N206 CoursePoint--Rest and Sleep
A student nurse is preparing a presentation on sleep hygiene practices. What information should the nurse include? Select all that apply. Do 15 to 30 minutes of exercise prior to bedtime. Take a hot bath prior to bedtime. Eliminate caffeine intake 6 hours prior to bedtime. Do not watch television in bed. Use blackout or other types of curtains/blinds to keep the room as dark as possible.
Eliminate caffeine intake 6 hours prior to bedtime. Do not watch television in bed. Use blackout or other types of curtains/blinds to keep the room as dark as possible. Explanation: Caffine is a stimulant and can interfere with sleeping. Establishing a routine of only sleeping in bed, not reading or watching television there, and keeping the room as dark as possible may help decrease insomnia. Taking a hot bath or doing exercise prior to bedtime may increase the time it takes to fall asleep. These activites should been done at least 1 to 2 hours prior to bedtime.
The nurse knows that a client understands the purpose of a sleep diary when the client states:
"I will record the time I go to bed and how long it takes me to fall asleep." Keeping notes of times of sleep and waking are important details to record in a sleep diary. The notes are usually maintained for 14 days and include specifics such as all wakeful activities and sleep patterns in strange environments.
A nurse is reviewing the medication administration record. Which order does the nurse question? a) A diuretic administered once daily at 9am. b) A diuretic administered twice daily at 9am and 9pm. c) A diuretic administered twice daily at 9am and 5pm. d) A diuretic administered every other day at noon.
A diuretic administered twice daily at 9am and 9pm. Explanation: A diuretic should not be administered after 6pm. This will promote sleep if a full bladder does not awaken the client. Once daily dosing and every other day dosing is not cause for question.
A nurse on the night shift checks on a client and suspects that the client is in REM sleep. Which client cue is indicative of this stage of sleep? The client's eyes dart back and forth quickly The client has a slow, regular pulse. The client's metabolism and body temperature have decreased. The client's blood pressure decreases.
The client's eyes dart back and forth quickly The nurse would find the client's eyes dart back and forth quickly during REM sleep. The client would have a rapid or irregular pulse. The client's metabolism and body temperature would increase. The client's blood pressure would increase.
Which client condition indicates the presence of a parasomnia? a) a man who takes several hours to fall asleep each night b) a child who awakens with nightmares three to four times a week c) a child who wets his bed each night d) a woman whose restless leg syndrome often awakens her
a child who wets his bed each night Enuresis is considered a parasomnia. Insomnia and RLS are classified as dyssomnias.
The nurse is providing client education for the parents of an obese child diagnosed with obstructive sleep apnea. What treatment measures would the nurse explain during the education session? Select all that apply.
a weight loss plan, use of a continuous passive airway pressure (CPAP) machine, use of a mandibular advancement device (MAD) A weight loss plan, use of a continuous passive airway pressure (CPAP) machine, and the use of a mandibular advancement device (MAD) are treatment measures that the nurse would explain during the education session on obstructive sleep apnea. The use of antibiotics and sleeping pills would not be included. Counseling for depression is not necessary as the question is written.
In Stage 4 sleep, the: - blood pressure is elevated - pulse rate is slow - respirations are irregular - temperature increases
pulse rate is slow Explanation: During slow-wave sleep, the muscles are relaxed, but muscle tone is maintained; respirations are even; and blood pressure, pulse, temperature, urine formation, and oxygen consumption by muscle all decrease.
The nurse is promoting bedtime rituals with a family. Which statement indicates the nurse may need to provide further instructions to the mother? - "Our rituals include a short bedtime story each night." - "I let the kids have a snack of peanut butter crackers or fruit shortly before bed." - "My boys love to rough-house in their room right before bedtime." - "My daughter sleeps soundly when she has her bear in bed with her and the nightlight is on."
"My boys love to rough-house in their room right before bedtime." Explanation: Bedtime rituals such as reading stories, having a healthy carbohydrate snack, holding a favorite stuffed toy, and use of a nightlight promote a healthy sleep routine for children. Most studies show that exercise right before going to bed impedes the person's ability to fall asleep quickly.
The nurse is promoting bedtime rituals with a family. Which statement indicates the nurse may need to provide further instructions to the mother? a) "My boys love to rough-house in their room right before bedtime." b) "Our rituals include a short bedtime story each night." c) "My daughter sleeps soundly when she has her bear in bed with her and the nightlight is on." d) "I let the kids have a snack of peanut butter crackers or fruit shortly before bed."
