Exam 4-Nur 111

Sleep-wake cycle

"circadian rhythm" light and dark, best known

The nurse is doing teaching regarding medication administration for a client who is being discharged. Which instruction should be rewritten for this client? A.)Lasix 20 mg po bid B.)Colace 10 mg by mouth once daily C.)Naproxen 250 mg by mouth twice a day D.)Betapace 80 mg by mouth 6 AM and 6 PM

A

patient records

A formal, legal document, each patient record must be timely, complete, accurate, confidential, client specific

After a disaster plan is enacted, a nurse in a pediatric unit is asked to prepare a list of clients who can be discharged home due to a local incident involving many children. Which of the following clients should the nurse place on the potential discharge list? (Select all that apply.) A.) A preschooler with asthma who has scattered wheezes that resolve with PRN albuterol B.) A school-age child with a femur fracture in an external fixation device whose pain is controlled with PRN oral codeine C.) An adolescent client who is developmentally delayed, has a PICC line, and needs 6 more weeks of antibiotics D.) A toddler with a ventricular septal defect and bronchiolitis who is on 28% oxygen by oxyhood E.)An adolescent client who is 1 day postoperative following scoliosis repair and is on a PCA pump

A, B, C

Constructivist theory

Building information, experiences, knowledge acquired by ongoing assimilation

A home health client has a complicated case involving occupational therapy, respiratory therapy, a dietitian, the nurse, and a nurse's aide who provides assistance with bathing, housekeeping, and grocery shopping. Who is responsible for coordinating the client's care? A.)Physician B.)Occupational therapist C.)Case manager D.)Home health agency

C

A nurse is performing an admission assessment for a client. Which of the following responses by the nurse reflects the communication technique of clarifying? A.)"Now that we have talked about your medications, let's talk about your pain." B.)"Are you having other symptoms?" C.)"It sounds like your pain is intermittent." D.)"It seems as though you have really had a rough time these past few weeks."

C

An unlicensed assistive person (UAP) has previously performed client transfers (bed to chair) safely on many occasions. It would be inappropriate to delegate this unsupervised task to the UAP under which condition? A.)The unit has a new wheelchair. B.)The client is older. C.)It is the client's first time out of bed after surgery. D.)The UAP has just returned from an extended leave of absence.

C

Why do we sleep?

Cope with stress Conserve energy restore mind and body Vital for psychologic & Physiologic function

Compliance

Extent to which an individual's behavior follows medical or health advise coincides with medical advice

Adolescents (Sleep)

Fall asleep later- wake later irritability, anxiety, anger longer sleep on weekends

Group problems

Group think, groupd fails to critically examine its own processes Scapegoat, someone who has been targeted to take blame for a failure or problem

Health History

Health care experiences and current health habits and lifestyle patterns.

Formal

Leadership selection, goals set at higher level, management

Sleep hormones

Melatonin (encouraged by darkness) Growth hormones Cortisol inhibited at night

Andragogy

Methods and practices used in teaching adults, independent, self-directed, cooperative adults

Pedagogy

Methods and practices used in teaching children, teachers method of transferring knowledge to a student

Electroencephalogram (EEG)

Monitor brain waves associated with NREM & REM sleep

Insomnia

Most common Acute = days-weeks Chronic = months-more risk factors: Females >60 mental health disorder

Informal

Not bound by any set of rules, regulations EX. Study groups

PIE model

Nursing specific Planning interventions Evaluation

Senders & recivers

Senders, caregivers who are transmitting patient info, releasing care Receivers, caregivers who are accepting patient, patients info

Charting by exception

Significant findings to defined norms are recorded, WNL & WDL

SBAR

Situation, Background, Assessment, Recommendation

Sleep rest disorders

Sleep apnea Insomnia (most common) Narcolepsy Parasomnia (unpleasant behaviors during sleep) -Sleep walking -Night terrors - restless leg syndrome

polysomnography

Sleep study, records Oxygen, HR, RR, eye & leg movement

SOAPIER

Subjective data Objective Data Assessment Planning Interventions Evaluation Revision

Purpose of groups

To achieve goals that would be unattainable through individual effort alone

Social learning theory

Visually learning

Micronutrients

Vitamins, minerals, needed in smaller amounts

Infants (sleep)

