MH_Chapter 26: Sleep Disorder

A client reports to the nurse that he has been experiencing increased sleep latency during a time of interpersonal stress and has been taking over the counter sleep aids several times a week. When assessing for the potential adverse effects of this medication, the nurse should include what question?

"Do you ever find that you feel especially groggy in the morning after taking them?"

The nurse is assisting a client in understanding the drawback of using benzodiazepine receptor agonists (BzRAs) to promote sleep. Which drawback is the most important to inform the client about?

It is possible to develop a dependence on the medication.

A nurse is reading a journal article about sleep. When reviewing the statistics about the average person in the Unites States, which of the following would the nurse most likely find as the average duration of sleep?

6-6.5 hours

A nurse is preparing a discussion about sleep for a senior adult community group. When talking about the usual number of hours of sleep individuals get per night, which amount would the nurse most likely include?

6-6.5 hours/night

When providing education to a group of health care providers who do shift work, a nurse educator should include which statements? Select all that apply.

- Sleep during the day is not the same as sleep at night. - Irregular bowel patterns can result from sleep associated with shift work. - Establishing a consistent sleep routine reduces injury.

A client with extreme fatigue reports not sleeping well for several months. Which topics should the nurse include when assessing this client? Select all that apply.

- Sleep environment - Current sleep schedule - Amount of daytime sleepiness - General sleep hygiene behaviors

A geriatrician is assessing an 84-year old male recently admitted to a sub-acute medical unit of a hospital for rehabilitation following recent falls and a hip contusion. Which of the following aspects of the client's sleep history would the physician want to follow up with education?

"I make sure that I take a long nap each afternoon to compensate for my frequent waking at night."

The nurse has been teaching a client ways to improve sleep patterns at home. The nurse evaluates teaching to have been effective when the client states which of the following?

"I need to take any caffeine-containing cold medicine no later than mid-afternoon."

The nurse is seeing a client who is employed as a long haul truck driver. The client reports symptoms of insomnia over the past two weeks. The client is concerned about taking medication to aid sleep due to the risk of being over-sedated. Which non-pharmacological intervention should the nurse recommend? Select all that apply.

- Tense and relax each muscle group in the body just before bedtime. - Do the same thing every day when preparing for bedtime. - Avoid any tea, coffee, or energy drinks during the day.

A client asks the nurse, "What causes insomnia?" Which response by the nurse would be most appropriate?

"No one factor is associated with causing insomnia."

When discussing options for medications to aid sleep, the client asks the nurse why it would be beneficial to take a benzodiazepine receptor agonist. Select the nurse's best response.

"The body absorbs the medication quickly. You will be able to fall asleep faster."

A nurse is teaching a client about appropriate sleep measures. During the education session, the nurse cautions the client about consuming caffeine based on the understanding that caffeine can result in which of the following? Select all that apply.

-Increased sleep latency -Decreased total sleep time -Decreased REM sleep

A nurse is teaching a client with insomnia about stimulus control. Which of the following would the nurse include in the education?

"You should avoid eating or watching television in your bedroom."

The nurse is concerned that a client is at risk for insomnia. Which findings caused the nurse to have this concern? Select all that apply.

- Age 70 - Female gender - Ingests alcohol daily - Widowed for 3 years

A nurse is reviewing the medication history of several clients experiencing difficulty with sleep. Which medication would the nurse most likely identify as playing a role due to its effect on decreasing rapid eye movement (REM) sleep? Select all that apply.

- Alcohol -Amphetamines - Barbiturates - Benzodiazepines - Antidepressants

A nurse is teaching a client about sleep hygiene and ways to promote sleep. Which of the following would the nurse include in the education plan? Select all that apply.

- Avoiding caffeine after mid-afternoon - Establishing a regular time for bed - Using the bedroom for sleep and sex

A nurse is assessing a client who is suspected of having hypersomnolence. Which of the following would the nurse expect to find? Select all that apply.

- Difficulty awakening in the morning - Functional impairment - Sleep inertia

A mother brings her 6-year-old son to the sleep clinic and tells the nurse that the child sleepwalks approximately 5 out of 7 nights each week. The mother adds that her son is very difficult to awaken during these episodes; when she can awaken him, he looks confused and just stares at her. What are some general safety interventions the nurse can recommend to this mother for this client? Select all that apply.

- Ensure that the child gets adequate sleep. - Keep a sleep log to assist in identifying how much sleep the child needs to prevent a sleepwalking event. - Install deadbolt locks - Secure all the windows

A 50-year-old client with insomnia is being treated in the sleep clinic. The nurse is conducting a teaching session with the client about tips for sleep. Which information would the nurse most likely include? Select all that apply.

- Establish a regular bedtime and rising time. - Abstain from alcohol - Exercise regularly - Use the bedroom only sleep and sex

Which of the following should be included in the client education plan to promote good sleep habits? Select all that apply.