"My boys love to rough-house in their room right before bedtime." Explanation: Bedtime rituals such as reading stories, having a healthy carbohydrate snack, holding a favorite stuffed toy, and use of a nightlight promote a healthy sleep routine for children. Most studies show that exercise right before going to bed impedes the person's ability to fall asleep quickly.
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: - "Five-year-olds sleep only 10 to 12 hours at night, but napping is very important at this stage." - "Don't let your child eat any candy or chocolate after dinner." - "This is normal development for children in this age group." - "It might be a problem. You should discuss this with your pediatrician."
"This is normal development for children in this age group." Explanation: Preschoolers typically sleep 10-16 hours, but become less dependent on napping as they approach school age. By 5 years, they usually do not need routine naps. Telling them to call their pediatrician is passing off responsibility. Sweets are not recommended before bedtime, and this child has normal sleep habits.
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: a) "This is normal development for children in this age group." b) "Five-year-olds sleep only 10 to 12 hours at night, but napping is very important at this stage." c) "Don't let your child eat any candy or chocolate after dinner." d) "It might be a problem. You should discuss this with your pediatrician."
"This is normal development for children in this age group." Explanation: Preschoolers typically sleep 10-16 hours, but become less dependent on napping as they approach school age. By 5 years, they usually do not need routine naps. Telling them to call their pediatrician is passing off responsibility. Sweets are not recommended before bedtime, and this child has normal sleep habits.
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 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 14-17 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." Explanation: Preschoolers, age 3-5, should get 10-13 total hours of sleep time in a 24-hour period. Newborns (0-3 months) require 14-17 total hours of sleep time in a 24-hour period. Infants (4-11 months) require 12-15 total hours of sleep time in a 24-hour period. School-agers (6-13 years old) require 9-11 total hours of sleep time in a 24-hour period.
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 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 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." Explanation: Newborns (0-3 months) require 14-17 Infants (4-11 months) require 12-15 Preschoolers, age 3-5, should get 10-13 School-agers (6-13 years old) require 9-11
The nurse is providing discharge instructions for a new mother about sleep practices for her newborn child. The mother will be breast-feeding her infant. Which pertinent information will the nurse provide? - "It will be easier to breast-feed if the newborn sleeps in your bed." - "Your newborn will probably sleep an average of 16 hours each day." - "Position your newborn on his side when preparing for sleep." - "It is OK to use a pillow in the crib to position your newborn."
"Your newborn will probably sleep an average of 16 hours each day." Explanation: Newborns usually sleep an average of 16 hours each day. Newborns are to be positioned on their back to decrease the risk of sudden infant death syndrome. Pillows should not be used; a pillow constitutes a risk for suffocation, as does placing the newborn in the parent's bed.
A nurse is reviewing the medication administration record. Which order does the nurse question? - A diuretic administered every other day at noon. - A diuretic administered once daily at 9am. - A diuretic administered twice daily at 9am and 5pm. - A diuretic administered twice daily at 9am and 9pm.
- A diuretic administered twice daily at 9am and 9pm. Explanation: A diuretic should not be administered after 6pm. This will promote sleep if a full bladder does not awaken the client. Once daily dosing and every other day dosing is not cause for question.
The nurse is managing the environment for clients on a busy hospital ward. Which interventions would the nurse perform to facilitate a more restful environment? Select all that apply. - Maintain a brighter room during daylight hours and dim lights in the evening. - Medicate for pain if needed. - Decrease the volume on alarms, pages, telephones, and staff conversations. - Schedule procedures separately to avoid tiring out the clients. - Keep the doors to the clients' rooms open. - Keep the room warm and provide earplugs and eye masks if requested.
- Maintain a brighter room during daylight hours and dim lights in the evening. - Decrease the volume on alarms, pages, telephones, and staff conversations. - Medicate for pain if needed. Explanation: The nurse could perform several of the interventions listed to facilitate a more restful environment. First, the nurse could maintain a brighter room during daylight hours and dim lights in the evening. Opening the curtains in the room during the day is an excellent way to carry out this intervention. The nurse would decrease the volume on alarms, pages, telephones, and staff conversations. The nurse would medicate the client for pain if needed. The nurse would not keep the room warm, but cool to aid in sleep. Procedures should be scheduled together if at all possible to decrease the amount of time the client is involved in procedures and promote rest. The nurse should keep the door to the client's room closed if possible to facilitate a more restful environment.