Wake every 3-4 hours, eat, back to bed 6 months, slep through the night, daytime naps 1 year, 2 naps a day

circadian rhythm

a biological rhythm Our bodies in sync with environment, begins at 6 weeks old, regular pattern by 3-6 months

Health literacy

a person's capacity to learn about and understand basic health information and services, and to use these resources to promote one's health and wellness

What is sleep?

an altered state of consciousness

teeth

appear 5-8 months after birth, lose teeth at 7, have all permanent teeth by age 25

Macronutrients

carbohydrates, proteins, and fats, body needs in large amounts

Semi-formal

formal structure, Voluntary but selective membership,

Teaching individual patients

goal of health teaching is to improve the health of patients and their families

Secondary Groups

larger and less interconnected Ex. Professional associations, task groups, political parties

Hypersomnia

narcolepsy, extreme daytime drowsiness

Gardener's 8 Intelligences

naturalist, linguistic, logical-mathematical, musical, spatial, bodily-kinesthetic, intrapersonal, interpersonal

Factors affecting learning

neg emotions, pain, fatigue, Cultural considerations

Toddlers (Sleep)

resist going to bed wake frequently, may fear dark eliminating TV can help

Braden scale

sensory perception, moisture, activity, mobility, nutrition, friction and shear, pressure ulcers

Transference vs Countertransference

transference: in the client role and the nurse caring for you reminds of a neg. person in your life Countertransference: The nurses patient reminds them of someone neg. in their life

Adult learning theory

- Need to know why they should learn something - Prefer that others treat them as capable of self-direction - Have accumulated life experiences that can enhance their current learning -Are often ready to learn what they must know in order to take care of themselves

Factors that facilitate learning

-Readiness -Motivation -Active involvement -Relevance -Feedback -Nonjudgmental support -Simple to complex -Repetition -Timing

Do Not use list

-U, u (unit) -IU (international unit), -Q.D., QD, q.d., qd, Q.O.D., QOD, q.o.d., qod -Trailing zero (x.0mg) -Lack of leading zero (.Xmg) -MSO₄ and mgSO₄

5 rights to delegation

1. Right task 2. Right circumstance 3. Right person 4. Right direction/communication 5. Right supervision/evaluation teaching and assessment can bot be delegated

Group

3 or more people, must be effective for group work to be successful, all nurses be knowledgeable about the dynamics of group interaction

A client who is NPO, comatose, and receiving oxygen has cracked lips, dry mucous membranes, swollen gums, and caked mucus on the tongue and teeth. Which is the most appropriate nursing intervention for this client? A.)Clean the teeth and tongue with a swab soaked with saline as needed. B.)Clean the mouth every half hour with lemon-glycerin swabs. C.)Moisten the lips and mucous membranes with mineral oil. D.)Rinse the oral cavity with hydrogen peroxide, followed with water.

A

A hospital fails to be reimbursed for care a particular client received while in the emergency department. The client came in with chest pain, which was later diagnosed as gastric reflux. Which example is a problem in documentation that may have caused the lack of reimbursement? A.)The client's record contained an incorrect DRG. B.)The client was charged for an ECG. C.)A code cart opened and the client was charged for medications the client did not use. D.)The physician made a diagnostic mistake.

A

A new nursing graduate's first job requires 12-hour night shifts. Which strategy will make it easier for the nurse to sleep during the day and remain awake at night? A.)Wear dark wraparound sunglasses when driving home in the morning, and sleep in a darkened bedroom. B.)Exercise on the way home to avoid waiting for equipment later in the day at the gym. C.)Drink several cups of strong coffee or 16 oz of caffeinated soda when beginning the shift. D.)Try to stay in a brightly lit area when working at night.

A

A nurse is admitting a client who will undergo a craniotomy. During the planning phase of the nursing process, which of the following actions should the nurse take? A.)Establish client outcomes. B.)Collect information about past health problems. C.)Determine whether the client has met specific goals. D.)Identify the client's specific health problems

A

A nurse is planning an in-service training session about nutrition. Which of the following statements should the nurse include in the teaching? A.)"Fats provide energy." B.)"Carbohydrates repair body tissue." C.)"Fats regulate fluid balance." D.)"Carbohydrates prevent interstitial edema."

