Chapter 34 Rest and Sleep

"My boys love to roughhouse in their room right before bedtime."

The nurse is promoting bedtime rituals with a family. Which statement indicates the nurse may need to provide further instructions to the mother?

14 to 18 hours

The nurse is teaching a first-time parent about the newborn's sleep needs. The nurse would inform the parent that newborns sleep approximately how many hours per day?

disturbed sleep pattern

The nurse learns during the assessment of a client that the client has difficulty falling asleep, wakes up early, and does not feel refreshed in the morning. This client is most likely experiencing:

do you usually go to bed and wake up about the same time each day?

Which interview question would be the best choice for the nurse to use to assess for recent changes in a client's sleep-wakefulness pattern?

a diuretic administered twice daily at 9 a.m. and 9 p.m

A nurse is reviewing the medication administration record. Which order does the nurse question?

stage 2

A client begins snoring and is sleeping lightly. The stage of sleep is:

hypothalamus

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?

older adults

A nurse working in a health clinic assesses sleep patterns during each health assessment. Based upon the nurse's knowledge regarding sleep needs, the nurse recognizes which age group as generally needing the least amount of sleep?

discuss the sleep pattern with the health care provider

A client calls a sleep clinic helpline and describes the spouse's sleep patterns of snoring loudly then becoming startled and waking up five or six times a night. The client is asking how to improve the spouse's sleep patterns. Which Information will the nurse include in teaching about healthy sleep patterns?

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

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?

- waking at the same time every morning - removing bedtime distractions such as watching television in bed - practicing relaxation techniques

A client describes difficulty falling asleep and difficulty maintaining sleep, and reports daytime fatigue and inability to concentrate. The nurse suggests which noninvasive techniques that may help promote restful sleep? Select all that apply.

- eat a small protein- and carbohydrate-containing snack about an hour before bedtime - discontinue the use of tobacco or tobacco products - perform moderate exercise

A client informs the nurse about difficulty getting a restful sleep. What education can the nurse provide to encourage adequate sleep and rest? Select all that apply.

the client will likely not be able to sleep

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?

- go on a daily walk - decrease caffeine intake - adhere to a regular schedule for waking and going to sleep

A client reports periodic difficulty falling asleep. Which teaching will the nurse provide? Select all that apply.

activates the receptors for the hormone melatonin

A client with difficulty sleeping is prescribed ramelteon. The client asks the nurse, "How does this medicine work?" Which information would the nurse include in the response?

modify the sleep environment to stimulate quiet and darkness

A factory worker has a work schedule involving rotating work hours between days, evenings, and nights. The client tells the nurse about being a "morning person" and not sleeping well when working the night shift. Which information will the nurse teach the client about sleep hygiene?

provide an opportunity for the client to talk about concerns

A new client in the medical-surgical unit complains of difficulty sleeping and is scheduled for an exploratory laparotomy in the morning. The nursing diagnosis is Sleep Pattern Disturbance: Insomnia related to fear of impending surgery. Which step is most appropriate in planning care for this diagnosis?

they are sleep deprived to some degree

A newly admitted client states to the nurse, "I average about 5.5 hours of sleep per night." What determination of this client's sleep patterns does the nurse discuss with the client?

insomnia

A nurse at the health care facility is caring for an older adult client who complains of sleeplessness. Which condition is a manifestation of depression in an older client?

"create a bedtime routine."

A nurse is caring for a client with insomnia. Which teaching will the nurse provide to help the client improve sleep?

sleep deprivation

A nurse is caring for a client with restless leg syndrome who complains of sleeplessness. Which nursing diagnosis is most appropriate for this client?

"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 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.

they may be disoriented on awakening

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:

use a night light in the bathroom

An 82-year-old client is newly admitted to an assisted living facility. Which intervention promotes safety at night for the client?

most sedative hypnotics lose their effect after 1 or 2 two weeks of administration

For the last 3 weeks, a nurse in a long-term care facility has administered a sedative hypnotic to a client who complains of insomnia. The client does not seem to be responding to the drug and is now lying awake at night. What is the most likely explanation?

pulse rate is slow

In Stage 4 sleep, the:

"this is normal development for children in this age group."

Parents tell the nurse that their 5-year-old is only sleeping 10 hours now and is refusing to take an afternoon nap. The nurse should teach the parents:

anticipate sleeping overnight at a health care center

The client is scheduled for a polysomnography to determine if the client has obstructive sleep apnea (OSA). The nurse instructs the client to:

OSA contributes to hypertension and heart disease

The nurse is admitting a client that has obesity and is diagnosed with obstructive sleep apnea (OSA). The client states, "I just wake up a lot and don't feel rested but it's not a big deal." What education should the nurse provide about the complications related to OSA?

observe the client's hours of sleep and review the client's sleep diary

The nurse is assessing a client for sleep disorders. The initial step in sleep assessment is:

"I know if I do not wear the CPAP the oxygen in my blood may drop and damage my heart."

The nurse is assessing a client with a history of sleep apnea who is noncompliant regarding wearing the continuous positive airway pressure (CPAP) apparatus. Which statement made by the client indicates understanding of risks related to noncompliance?

temazepam

The nurse is caring for a client who is having difficulty sleeping. Which medication does the nurse anticipate will be prescribed by the health care provider?

find a phone app that plays sounds of the city

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?

newborns sleep 16 to 17 hours per day

The nurse is caring for new parents. During her education session, the nurse instructs the parents on a newborn's sleep patterns. Which statement is accurate about a newborn's sleep patterns?

Sleep Pattern Disturbance related to acute pain

The nurse is completing an admission assessment for a client scheduled for back surgery after a construction accident. The nurse notes the client is having slowed speech and focus, irritability, yawning, and that he reports severe lumbar and right leg pain. The nurse suspects a nursing diagnosis of:

use caution when driving an automobile

The nurse makes the following assessment. A middle-age client reports falling asleep frequently at his job during the day, feels like he is not getting enough sleep at night (even though the number of hours of sleep is unchanged), continues to feel tired, and is not able to think clearly. Also, the client reports his wife believes he is irritable upon awakening. Nursing interventions include teaching the client to:

assess the client's vital signs and pulse oximetry

The nurse observes the sleep pattern of an obese client with cardiac disease and notes occasional periods of apnea. Which action should the nurse take?

inform parents that daytime napping decreases during the preschool period, and, by the age of 5 years, most children no longer nap

The pediatric nurse teaches parents about normal sleep patterns in their children. Which education point should the nurse include?

the child should limit fluid intake after supper

The student nurse is providing an education program for preschool parents. The nursing student should include which intervention to improve the child's sleep?

chronic sleep deprivation is present

What factor has been hypothesized by researchers regarding current thoughts on sleep?

eat some crackers with peanut butter at bedtime

Which activity would be appropriate to suggest to the client who reports having difficulty falling asleep every evening?

rapid growth

Which factor necessitates the need for more sleep in the adolescent population?