Nursing Fundamental Chapter 35- rest and sleep

A nurse is conducting an assessment of a middle-aged client who reports difficulties with sleeping at night. Which information would the nurse correlate with the client's sleep-wakefulness pattern? Select all that apply. "I usually go to bed around 9 and get up at about 7." "I usually get up two to three times a night to urinate." "I'm always tired and feel like I don't have much energy anymore." "I like to keep a dim light on during the night in case I need to get up." "I have never tried using any medicine to fall asleep."

"I usually go to bed around 9 and get up at about 7." "I usually get up two to three times a night to urinate."

A school nurse is speaking to a group of parents regarding the sleep needs of adolescents. Which statement by a parent indicates a need for further education? "Adolescents naturally develop an owl-like sleep pattern in which they go to bed later and sleep later in the morning." "Academic performance in adolescents is good when they sleep about 7 hours per night." "Adolescents catch up on sleep on the weekends, when they typically sleep later." "Adolescent girls are more likely to develop insomnia than boys."

"Academic performance in adolescents is good when they sleep about 7 hours per night."

The nurse awakens a client while the client is experiencing rapid eye movement sleep. What statement made by the client indicates they were awakened during REM sleep? "It feels like I just went to sleep." "I was having a great dream and I remember all of it." "I heard you immediately when you came in my room." "I feel really cold."

"I was having a great dream and I remember all of it."

A hospitalized client informs the evening shift nurse about not being able to sleep without a shot of whiskey each night before bed and asks if the spouse can bring in a bottle. Which is the best response by the nurse? "Let's discuss that with your health care provider." "It will be difficult for you to continue that routine in the hospital." "Go ahead and ask your spouse to bring a bottle." "Do you really think that is a good habit?"

"Let's discuss that with your health care provider."

A client comes to the clinic and states to the nurse, "I am traveling overseas for a project frequently and am having a difficult time adjusting because of jet lag. What is the best response by the nurse? "If you have jet lag once, you shouldn't have any further problems on your next trip overseas." "You should take sleeping pills when you board so that you will sleep until you arrive at your destination. "Light therapy can be beneficial and help ease the transition to a new time schedule or zone." "Try to stay awake for the duration of the flight and sleep when you arrive."

"Light therapy can be beneficial and help ease the transition to a new time schedule or zone."

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."

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 to 17 total hours of sleep time in a 24-hour period." "Your child should get 12 to 15 total hours of sleep time in a 24-hour period." "Your child should get 10 to 13 total hours of sleep time in a 24-hour period." "Your child should get 9 to 11 total hours of sleep time in a 24-hour period."

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

A new parent calls the pediatric nurse to talk about the 4-month-old infant, who sleeps "all day long." The nurse informs the parent that an infant of this age requires how many hours of sleep? 12 to 16 hours each day 8 to 9 hours each day 10 to 11 hours each day 17 to 18 hours each day

12 to 16 hours each day

A nurse is caring for a client diagnosed with sleep apnea. What guidance should the nurse provide the client to promote sleep? Encourage the client to work at night. Avoid sedatives for sleeping. Encourage deep breathing exercises. Create good ventilation in the room.

Avoid sedatives for sleeping.

The parents of a newborn ask when they can expect the newborn to sleep through the night. The nurse responds that the newborn will likely sleep through the night by what age? 12 weeks 6 to 9 months 1 year 18 months

6 to 9 months

The nurse observes the sleep pattern of a client with a BMI >30 and cardiac disease. The nurse notes occasional periods of apnea. Which action should the nurse take first? Assess the client's vital signs and pulse oximetry. Administer bronchodilators. Ask a colleague to come and observe the sleep pattern. Review the client's health record for factors contributing to sleep disturbances.

Assess the client's vital signs and pulse oximetry.

Which is not a lifespan consideration for sleep cycles? By middle age, the frequency of nocturnal awakenings decreases, and satisfaction with sleep quality increases. Newborns can sleep up to 16 to 18 hours per day. Getting the toddler and preschooler to fall asleep is a common problem. In adolescents, there is a shift to later evening bedtime.

By middle age, the frequency of nocturnal awakenings decreases, and satisfaction with sleep quality increases.

A nurse is explaining the use of sleep hygiene to a client experiencing insomnia. Which statement accurately describes recommended guidelines for the use of this technique? Select all that apply. Drink an alcoholic beverage before bedtime. Take frequent naps during the day. Eat a light meal before bedtime. Sleep in a dark room that is as warm as possible. Take a warm bath before bedtime.

Eat a light meal before bedtime. Take a warm bath before bedtime.