A

A nurse who works days fills in for a week for a nurse who works nights. After returning to the regular shift, the nurse feels tired all the time and finds it difficult to fall asleep at night. Which nursing diagnosis is most appropriate for this client? A.)Sleep Deprivation related to change in sleep-wake patterns B.)Risk for Injury related to somnambulism C.)Anxiety related to sleep apnea D.)Activity Intolerance related to excessive daytime sleepiness

A

The case manager is working with a jobless, homeless at-risk pregnant woman, who also has a toddler, in an outpatient community-based nonprofit organization. The case manager would include which topic as the priority in the plan of care? A.)Resources to provide proper nutrition during pregnancy B.)Job placement training to address her jobless situation C.)Educational resources and opportunities for her toddler child D.)Community-based support group for mothers with toddlers

A

The nurse explains to a client and family the relationship between rest and sleep, which includes which information? A.)Sleep always includes rest B.)Rest always includes sleep C.)Rest and sleep have no relationship D.)Sleep is part of the rest cycle

A

The nurse is caring for older adults in a long-term care setting. The nurse is aware that which physiological changes have the greatest impact on an older adult's nutritional status? A.)Xerostomia, loss of thirst sensation, and decrease in number of taste buds B.)Ill-fitting dentures, chronic illnesses, and fatigue C.)Cognitive impairment, bladder incontinence, and increase in gastric sections D.)Dental caries, weakness, and frequent infections

A

The nurse is seeing a 6-month-old infant and the parent in the clinic setting. The nurse is teaching the parent about dental care for the child. What information is not appropriate for the nurse to include in the teaching plan? A.)Brush teeth daily with a fluoride toothpaste. B.)Schedule the initial dental visit at this time. C.)Do not allow the infant to take a bottle to bed. D.)Seek professional dental attention for any problems or concerns.

A

Which guideline in organizing learning experiences is most appropriate when teaching clients about self-catheterization? A.)Teach the basics before any variations of self-catheterization. B.)Demonstrate while explaining the procedure. C.)Start by giving a lecture and visual presentation. D.)Cover all the aspects of catheterization.

A

While assessing an older client, the nurse notices that the client's teeth have obvious caries and that the client has difficulty swallowing. The client tells the nurse that the mouth feels very dry. The nurse's primary concern is that the client could experience which health problem from these findings? A.)Nutritional deficit B.)Acute pain C.)Altered elimination D.)Infection

A

A nurse is preparing to perform care activities for a client within their personal zone that requires the nurse to use touch. Which of the following activities should the nurse perform in this zon? SATA A.)Removing the clients dentures B.)Checking the clients eMAR C.)Palpating for pedal edema D.)Counting a radial pulse E.) Placing the clients food on the bedside tray

A, C, D

The nurse is examining role expectations and boundary issues causing conflict within a healthcare unit. Which issue should be addressed by the nursing staff? SATA A.)Lack of understanding B.)Effective communication C.)resistance to change D.)inaccurate information E.)Consistent cooperation

A, C, D

Which activities should the nurse recognize as supporting the building of skills for successful collaboration of interpersonal healthcare teams? SATA A.)Practicing with additional credentials to increase nursing authority B.)focusing care delivery on individual groups C.)Role playing scenarios to practice communication skills D.) Advocating for policy change with local legislation E.)Encouraging clinical problem solving through group work

A, C, D, E

The nurse is planning care for a client following a surgical procedure. Which collaborative action should the nurse include? SATA A.)Updating the physical therapist regarding the client's physical activity and tolerance earlier in the day B.)Changing the medication order after speaking with the client about adverse effects C.)Informing the pharmacist that the clients blood pressure (BP) is low and to hold the BP D.)Consulting the pharmacist regarding interactions between medications the client is prescribed E.) Informing the dietician that the client is on a special diet and needs reteaching about the diet

A, D, E

Cognitive theory

Acquiring information processing the information Using the information

Learning need

An identified deficit in knowledge, information, or skills needed to achieve a particular goal

Sedative-hypnotic medications

Anxiolytics/ antianxiety Barbiturates & Benzodiazepines Anti-parkinsons Opiods Anticonvulsants

A client has received a temporary colostomy bag during her treatment for colon cancer. The nurse would know which theory would most want the patient to demonstrate the skill? A.)Multiple intelligences theory B.)Social learning theory C.)Constructivist theory D.)Pedagogy

B

A client has specific cultural needs with regard to the plan of care. Where would this information be found? A.)Database B.)Problem list C.)Plan of care D.)Progress notes

B

A client is going to have a sleep study done and wants to know what type of tests to anticipate. Which test should the nurse state in the response? A.)Electrocardiography B.)Electroencephalography C.)Electromyelography D.)electrolysis exam

B

A client is in the emergency department after experiencing trauma from an automobile accident. The client lost consciousness at the scene of the accident but is now awake and alert. The nurse anticipates that the client will make which request? A.)Request food or water. B.)Request that the nurse notify the client's family. C.)Request the doctor's name from the nurse. D.)Request that the nurse notify the insurance company.

