Fundamentals Chapter 18: Comfort, Rest, and Sleep

16. A man with numerous comorbid health problems has presented to the clinic for a scheduled appointment. The man states that he has been awakening frequently during the night to void. The nurse should inquire about the time of day that the client is taking his prescribed: anticoagulant. antihyperglycemic. diuretic. stool softener.

diuretic

2. A nurse is caring for a client who has started phototherapy for seasonal affective disorder. Which instruction should the nurse give the client to prevent the recurrence of symptoms? Take phototherapy for 2 to 6 hours. Try to relax during the therapy. Maintain good fluid intake during therapy. Avoid abrupt discontinuation of the therapy.

Avoid abrupt discontinuation of the therapy.

9. A nurse is caring for a client diagnosed with sleep apnea. What should the nurse do in order to promote sleep in the client? Encourage the client to lose weight. Avoid sedatives for sleeping. Encourage deep breathing exercises. Provide good ventilation in the room.

Avoid sedatives for sleeping.

27. A nurse is caring for a client with insomnia. Which teaching will the nurse provide to help the client improve sleep? "Create a bedtime routine." "Limit fluids in the evening." "Eat a heavy meal for dinner." "Watch television in bed before sleep."

"Create a bedtime routine."

17. A client reports to the nurse, "Sleep really isn't necessary." Which teaching by the nurse is appropriate? Select all that apply. "Sleep helps your blood flow to the brain." "Sleep can make your moods fluctuate over time." "Sleep helps you to learn easier and remember more." "Sleep takes time, which can be stressful for some people." "Sleep helps your immune system to fight off infections."

"Sleep helps your blood flow to the brain." "Sleep helps you to learn easier and remember more." "Sleep helps your immune system to fight off infections."

18. The nurse is educating a client and spouse about sudden jerking that occurs during sleep. What is the most appropriate nursing response? "Sudden twitches that occur during the early phases of sleep are common." "Those are hypnogogic twitches that happen during REM sleep." "Sudden jerking movements can indicate vivid dreaming." "When oxygen levels drop during sleep, muscles will jerk suddenly."

"Sudden twitches that occur during the early phases of sleep are common."

23. The caregiver of a preschool-age child tells the nurse, "I am afraid my child sleeps too much," and reports that the child takes a daily 2-hour nap in addition to sleeping 12 hours at night. What is the appropriate nursing response? "Your child should get 14-17 total hours of sleep time in a 24-hour period." "Your child should get 12-15 total hours of sleep time in a 24-hour period." "Your child should get 10-13 total hours of sleep time in a 24-hour period." "Your child should get 9-11 total hours of sleep time in a 24-hour period."

"Your child should get 10-13 total hours of sleep time in a 24-hour period."

13. A nurse suspects that an older adult's insomnia may be partially attributable to excessive daytime napping. The nurse has taught the client that the client may not need as much sleep as the client believes. The nurse should know that older adults typically require how much sleep in any given 24-hour period? 5.5 to 7.5 hours 8 hours 7 to 9 hours 9 to 10 hours

7 to 9 hours

7. A nurse is caring for an elderly client at a health care facility. What should the nurse do to provide an appropriate environment for the client? Ensure that there are bright lights on during the night. Ensure that the bed has raised side rails. Ensure that the environment is warmer than normal. Ensure that the client's belongings are in order.

Ensure that the environment is warmer than normal.

15. A female client has been admitted to the hospital with a diagnosis of pneumonia and admitted to a four-bed room. The client has found it difficult to sleep in this environment and explained this to the nurse. The nurse's first action in response to this client's complaint should be to: Facilitate as many aspects of the client's sleep rituals as possible. Encourage the client to take naps during the day to reduce her nighttime sleep needs. Obtain a prescription for a benzodiazepine from the client's physician. Administer more of the client's medications in the morning rather than the evening.

Facilitate as many aspects of the client's sleep rituals as possible.

26. The nurse is caring for a client who reports insomnia. The client has recently moved from an area near a fire station in the inner city to the country. Which recommendation will the nurse make to facilitate sleep? Enjoy the peace and quiet of the country. Find a phone app that plays sounds of the city. Avoid eating right before bedtime. Ingest 1 ounce of liquor before going to sleep.

Find a phone app that plays sounds of the city.

11. A nurse is explaining to an insomniac client the effect of a prescribed medication and the different phases of sleep. Which statement is true for nonrapid eye movement (NREM) sleep? It is called slow wave sleep. It is called paradoxical sleep. It is the deepest stage of sleep. It is called active sleep.

It is called slow wave sleep.

22. The nurse is caring for a client on the acute care unit who experiences automatic behaviors associated with narcolepsy. What is the priority nursing intervention? Contact the health care provider to consider prescribing a stimulant drug. Educate the client about other symptoms that may be experienced, such as sleep paralysis. Keep the client safe by monitoring ambulation on the unit. Ask the client about willingness to explore taking an antidepressant to reduce symptoms associated with atypical REM sleep.