A perimenopausal woman reports insomnia. Which intervention(s) will the nurse suggest to the client? Select all that apply. Nap frequently during the day to make up for the lost sleep at night. Eliminate caffeine and alcohol in the evening because both are associated with disturbances in the normal sleep cycle. Exercise vigorously before bedtime to promote drowsiness. Eat a small snack of protein and carbohydrate before bedtime. Discuss the use of a sleep aid with the health care provider.

Eliminate caffeine and alcohol in the evening because both are associated with disturbances in the normal sleep cycle. Eat a small snack of protein and carbohydrate before bedtime. Discuss the use of a sleep aid with the health care provider.

A middle-aged client reports to the nurse that the client has difficulty falling asleep at night. The nurse assessed the client as having poor sleep hygiene habits. What should the nurse instruct the client to try? Select all that apply. Establish a set time to go to sleep each night. Drink one or two ounces of alcohol before bedtime. Eat a snack that contains a small amount of fat. Perform moderate exercise three or four times each week. Participate in an enjoyable activity each day.

Establish a set time to go to sleep each night. Perform moderate exercise three or four times each week. Participate in an enjoyable activity each day.

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.

A nurse is preparing a presentation regarding hypnotic medications. What information should the nurse include? Select all that apply. Hypnotics induce a normal sleep pattern. Hypnotics may impair waking in a client. Hypnotics are safe for long-term use. Hypnotics may cause dependence. Tapering of doses may be required after long-term use.

Hypnotics may impair waking in a client. Hypnotics may cause dependence. Tapering of doses may be required after long-term use.

A nurse notes that a client admitted to a long-term care facility sleeps for an abnormally long time. After researching sleep disorders, the nurse learns that which area of this client's brain may have suffered damage? Cerebral cortex Hypothalamus Medulla Midbrain

Hypothalamus

The client is sleeping, and arousal is easy. Occasionally, the client exhibits involuntary muscle jerking, which appears to startle the client. Vital signs are unchanged from 1 hour ago. The nurse assesses the stage of nonrapid eye movement (NREM) sleep, which the client exhibits as Stage: I. II. III. IV.

I

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.

A nurse is providing community education about the importance of getting enough sleep. Which information about REM sleep is most accurate? It plays a role in memory. Muscle tone is enhanced. The person is easily arousable. The blood pressure decreases.

It plays a role in memory.

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.

Which activity is appropriate to suggest to the client who states that they have difficulty falling asleep at night? Take a cool shower before bedtime. Keeping the room cool and as dark as possible. Exercise lightly for 30 minutes before sleep. Watch television for a few minutes to induce sleepiness.

Keeping the room cool and as dark as possible.

The client reports to the sleep clinic for a study following reports of sleepwalking and enuresis. Which sleep stage of non-rapid eye movement (NREM) sleep is affected based on the client's reports? NREM alpha NREM theta NREM delta NREM kappa

NREM delta

A nurse is reviewing a journal article about the physiology of sleep. The nurse demonstrates understanding of the information by identifying which neurotransmitter as being involved with excitation? Select all that apply. GABA Norepinephrine Acetylcholine Dopamine Serotonin

Norepinephrine Acetylcholine Dopamine Serotonin

A new client in the medical-surgical unit reports difficulty sleeping and is scheduled for an exploratory laparotomy in the morning. The nurse identifies the nursing concern of altered sleep pattern with insomnia related to fear of impending surgery. Which step is most appropriate in planning care for this this client's nursing concern? Help the client maintain normal bedtime routine and time for sleep. Provide an opportunity for the client to talk about concerns. Use tactile relaxation techniques, such as a back massage. Bring the client a warm glass of milk at bedtime.

Provide an opportunity for the client to talk about concerns.

The nurse is attempting to wake a client from sleep and is having a difficult time arousing them. What stage of sleep does the nurse identify the client is experiencing? REM sleep stage 1 NREM sleep stage 4 NREM sleep REM rebound period

REM sleep

An adult client reports sleep latency of approximately 45 minutes each night. What action should the nurse take? Encourage physical activity 30 minutes before bed. Assess the client's usual evening food intake. Document this expected assessment finding. Secure referrals for treatment of insomnia.

Secure referrals for treatment of insomnia.

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.

A nurse attempts to wake a sleeping client who is scheduled for tests. The client is easily aroused from sleep. Which stage of sleep is was this client most likely experiencing? Stage I Stage II Stage III Stage IV

Stage II

The nurse is creating a plan of care for a client that is reporting an inability to sleep and rest. What outcome criterion will the nurse address for a goal that the client will demonstrate physical signs of being rested? The client reports a decrease in sleep latency to 10-15 minutes. The client has decreases both in under-eye circles and in excessive yawning by 1 week. The client reports less anxiety regarding falling asleep. The client reports drinking only one cup of coffee a day.

The client has decreases both in under-eye circles and in excessive yawning by 1 week.