B

A client who reports shortness of breath requests the nurse's help in changing positions. After repositioning the client, which of the following actions should the nurse take next? A.)Encourage the client to take deep breaths B.)Observe the rate, depth, and character of the client's respirations C.)Prepare to administer oxygen D.)Give the client a back rub to promote relaxation

B

A graduate nurse is caring for clients and does not want to delegate tasks to the LPN/LVN because the nurse feels that the responsibility for care belongs to the RN. As a result, what may the newly licensed nurse experience? A.)Increased client satisfaction B.)Lack of trust from coworkers C.)Confidence that tasks will be done D.)Pride that clients are cared for appropriately

B

A newly licensed nurse is interviewing with the nurse manager who states the unit uses the team nursing model of care delivery. The new nurse knows this model provides care in which way? A.)The nurse provides, and is responsible for, all care during the shift. B.)Individualized care is provided by a team of care providers to whom the nurse delegates tasks. C.)There is a task-oriented care focus where the nurse delegates tasks to the team members. D.)The nurse is responsible for overseeing the total care of a number of patients 24 hours a day, 7 days a week, even if the nurse does not deliver all of the care personally.

B

A nurse is caring for a client who is postoperative and has paralytic ileus. Which of the following abdominal assessments should the nurse expect? A.)Frequent bowel sounds with flatus B.)Absent bowel sounds with distention C.)Hyperactive bowel sounds with diarrhea D.)Normal bowel sounds with increased peristalsise expect?

B

A nurse is participating in a community health education on the topic of nutrition. Which information presented by the nurse about the physiological effects of marasmus is accurate? A.)Abdominal ascites as a result of edema B.)Wasting of subcutaneous tissue, muscle, and fat C.)Development of dermatitis D.)Fatty degeneration of the liver

B

A nurse is participating in community health education on the topic of nutrition. Which information presented by the nurse about vitamin D deficiency in children is accurate? A.)It causes scurvy. B.)It causes rickets. C.)It causes beriberi. D.)It causes pellagra.

B

A nurse is planning an in-service training session about nutrition. Which of the following pieces of information should the nurse include? A.)Fat breaks down into amino acids. B.)Protein serves as an energy source when other sources are inadequate. C.)Glucose breaks down into ammonia. D.)Carbohydrates provide 9 cal/g of energy.

B

The newly licensed nurse is interviewing for a position on a medical/surgical unit. The nurse asks the manager what opportunities the nurse will have to develop skills, especially delegation. The manager tells the nurse that promoting delegation is a goal for the unit for which reason? A.)RNs are too valuable to do bed baths. B.)Client satisfaction increases. C.)There is not enough qualified staff. D.)Productivity is too low.

B

The nurse has chosen to work in a health promotion setting. The nurse understands what is the focus of this cost-containment strategy? A.)Information is gathered from the client to analyze for potential unidentified health concerns. B.)The client is assigned a primary healthcare provider to see on a regular basis to help identify health concerns. C.)Social media and other resources are used to provide general healthcare information to the client. D.)Prevention of disease, management of chronic illness, and health promotion help to bring down health costs.