Keep the client safe by monitoring ambulation on the unit.

12. A nurse is caring for an older adult client with chronic back pain and a sleeping disorder. The nurse suggests some relaxation techniques to be performed before bedtime. Which technique should the nurse suggest? Drink a glass of milk. Perform yoga. Sit in a rocking chair. Wear warm clothes.

Sit in a rocking chair.

24. The nurse is teaching a client with seasonal affective disorder about proper use of a full- spectrum light. Which teaching will the nurse include? Begin using the light in April or May. Eyeglasses or contact lenses with ultraviolet filters should be used while using the light. Sit within 3 ft (1 m) of the light for approximately 2 hours soon after awakening. Do not engage in other activities while undergoing full-spectrum light therapy.

Sit within 3 ft (1 m) of the light for approximately 2 hours soon after awakening.

25. A client taking a diuretic twice daily for treatment of hypertension reports being awakened often by a full bladder. What teaching regarding the diuretic will the nurse provide? Take it immediately before going to sleep. Take it before 6:00 p.m. at night. Skip the bedtime dose of medication. Take the second dose when awakening to urinate.

Take it before 6:00 p.m. at night.

28. A nurse on the night shift notices that a client is grinding the teeth while sleeping. Which information will the nurse teach the client? Select all that apply. Teeth grinding is called bruxism. Teeth grinding can be caused by stress. You should observe for damage to teeth. With teeth grinding you should get regular dental care. You should limit caffeine at night.

Teeth grinding is called bruxism. Teeth grinding can be caused by stress. You should observe for damage to teeth. With teeth grinding you should get regular dental care. You should limit caffeine at night.

14. A 78-year-old resident of an assisted living facility has told the nurse of often feeling tired during the day but experiencing frequent awakenings during the night. The nurse is conducting a comprehensive sleep assessment. The nurse should be aware of what change in sleep characteristic that accompanies older age? a gradual decrease in the amount of sleep required an increase in the proportion of REM sleep an absence of recognizable sleep cycles an increase in the intensity of dreams

an increase in the proportion of REM sleep

1. A client diagnosed with impaired thermoregulation reports feeling uncomfortable due to excessive sweating. Which activity would help the nurse maintain the humidity of the environment? using electrical fans using a dehumidifier air conditioning the room keeping the window open

air conditioning the room

10. A client visits a health care facility and reports that he falls asleep nearly immediately in the evening but often awakens between 4 and 5 a.m. The nurse should assess for: alcohol consumption. regular exercise. environmental stimulus. recreational activities.

alcohol consumption.

6. A nurse is caring for an older adult client who has been prescribed flurazepam by the physician. Which effect of flurazepam is a potential hazard for clients taking the medication? drowsiness nausea and vomiting as a side effect excessive sleep due to cumulative effect risk of gastrointestinal upset

drowsiness

3. A nurse is making a bed for a client confined to bed due to coma. Which position should the nurse place the client in to facilitate bedmaking? lateral position supine position prone position Fowler's position

lateral position

5. A nurse is caring for an older adult client confined to bed who reports an inability to sleep. What activity should the nurse include in the client's plan of care to promote sleep? sleeping about 1 to 2 hours during the day watching television before sleep performing chair exercises during the day going to bed in the early evening if the client feels fatigued

performing chair exercises during the day

4. A nurse is caring for a client who is having difficulty breathing. Which bed accessory should the nurse use to provide a comfortable position to the client? chair pillows side rails headboards

pillows

8. A nurse is supervising a nursing assistant who is preparing an occupied bed. What action by the nursing assistant indicates a need for further learning? rolling the client to the far end of the bed pulling the draw sheet from below the client loosening the bed linen from one side of the bed wearing disposable gloves

pulling the draw sheet from below the client

21. The nurse is caring for a client with narcolepsy. The client reports experiencing being unable to move upon awakening from sleep. The client's spouse states that the client makes sandwiches in the middle of the night, yet the client does not recall this behavior. How does the nurse document these concerns? sleep paralysis and hypnogogic hallucinations cataplexy and hypnogogic hallucinations hypnogogic hallucinations and sleep paralysis sleep paralysis and automatic behavior

sleep paralysis and automatic behavior

20. A nursing student is changing the client's bed. Which action requires intervention from the nursing instructor? placing the bed in a high position removing the call light attached to the bed sheet tossing soiled linen on the floor placing the clean linen on a dry bedside table

tossing soiled linen on the floor

19. An 82-year-old client is newly admitted to an assisted living facility. Which intervention promotes safety at night for the client? using a night light in the bathroom leaving a bright light on in the bathroom administering diuretics at bedtime leaving the door open to the nursing hallway

using a night light in the bathroom