A client is worried and states, "I just know I won't be able to sleep before my surgery." What sleeping pattern would the nurse anticipate? The client will likely not be able to sleep. The worry will make the client fall asleep quickly. The client will probably not be able to stay asleep. The client will likely sleep all night.

The client will likely not be able to sleep.

A nurse is working with an older adult client who has been diagnosed with onset insomnia and informs the nurse about waking at least once during the night. What actions by the nurse can help promote adequate sleep? Select all that apply. The nurse advises the client to exercise no closer than 6 hours to bedtime. The nurse encourages the client to remove the television from the bedroom. The nurse encourages the client to minimize caffeine intake several hours prior to bedtime. The nurse helps the client come up with a bedtime routine that can be implemented each night. The nurse teaches the client that shorter, unbroken sleep periods are not normal.

The nurse advises the client to exercise no closer than 6 hours to bedtime. The nurse encourages the client to remove the television from the bedroom. The nurse encourages the client to minimize caffeine intake several hours prior to bedtime. The nurse helps the client come up with a bedtime routine that can be implemented each night.

The nurse is assessing a client and determines that they are in rapid eye movement (REM) sleep. What finding indicates to the nurse that the client is in this stage? There is rapid eye movement under the eyelids. There is muscle jerking that may awaken the individual. Respirations are regular. The individual is transitioning from wakefulness to sleep.

There is rapid eye movement under the eyelids.

The nurse should obtain a sleep history on which clients as a protocol? only clients who have been suffering from a sleep disorder only clients who suffer from a sleep disorder or have been unconscious clients who suffer from a sleep disorder or who are spending time in the CCU all clients admitted to a health care agency

all clients admitted to a health care agency TAKE ANOTHER QUIZ

The client is scheduled for a polysomnography to determine if the client has obstructive sleep apnea (OSA). The nurse instructs the client to: anticipate sleeping overnight at a health care center. take a prescribed sedative before trying to sleep. insert an oral appliance prior to attempting sleep. apply a facial mask that will deliver positive air pressure.

anticipate sleeping overnight at a health care center.

The nurse is instructing a parent on how to promote restful sleep for a child. What food would be the best bedtime snack for the child? cheese and crackers chocolate bar grapes with honey tuna salad

cheese and crackers

Which client will the nurse monitor closely for excessive sleepiness? client diagnosed with hypothyroidism client with type 2 diabetes client with an anxiety disorder client being treated for glaucoma

client diagnosed with hypothyroidism

A nursing instructor is describing the difference between sleep and rest. Which characteristic would the instructor identify as distinguishing sleep from rest? decrease in motor response to stimuli involves all the body systems decrease in cognitive response to stimuli decrease in awareness of environment

decrease in awareness of environment

Which physiologic change occurs during non-rapid eye movement (NREM) sleep? absence of muscle tone unregulated body temperature increased sympathetic nerve activity from wakefulness decreased brain activity from wakefulness

decreased brain activity from wakefulness

A client is experiencing slow-wave sleep. What assessment finding will the nurse identify as being consistent with this sleep stage? increased blood pressure decreased temperature irregular respirations increased heart rate

decreased temperature

During an orientation class for new RN graduates, the nurse educator identifies which conditions as potential risks for clients to experience sleep pattern disturbance? Select all that apply. depression substance use constipation type 1 diabetes mellitus stroke glaucoma

depression substance use constipation stroke

A client begins snoring and is sleeping lightly. The stage of sleep is: stage 1. stage 2. stage 3. stage 4.

stage 2.

The nurse is caring for a client who must receive medication overnight. As the nurse prepares to administer the medication, the client is noted to have relaxed muscle tone, is not moving, snores, and is difficult to arouse. How will the nurse document this stage of sleep? NREM stage 2 stage 3 REM

stage 3

The nurse is completing a sleep history on a client who reports sleeping problems. Which of the client's regular behaviors will cause the client to have difficulty with sleep? exercising immediately after getting off work at 5 p.m. drinking 2 cups of coffee every morning using a white noise machine to mask outside noise taking a diuretic at 9 a.m. and 5 p.m. daily

taking a diuretic at 9 a.m. and 5 p.m. daily

A nurse is discussing sleep with a group of orienting unlicensed personnel. The nurse explains that the older adults can have issues with physical safety in relation to the sleep patterns because: they nap in the afternoon, which lessens their hours of sleep at night. they are typically prone to sleep walking. they are the age group least likely to use prescribed sleep medications. they may be disoriented on awakening.

they may be disoriented on awakening.

The nurse is preparing a care plan for a client recently diagnosed with obstructive sleep apnea. What lifestyle factor has the ability to reduce the severity of the client's sleep apnea? chest physiotherapy supplementary oxygen weight loss temporary use of hypnotic sleep medications

weight loss