A client has voiced concerns about her inability to fall asleep. When reviewing her history, what information would the nurse expect to find? Select all that apply. - works 30 hours per week - smokes 1 pack of cigarettes daily - history of hyperthroidism - exercises 30 to 60 minutes daily - drinks coffee with all meals
- smokes 1 pack of cigarettes daily - drinks coffee with all meals - history of hyperthroidism Explanation: Insomnia is associated with the consumption of stimulants (e.g., caffeine, nicotine, methamphetamine, and other drugs of abuse). Insomnia is also a side effect of hyperthroidism. Exercising 30 to 60 minutes daily can help a client fall asleep faster.
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 are 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: - use caution when driving an automobile. - drink at least 1 cup of coffee with the evening meal. - ingest a small amount of alcohol prior to bedtime. - change bedtime to later in the evening.
- use caution when driving an automobile. The client is describing hypersomnia and is at increased risk for a motor vehicle accident when drowsy while driving an automobile. The client is to avoid alcohol, caffeine, and late night activities.
An 82-year-old client is newly admitted to an assistive living facility. Which intervention promotes safety at night for the client? - leaving the door open to the nursing hallway - administering diuretics at bedtime - using a night light in the bathroom - leaving a bright light on in the bathroom
- using a night light in the bathroom Explanation: Using night lights rather than bright room lights is preferred if an older adult arises during the night. Bright lights stimulate the brain and interfere with efforts to resume sleep. Administering a diuretic at night will cause nocturnal diuresis causing the client to be up more at night. Leaving the door open to the nursing hallway does not promote safety.
The nurse is educating a client about nonpharmacologic measures to alleviate restless leg syndrome (RLS). Which education points would the nurse include in her plan? Select all that apply. -A mild analgesic before bed can help relieve symptoms -Applying heat or cold to the extremity can help relieve the symptoms -Biofeedback and TENS can help relax the client and relieve symptoms -Massaging the legs may relieve symptoms -An alcoholic drink is recommended before bed to relax the client -Drinking a cup of coffee before bed can help relieve the tingling sensations
-applying heat or cold to the extremity can help relieve the symptoms -Biofeedback and TENS can help relax the client and relieve symptoms -massaging the legs may relieve symptoms Explanation: The nurse would instruct the client that applying heat or cold to the extremity can help relieve the symptoms of restless leg syndrome (RLS). The nurse would instruct the client that biofeedback and TENS can help relax the client and relieve symptoms. The nurse would instruct the client that massaging the legs may relieve RLS symptoms. Caffeine and alcohol should be avoided by the client before bed. A mild analgesic before bed will not help relieve RLS symptoms.
The client has been in the intensive care unit for several days. The client appears to be sleeping throughout the night. The nurse records the data listed above. The nurse evaluates that rapid eye movement (REM) sleep is occurring at: [there's a pic that's supposed to go with this]
0100 During REM sleep, the client's temperature, pulse, blood pressure, and respirations increase. The client may experience small muscle twitching, such as facial muscles twitching, and irregular pulse rate and respirations. During non-eye movement sleep, the client will exhibit a decrease in body temperature, pulse, blood pressure, and respirations. https://s3.amazonaws.com/prepu/prod/images/625.gif
A nurse is visiting the home of a first-time mother and her newborn. The nurse is teaching the mother about the newborn's sleep needs. The nurse would inform the mother that newborns sleep approximately how many hours per day? 10 to 12 hours 8 to 10 hours 18 to 22 hours 14 to 20 hours
14 to 20 hours On average, infants require 14 to 20 hours of sleep each day.
A new mother calls the pediatric nurse to talk about her baby, who sleeps "all day long." The nurse informs the new mother that an infant requires how many hours of sleep? - 12 to 14 hours each day - 14 to 20 hours each day - 9 to 12 hours each day - 8 to 9 hours each day
14 to 20 hours each day Explanation: The pediatric nurse informs the new parent that on average, infants require 14 to 20 hours of sleep each day.
A client has been in the hospital for the past 10 days following the development of an infection at her surgical incision site. Each morning the client reports overwhelming fatigue and has told the nurse, "I just can't manage to get any sleep around here." How should the nurse first respond to this client's statement? Facilitate a change in the client's diet to ensure more carbohydrates at dinner. Assess the factors that the client believes contribute to the problem. Educate the client on relaxation techniques and reduce noise levels on the unit. Obtain a p.r.n. order for a sedative-hypnotic from the client's physician.
Assess the factors that the client believes contribute to the problem.
