18, heart 80 3. Eyes closed, mumbling to self, respirations 16, heart rate 68 4. Eyes closed, lying supine in bed, respirations 22, heart rate 66

1

The nurse is beginning a sleep assessment on a patient. Which question will be most appropriate for the nurse to ask initially? 1. "What is going on?" 2. "How are you sleeping?" 3. "Are you taking any medications?" 4. "What did you have for dinner last night?"

2

The nurse is having a conversation with an adolescent regarding the need for sleep. The adolescent states that it is common to stay up with friends several nights a week. Which action should the nurse take next? 1. Talk with the adolescent's parent about staying up with friends and the need for sleep. 2. Discuss with the adolescent sleep needs and the effects of excessive daytime sleepiness. 3. Refer the adolescent for counseling about alcohol abuse problems. 4. Take no action for this normal occurrence.

2

The nurse is teaching a new mother about the sleep requirements of a neonate. Which comment by the patient indicates a correct understanding of the teaching? 1. "I can't wait to get the baby home to play with the brothers and sisters." 2. "I will ask my mom to come after the first week, when the baby is more alert." 3. "I can get the baby on a sleeping schedule the first week while my mom is here." 4. "I won't be bale to nap during the day because the baby will be awake."

2

A patient has obstructive sleep apnea. Which assessment is the priority? 1. Gastrointestinal function 2. Neurological function 3. Respiratory status 4. Circulatory status

3

The nurse is caring for a patient in the sleep lab. Which assessment finding indicates to the nurse that the patient is in stage 4 NREM? 1. The patient awakens easily. 2. The patient's eyes rapidly move. 3. The patient is difficult to awaken. 4. The patient's vital signs are elevated.

3

The nurse is caring for a patient who is having trouble sleeping. Which action will the nurse take? 1. Suggest snug-fitting nightwear. 2. Provide a favorite beverage. 3. Encourage deep breathing. 4. Walk with the patient.

3

The patient has just been diagnosed with narcolepsy. The nurse teaches the patient about management of the condition. Which information from the patient will cause the nurse to intervene? 1. Takes antidepressant medications 2. Naps shorter than 20 minutes 3. Sits in hot, stuffy rooms 4. Chews gum

3

The patient presents to the clinic with reports of irritability, being sleepy during the day, chronically not being able to fall asleep, and being tired. Which nursing diagnosis will the nurse document in the plan of care? 1. Anxiety 2. Fatigue 3. Insomnia 4. Sleep deprivation

3

A nurse is teaching the staff about the sleep cycle. Which sequence will the nurse include in the teaching session? 1. NREM Stage 1, 2, 3, 4, REM 2. NREM Stage 1, 2, 3, 4, 3, 2, 1, REM 3. NREM Stage 1, 2, 3, 4, REM, 4, 3, 2 REM 4. NREM Stage 1, 2, 3, 4, 3, 2, REM

4

A single parent is discussing the sleep needs of a preschooler with the nurse. Which information will the nurse share with the parent? 1. "Most preschoolers sleep soundly all night long." 2. "It is important that the 5-year-old get a nap everyday." 3. "On average, the preschooler needs to sleep 10 hours a night." 4. "Preschoolers may have trouble settling down after a busy day."

4

The nurse adds a nursing diagnosis of ineffective breathing pattern to a patient's care plan. Which sleep condition caused the nurse to assign this nursing diagnosis? 1. Insomnia 2. Narcolepsy 3. Sleep deprivation 4. Obstructive sleep apnea

4

The nurse is caring for a postpartum patient. The patient's labor has lasted over 28 hours within the hospital; the patient has not slept and is disoriented to date and time. Which nursing diagnosis will the nurse document in the patient's care plan? 1. Insomnia 2. Impaired parenting 3. Ineffective coping 4. Sleep deprivation

4

The nurse is caring for a young-adult patient on the medical-surgical unit. When doing midnight checks, the nurse observes the patient awake, putting a puzzle together. Which information will the nurse consider to best explain this finding? 1. The patient misses family and is lonely. 2. The patient was waiting to talk with the nurse. 3. The patient has been kept up with the noise on the unit. 4. The patient's sleep-wake cycle preference is late evening.

4

The nurse is caring for an adolescent with an appendectomy who is reporting difficulty falling asleep. Which intervention will be most appropriate? 1. Close the door to decrease noise from unit activities. 2. Adjust temperature in the patient's room to 21 C (70 F). 3. Ensure that the night-light in the patient's room is working. 4. Encourage the discontinuation of a soda and chocolate nightly snack.

4