B

The nurse is aware that vertically integrated health service organizations are one way to help control healthcare costs. What effect do these organizations have on healthcare outcomes? A.)Decrease in client satisfaction B.)Improved quality of care provided C.)Lack of coordination of services D.)Increase in client out-of-pocket costs

B

The nurse is preparing to teach an adult client to self-administer insulin at home. The nurse recognizes that this type of skill is representative of which domain of learning? A.)Linguistic B.)Psychomotor C.)Cognitive D.)Affective

B

The nurse is seeing a pregnant client in the outpatient clinic. The client is complaining of not being able to sleep well in her last trimester of pregnancy. What medical conditions are common with pregnant women at stage of pregnancy that could impact quality sleep? A.)Constipation and night sweats B.)Restless leg syndrome and gastroesophageal reflux disease C.)Nocturia and hives D.)Contractions and numbness in arms and fingers

B

The nurse is teaching a client about a disease process. The nurse validates that the client understands the teaching by documenting which information? A.)A family member's opinion B.)The responses of the client C.)That the teaching was done D.)That feedback questionnaires were used

B

The nurse knows that a client understands education about promoting restful sleep when the client responds with which statement? A.)"I'll make a list of things to do the next day and put it by my bedside to look at before I go to bed." B.)"I bought some flannel sheets to help me stay warm at night." C.)"I'll do push-ups before bedtime so I will be worn out and tired." D.)"I won't take my water pill anymore because it makes me get up in the night to go to the bathroom."

B

What is an important responsibility of the nurse in client education? A.)Insist that all clients use the Internet for medical information. B.)Inform clients of reputable Internet sites for healthcare information. C.)Tell clients that if they do not know how to use the Internet, they should take a course. D.)Tell clients that the Internet is not useful in providing medical advice.

B

A nurse is caring for a client who is receiving mechanical ventilation via a tracheostomy tube and has a gastrosoty tube for enteral feedings. which pieces of information are critical to communicate to the next nurse who woll be caring for this client? SATA A.) Room Temp B.)New prescriptions C.)Number of visitors D.)Critical lab values E.)Tracheal secretion characteristics

B,D,E

A nurse is planning care for a client who reports abdominal pain. An assessment by the nurse reveals the client has a temperature of 39.2°C (102.6°F), a heart rate of 105/min, a soft nontender abdomen, and menses overdue by 2 days. Which of the following findings should be the nurses priority. A.)Heart rate of 105/min B.)Soft nontender abdomen C.)Temperature D.)Overdue menses be the nurse's priority?

C

A nurse works in a hospital that uses a charting by exception documentation system. When providing care and performing assessments, the nurse may not address all of the sections on a client's flow sheet, especially if the client did not require the particular care mentioned in these sections. What is the best way for the nurse to indicate that these areas were addressed, but no care was needed? A.)Leave them blank. B.)Leave them blank, but then add an extensive explanation in the progress notes section of the chart. C.)Write N/A on the flow sheet in the areas that are not applicable to that client. D.)Make sure this information gets passed along in the shift report.

C

In teaching a client about heart disease, the client may need to know the effects of smoking before recognizing the need to stop smoking. In this situation, what factor can best facilitate client learning? A.)Readiness B.)Active involvement C.)Motivation D.)Allotted time

C

The newly licensed nurse is asking about what individuals are involved in case management. Which is the correct individual cited by the preceptor? A,)Nurses are the only providers involved in the client's care. B.)Nurses and healthcare providers are involved in the client's care. C.)Interdisciplinary team members are involved in the client's care. D.)Social workers are the only providers involved in the client's care.

C

The nurse is answering questions after a presentation on sleep at a local senior citizens' center. A client, in the late 70s, asks for an opinion about the advisability of napping for 15 to 20 minutes each afternoon. Which response by the nurse is most appropriate? A.)"Taking an afternoon nap will interfere with the ability to sleep at night." B.)"If enough sleep is obtained at night, naps are not needed." C.)"Unless a person has trouble falling asleep at night, a brief afternoon nap is fine." D.)"Consume coffee or some other caffeinated beverage at lunch to prevent drowsiness in the afternoon."

C

The nurse is caring for older adults with dementia in a long-term care facility. The nurse is aware that these clients can exhibit signs of sundown syndrome in the late afternoon/early evening timeframe. The nurse should be aware that which behavior is not a common manifestation of this syndrome? A.)Agitation B.)Anxiety C.)Apathy D.)Aggression

C

The nurse is giving instructions to a client who does not speak English. The client does not have an interpreter to assist. What is the best alternative? A.)Give written instructions in English and tell the client to have them interpreted at home by a friend or family member. B.)Respect the misinterpretation of the client as a cultural aspect as it can be uncomfortable for the client to question the nurse. C.)Obtain pamphlets, teaching materials, and instructions of any teaching in the language of the client. D.)Have the client make written notes in their native language of any teaching demonstrations performed by the nurse.