A client has been in the hospital for the past 10 days following the development of an infection at her surgical incision site. Each morning the client reports overwhelming fatigue and has told the nurse, "I just can't manage to get any sleep around here." How should the nurse first respond to this client's statement? - Assess the factors that the client believes contribute to the problem. - Obtain a p.r.n. order for a sedative-hypnotic from the client's physician. - Facilitate a change in the client's diet to ensure more carbohydrates at dinner. - Educate the client on relaxation techniques and reduce noise levels on the unit.
Assess the factors that the client believes contribute to the problem. Explanation: Assessment is the first step in the nursing process. Consequently, the nurse should determine the factors contributing to the client's problem before performing interventions.
A nurse on the night shift notices that a client is grinding his teeth while sleeping. How should the nurse document the diagnosis for the client? a) Cataplexy b) Insomnia c) Narcolepsy d) Bruxism
Bruxism Explanation: The nurse should document the client's condition as bruxism, or teeth grinding. Insomnia is not an appropriate diagnosis because the client does not have difficulty sleeping. Narcolepsy is an inappropriate diagnosis because the client does not have a sudden onset of daytime sleep. Cataplexy is not an accurate diagnosis because cataplexy is associated with the sudden loss of muscle tone triggered by an emotional change, such as happiness or anger.
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) In what way does the sleep you get each day affect your everyday living? b) Do you usually go to bed and wake up about the same time each day? c) What do you usually do to help yourself fall asleep? d) How much sleep do you think you need to feel rested?
Do you usually go to bed and wake up about the same time each day? Explanation: The best interview question for the nurse to use to assess for recent changes in a client's sleep-wakefulness pattern would be to ask if the client usually goes to bed and wakes up about the same time each day. The other questions are possible to ask the client, but are not related to recent changes in the client's sleep-wakefulness pattern.
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? - How much sleep do you think you need to feel rested? - In what way does the sleep you get each day affect your everyday living? - What do you usually do to help yourself fall asleep? - Do you usually go to bed and wake up about the same time each day?
Do you usually go to bed and wake up about the same time each day? Explanation: The best interview question for the nurse to use to assess for recent changes in a client's sleep-wakefulness pattern would be to ask if the client usually goes to bed and wakes up about the same time each day. The other questions are possible to ask the client, but are not related to recent changes in the client's sleep-wakefulness pattern.
Which activity would be appropriate to suggest to the client who reports having difficulty falling asleep every evening?
Eat some crackers with peanut butter at bedtime. Carbohydrates make tryptophan more available to the brain, thereby promoting sleep. Therefore, a small protein- and carbohydrate-containing snack such as peanut butter on toast or cheese and crackers are effective. Nicotine contained in cigarettes has a stimulating effect, and smokers usually have a more difficult time falling asleep. The client must be encouraged to quit smoking or to eliminate cigarette smoking after the evening meal. Exercise that occurs within a 3-hour interval before normal bedtime can hinder sleep. Caffeinated products, such as chocolate, coffee, and tea are considered stimulants and can interfere with sleep.
The nurse is caring for a client who reports insomnia. The client has recently moved from an area nearby a fire station in the inner city to the country. Which recommendation will the nurse make to facilitate sleep? - Ingest 1 ounce of liquor before going to sleep. - Enjoy the peace and quiet of the country. - Avoid eating right before bedtime. - Find a phone app that plays sounds of the city.
Find a phone app that plays sounds of the city. Explanation: Clients tend to adapt to the unique sounds where they live, such as traffic, trains, and the hum of appliance motors or furnaces. Unfamiliar sounds tend to interfere with the ability to fall or stay asleep. The nurse will recommend that the client find an app that plays sounds of the city, which mimics the sounds with which the client is most familiar. Ignoring the problem by telling the client to adapt to the new environment does not address the problem. Avoiding eating before bedtime could cause the client to wake up hungry in the middle of the night. The nurse does not recommend alcohol, a depressive drug, to clients.
During the morning assessment, the client reports to the nurse that the client is experiencing a hangover from a sleeping pill. The nurse reviews the Medication Administration Record. Which medication is most likely to cause the client's complaint? - Ramelteon - Flurazepam - Zolpidem - Eszopiclone
Flurazepam Explanation: All of the listed medications are ones that promote sleep. Flurazepam is the drug most likely to cause the client's complaint of a morning hangover.
Which statement about the sleep patterns of toddlers should the nurse incorporate into an education plan for parents? - Nightmares are rare in toddlers. - Getting the child to sleep can be difficult. - Slow-wave sleep occurs less in toddlers than in adults. - Most toddlers fall asleep easily.