- Exercise regularly - Provide a comfortable enviroment - Refrain from caffeine after mid-afternoon - Abstain from alcohol

A client reports difficulty sleeping when the clocks are changed in the spring and fall. Which should the nurse recommend to help this client achieve adequate sleep? Select all that apply.

- Limit the bedroom to sleeping and sex - Stick to regular bedtime and rising time - Avoid caffeine and nicotine before bedtime

A nurse is preparing to conduct a sleep history for a client. Which area would the nurse most likely include in this assessment? Select all that apply.

- Quality of sleep - Sleep hygiene - Perception of the sleep problem - Sleep environment - Sleep quality

The nurse is assessing a client who was involved in a car accident two weeks prior. The client describes sleep quality as "poor" but is unable to elaborate further. Which intervention should the nurse recommend?

Keep a sleep diary

According to the Centers for Disease Control and Prevention, approximately what percentage of Americans sleep less than seven hours per night?

33%

A client states that he has been treated for obstructive sleep apnea syndrome. You note this and report to the oncoming evening nurse to be aware of which of the following symptoms?

Loud snoring or gasping during sleep

A client reports falling asleep after dinner and being wide awake at 0300. For which type of circadian rhythm sleep disorder should the nurse plan care for this client?

Advanced sleep phase

Which of the following circumstances would a person expect to cause the most sleep difficulties?

An overseas flight to Ireland

During an admission interview, a client informs you that she has been taking an over-the-counter sleeping pill. She asks you if the pill will interact with any medications. You tell the client that OTC sleep medications may have adverse effects when used with anticholinergic drugs and central nervous system depressants. You made this statement based on the knowledge that most OTC sleeping pills contain which of the following?

Antihistamines

A physician is providing care for a 40-year-old male who is experiencing chronic insomnia in recent months while going through a divorce and child custody proceedings. The man is requesting a prescription for "sleeping pills" to help him through this time. Which of the following statements forms a valid basis for the physician's plan for treatment?

Behavioral therapies, counseling and education may be of some use for the client

The nurse is seeing a client who reports having insomnia. After taking the client's history, the nurse notes the client has been experiencing low mood and anxiety over the past two weeks. Which intervention would be most appropriate for the nurse to include in this client's plan of care?

Cognitive behavioral therapy

A client is telling a nurse about repeated frightening dreams that the client has been having and that have awakened the client from sleep. When assessing this complaint further, which would the client most likely report?

Continued sense of fear after awakening

The parents of a 15-year-old boy are frustrated at his persistent inability to fall asleep at a reasonable hour each night, as well as the extreme difficulty that they have rousing him in the morning. While sleepy after waking, the son claims not to feel drowsy after lunch or in the evening. Which circadian rhythm disorder would the nurse suspect?

Delayed sleep phase type

A client comes to the clinic reporting insomnia that began with depression that was diagnosed about 2 months ago. The client informs the nurse that she goes to bed at the same time each night, drinks a glass of warn milk prior to bedtime, and mediates for 20 minutes before turning out the lights. What does the nurse suspect is the cause of this client's insomnia?

Depression

When performing a nursing history with a client reporting a sleep disturbance, it is important to assess for which potential contributing factor to sleep difficulties?

Daily use of caffeine

Jacob is admitted to a hospital with pneumonia. During the admission assessment, Jacob reveals to the nurse that he has had sleeping difficulties for the past 2 years. After testing, it is discovered that Jacob has sleep apnea. Which of the following would be the primary nursing diagnosis for Jacob related to his sleep condition?

Disturbed Sleep Patterns

A client has been prescribed zolpidem for insomnia disorder. What common side effect should be included in the medication teaching for this client?

Drowsiness

A client reports recent sleep patterns that are suggestive of insomnia. What is the nurse's best initial action?

Encourage the client to keep a sleep diary to accurately monitor sleep patterns

Which of the following is the primary symptom to occur in narcolepsy?

Excessive sleepiness

A nurse is seeing a client who reports having difficulty establishing a regular time to go to bed each night. Which occupation does this client most likely have?

Flight attendant

The nurse is seeing a client who has been given a diagnosis of hypersolemnence. Which treatment intervention should be discussed first with the client?

Habits associated with normal sleep

The nurse is caring for a client who is post-operative from a total hysterectomy. The nurse should anticipate which change is going to impact the client's recovery from surgery?

Hormone fluctuations decrease sleep quality.

After teaching a group of nursing students about shift-work type circadian rhythm disorder, the instructor determines the need for additional education when they identify which of the following as characteristic of a person who rotates shifts?

Improved alertness during work

Which of the following statements about sleepwalking is most accurate?

Individuals who are sleepwalking are typically confused if awakened.

A client who comes to the sleep clinic reports being tired in the morning. Upon further assessment, the client discusses difficulty falling asleep at night and waking up in a bad mood in the morning. The client also acknowledges difficulty staying awake during the day. Which of the following diagnoses would the nurse suspect?