C

The nurse is working with an older client in the home. During assessment, the nurse assesses that the client has lost 2 more pounds, and the goal was for the client to gain 1 pound. The nurse determines that the client might benefit from a meal delivery service when the client makes which statement? A.)"I am too busy to eat." B.)"I eat a lot of fruits and vegetables." C.)"I do not have the ability to shop." D.)"I like to cook."

C

Primary groups

Close, person, and inclusive (friend groups)

A nurse is caring for a group of clients on a mental health unit. Which of the following actions should the nurse implement to establish therapeutic relationships with the clients? A.)Provide Sympathy during interactions B.)Focus on the words of clients C.)Control the pace of establishing the nurse-client relationship D.)Demonstrate genuineness when communicating

D

An RN has been assigned to care for several clients on the shift. An admitted client experiencing pneumonia is to arrive from the emergency department. The nurse plans to delegate which task to the LPN/LVN regarding this client? A.)Administering IV push morphine for pain B.)Performing admission assessment C.)Taking the telephone orders for morphine from the physician D.)Performing an ordered dressing change

D

The nurse is working in a busy pediatric ICU. Several of the nurses on the unit are interested, at the request of parents, in changing the rules to allow families to be present in a code situation for their child. The nurses are afraid to speak their minds openly because some of the doctors do not support the change and the nurses do not want to cause hard feelings. The nurse manager suggests a meeting of all concerned and might use which technique to help with decision making? A.)Present both sides of the argument to the group members. B.)Ask the nurses to present their changes. C.)Ask the members to be open minded. D.)Have group members present concerns and questions on paper.

D

The nurse is working with a pregnant woman who is considering breast feeding. The nurse would include what piece of information in the client teaching plan? A.)Exclusive breastfeeding reduces the incidence of otitis media by 100%. B.)Any breastfeeding reduces the incidence of gastrointestinal disorders by a small percentage. C.)Every mother has the ability to breastfeed her child. D.)Breastfeeding has been associated with a reduction in the incidence of sudden infant death syndrome.

D

Which client behavior may cause a nurse to suspect a literacy problem? A.)The client displays a pattern of compliance. B.)The client reads the instructions slowly. C.)The client recognizes that he or she does not know the information. D.)The client displays a pattern of making excuses for not reading the instructions.

D

Which skill would be most important to a nurse who provides community-based services in a Mexican-American senior center? A.)Having an in-depth understanding of the healthcare system B.)Having increased knowledge of the geriatric population C.)Having management experience to run the clinic D.)Having knowledge of the client's culture

D

Focus Charting

DAR (Data, Action, Response).

problem oriented medical record (POMR)

Data arranged according to patient problems rather than source of information Pros: Encourage collaboration, Allow for rapid identification of current patient needs Cons: Caregivers vary in their ability to use the required charting format, challenging and inefficient, extremely time consuming

Alterations of oral health

Dental caries (cavities) Periodontal disease (gum disease) Plaque (bacteria on enamel) develops into tartar (calculus) Gingivitis (red, swollen gums) Pyorrhea (advanced periodontal disease

Older adults (sleep)

Don't get into deep sleep more disturbed sleep = negative impact on life

Electronic Documentation

Electronic health record (EHR, whole record) Electronic medical record (EMR, this visit). Electronic medication administration records (eMARs)

Newborns (Sleep)

Enter REM sleep immediately Sleep on back to decrease SIDS Put to bed when sleepy not asleep

Non-REM

Non-rapid Eye movement: 80% NI:Very light sleep, eyes & muscle move slow NII: Light sleep, Eye movement stops (HR, BP, RR slow down) NIII & NIIII: Start of deep sleep, eyes do not move, muscle activity stops, difficult to arouse (bedwetting, night terrors, sleepwalking)

teaching plans

Nutrition, physical activity, personal safety, medication, need for follow up care

psychologic effects on sleep

Poor concentration memory issues difficulty making decisions risk taking behavior

Behaviorist theory

Positive & negative reinforcement

REM

Rapid eye movement 20%: starts 70-90 minutes after sleep begins, body & brain very active, Breathing more rapid, irregular, shallow. Thinking, learning, organizing information.

Sleep apnea

Repetitive periods of complete or partial airway obstruction >5 apneic an hour >30 is severe Use CPAP Risk factors: Obesity & large neck Smoking males