Getting the child to sleep can be difficult. Explanation: Getting the child to fall asleep is the most commonly reported problem, but frequent awakenings and occasional night terrors may also occur.
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 - Midbrain - Medulla
Hypothalamus Explanation: The hypothalamus has control centers for several involuntary activities of the body, one of which concerns sleeping and waking. Injury to the hypothalamus may cause a person to sleep for abnormally long periods. The medulla and midbrain are part of the reticular activating system (RAS), which plays a part in the cyclic nature of sleep. The cerebral cortex does not have any role in the sleep process.
The pediatric nurse teaches parents about normal sleep patterns in their children. Which education point should the nurse include? - Inform parents about the preschool child's awareness of the concept of death possibly occurring and encourage parents to help alleviate the child's fears. - Advise parents that waking from nightmares or night terrors is common during the adolescent stage. - Teach parents of infants to report any eye movements, groaning, or grimacing by their infant during sleep periods. - Inform parents that daytime napping decreases during the preschool period, and, by the age of 5 years, most children no longer nap.
Inform parents that daytime napping decreases during the preschool period, and, by the age of 5 years, most children no longer nap. Explanation: The nurse would include the education point that daytime napping decreases during the preschool period, and, by the age of 5 years, most children no longer nap. It is normal for infants to have eye movements, groaning, or grimacing during sleep periods. School-age children become aware of the concept of death, not preschool children. Waking from nightmares or night terrors is common during the preschooler stage.
The pediatric nurse teaches parents about normal sleep patterns in their children. Which education point should the nurse include? a) Advise parents that waking from nightmares or night terrors is common during the adolescent stage. b) Inform parents that daytime napping decreases during the preschool period, and, by the age of 5 years, most children no longer nap. c) Teach parents of infants to report any eye movements, groaning, or grimacing by their infant during sleep periods. d) Inform parents about the preschool child's awareness of the concept of death possibly occurring and encourage parents to help alleviate the child's fears.
Inform parents that daytime napping decreases during the preschool period, and, by the age of 5 years, most children no longer nap. Explanation: The nurse would include the education point that daytime napping decreases during the preschool period, and, by the age of 5 years, most children no longer nap. It is normal for infants to have eye movements, groaning, or grimacing during sleep periods. School-age children become aware of the concept of death, not preschool children. Waking from nightmares or night terrors is common during the preschooler stage.
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? a) Nocturnal enuresis b) Insomnia c) Nightmares d) Somnambulism
Insomnia Insomnia and hypersomnia are often manifestations of depression in older clients. Nightmares, somnambulism (sleepwalking), and nocturnal enuresis are examples of parasomnias. These are conditions associated with activities that cause arousal, or partial arousal, usually during transitions in NREM periods of sleep. However, these are not manifestations of depression in an older adult client.
Which factor necessitates the need for more sleep in the adolescent population? - increased nutritional needs - increased life stresses - rapid growth - part-time employment
Rapid growth Explanation: The growth spurt that occurs during adolescence may necessitate the need for more sleep. However, the stresses of school, activities, and part-time employment may cause adolescents to have restless sleep, and many adolescents do not get enough sleep.
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? Most sedative-hypnotics lose their effect after 1 or 2 two weeks of administration. The nurse needs to administer another drug such as diphenhydramine for effectiveness. The client is eating carbohydrates prior to bedtime. The client's daily activity is interfering with the drug.
Most sedative-hypnotics lose their effect after 1 or 2 two weeks of administration. Although most sedative-hypnotic drugs provide several nights of excellent sleep, the medication often loses its effects after 1 or 2 weeks. Alcohol and diphenhydramine should not be administered with a sedative-hypnotic drug. Increased activity assists the client in sleeping. Foods such as protein and carbohydrates have been shown to help a client sleep.
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? - Most sedative-hypnotics lose their effect after 1 or 2 two weeks of administration. - The client's daily activity is interfering with the drug. - The nurse needs to administer another drug such as diphenhydramine for effectiveness. - The client is eating carbohydrates prior to bedtime.
Most sedative-hypnotics lose their effect after 1 or 2 two weeks of administration. Explanation: Although most sedative-hypnotic drugs provide several nights of excellent sleep, the medication often loses its effects after 1 or 2 weeks. Alcohol and diphenhydramine should not be administered with a sedative-hypnotic drug. Increased activity assists the client in sleeping. Foods such as protein and carbohydrates have been shown to help a client sleep.