Insomnia

A nurse preceptor working in a sleep clinic informs a graduate that the most common sleep disorder in adults is which of the following?

Insomnia

After teaching a group of nursing students about sleep-wake disorders, the instructor determines that the education was successful when the students identify which of the following as the most prevalent disorder?

Insomnia

Amanda is a 42-year-old woman who has been diagnosed with severe depression. Which of the following sleep disorders is most likely to coincide with depressive disorders?

Insomnia

The nurse is counseling a client who is grieving the loss of her spouse 4 months ago. The client reports having trouble falling and staying asleep at least 3 to 4 nights per week. The nurse recognizes the client is most likely experiencing which sleep-wake disorder?

Insomnia disorder

A nurse has acted on the obligation to be fit to practice by planning which non-work activities?

Meeting a friend for lunch at noon after the last night shift

A nursing student has learned that the sleep-wake cycle is partially regulated by which of the following hormones?

Melatonin

A client is prescribed Ramelteon (Rozerem). The nurse understands that this drug is classified as which of the following?

Melatonin receptor agonist

A nurse walks into a client's room to administer medications and finds the client sitting up in a chair. He is holding the newspaper but appears to be sleeping and not reading. His wife tells the nurse that he does this all the time and sometimes falls asleep while driving. For what should the nurse assess this client?

Narcolepsy

A nurse is reading a journal article about sleep-wake disorders. The article mentions a REM disorder. Which of the following would the nurse expect to be discussed?

Nightmare disorder

A client comes to the sleep clinic and reports fatigue and daytime sleepiness. Assessment reveals a weight gain of 40 lbs over the last year following smoking cessation and a history of gastroesophageal reflux disease (GERD). The client's wife says that her husband snores so loudly, she cannot remember the last time that she slept well. From what should the nurse suspect this client is suffering?

Obstructive sleep apnea syndrome

When educating a client on insomnia, which of the following would the nurse include?

One of the major reasons for insomnia is depression.

A client is diagnosed with a parasomnia that affects the rapid eye movement (REM) sleep phase. While preparing for dischage planning, which medication does the nurse anticipate will be ordered for this client?

Phenothiazine

The nurse assesses a female client who reports losing tone in her legs after laughing heavily. The nurse should anticipate the client will require which intervention?

Polysomnogram

An 85-year-old client has been diagnosed with insomnia disorder. Which of the following would be the priority for this client?

Promoting client safety

A client is prescribed a melatonin receptor agonist to treat her insomnia. The nurse would identify which drug as being prescribed?

Ramelteon

A new graduate nurse is experiencing trouble re-establishing healthy sleep after completing a set of shifts on a hospital medical unit. The nurse works both 12-hour day and night shifts. Which sleep-promoting agent would be best for the nurse to normalize sleep while maintaining fitness to practice?

Ramelteon

The nurse observes a client talking while asleep accompanied by rapid leg movements. Which type of sleep disorder should the nurse suspect this client is experiencing?

Rapid eye movement sleep behavior

A client with a sleep disorder has been ordered trazodone. The nurse correctly identifies this medication as belonging to which classification?

Sedating antidepressant

The client is a single mother studying broadcast journalism. The client works two part-time jobs in addition to school to cover family and educational expenses. Last night driving home from work the client drifted off the road and nearly had an accident. Luckily there was no harm, but the client realized the need to change a life factor, because the client is most likely suffering the negative consequences of:

Sleep deprivation

The nurse is seeing a client who reports sleeping 8 or 9 hours per night but waking up feeling unrested. The nurse is interested in determining how much actual sleep the client is getting while the client is physically laying in bed in order to identify the underlying problem preventing quality sleep. What does the nurse need to help the client investigate further?

Sleep efficiency

A child is diagnosed with a parasomnia occurring during the non-REM stage of sleep. The child's history reveals emotional experiences that are frightening. Which condition would the nurse most likely suspect?

Sleep terrors

The nurse is providing counseling to a client who is experiencing depression. When providing education to the client about the importance of each stage of sleep, which teaching point should the nurse include?

Slow-wave sleep plays an important part of helping the body repair.

A client with insomnia is instructed to avoid watching television and refraining from doing anything in the bedroom except sleep. Which intervention is being used?

Stimulus control

A client comes to the clinic for evaluation. The nurse suspects that the client is experiencing advanced sleep phase syndrome (ASPS). Which client complaint would the nurse identify as supporting the suspicion?

Trouble staying awake in the evening and waking up in the morning feeling rested.

A nurse is assessing a client who reports feeling unrested throughout the day. Which factor should signal the nurse to assess further for obstructive sleep apnea (OSA)?

The client is post-menopausal

The nurse is providing education to an older adult who is concerned about age-related changes in sleep. The nurse should provide the client with what information?

With advancing age, people normally become more sleepy at night