When a client tells the clinic nurse that he has irresistible sleep attacks throughout the day lasting from 10 to 15 minutes, the nurse suspects that the client may be experiencing what? a) Insomnia b) Prolonged latency c) Narcolepsy d) Cataplexy
Narcolepsy Explanation: Narcolepsy is a disorder of excessive daytime sleepiness characterized by short, almost irresistible daytime sleep attacks, usually lasting 10 to 15 minutes and with abnormal manifestations of REM sleep.
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 patters? - Newborns have shorter periods of REM sleep. - Newborns are inactive when awake. - Newborns sleep 16 to 17 hours per day. - Newborns will nap two times per day.
Newborns sleep 16 to 17 hours per day. Newborns sleep an average of 16 to 17 hours per 24 hours a day, divided into about seven sleep periods distributed fairly evenly throughout the day and night.
A nurse is caring for a client who has been diagnosed with a disturbed sleep pattern. What measures should the nurse implement to promote sleep? Select all that apply.
Promoting daytime exercises, Providing a back massage, Assisting with progressive relaxation In order to promote sleep in a client, the nurse could use the following measures: promoting daytime exercise, providing a back massage, and assisting the client with progressive relaxation. However, the nurse should reduce the intake of stimulating chemicals to promote sleep in a client. Diuretics may awaken those who take them with a need to empty the bladder. For this reason, diuretics generally are administered early in the morning so that the peak effect has diminished by bedtime.
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? a) Help the client maintain normal bedtime routine and time for sleep. b) Provide an opportunity for the client to talk about concerns. c) Bring the client a warm glass of milk at bedtime. d) Use tactile relaxation techniques, such as a back massage.
Provide an opportunity for the client to talk about concerns. Explanation: Stress and anxiety interfere with a person's ability to relax, rest, and sleep. The client is scheduled for a surgical procedure in the morning. The nursing diagnosis addresses this particular concern. Providing an opportunity for the client to talk about concerns and issues would be beneficial. The other options are incorrect because the options do not address the situation at hand, or the nursing diagnosis that is noted.
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? - Help the client maintain normal bedtime routine and time for sleep. - Bring the client a warm glass of milk at bedtime. - Provide an opportunity for the client to talk about concerns. - Use tactile relaxation techniques, such as a back massage.
Provide an opportunity for the client to talk about concerns. Explanation: Stress and anxiety interfere with a person's ability to relax, rest, and sleep. The client is scheduled for a surgical procedure in the morning. The nursing diagnosis addresses this particular concern. Providing an opportunity for the client to talk about concerns and issues would be beneficial. The other options are incorrect because the options do not address the situation at hand, or the nursing diagnosis that is noted.
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? a) Help the client maintain normal bedtime routine and time for sleep. b) Bring the client a warm glass of milk at bedtime. c) Use tactile relaxation techniques, such as a back massage. d) Provide an opportunity for the client to talk about concerns
Provide an opportunity for the client to talk about concerns. Explanation: Stress and anxiety interfere with a person's ability to relax, rest, and sleep. The client is scheduled for a surgical procedure in the morning. The nursing diagnosis addresses this particular concern. Providing an opportunity for the client to talk about concerns and issues would be beneficial. The other options are incorrect because the options do not address the situation at hand, or the nursing diagnosis that is noted.
A nurse is caring for a client with restless leg syndrome who complains of sleeplessness. Which nursing diagnosis is most appropriate for this client? a) Relocation Stress Syndrome b) Risk for Injury c) Sleep Deprivation d) Impaired Bed Mobility
Sleep Deprivation Sleep deprivation is the most appropriate nursing diagnosis for this client because the symptoms of restless legs syndrome keep the person awake and prevent continuous sleep. Eventually, sleep deprivation affects the person's life, damaging work productivity and personal relationships. Relocation Stress Syndrome would not be an appropriate diagnosis because the symptoms are not due to relocation to a new place. Impaired Bed Mobility is an inappropriate diagnosis because the client is not confined to a bed. The client does not have a risk for injury; therefore, the diagnosis of Risk for Injury would be incorrect.
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: - Anxiety related to hospitalization. - Mobility, Impaired Physical related to Restless Leg Syndrome (RLS). - Sleep Pattern Disturbance related to acute pain. - Role Performance, Ineffective related to inability to work at occupation.
Sleep Pattern Disturbance related to acute pain. Explanation: The client is demonstrating classic signs of sleep disturbance from the acute back and leg pain he is experiencing. Anxiety may be present but that is a symptom of his problem rather than the nursing diagnosis. He may have impaired mobility, but it is not due to RLS. Also, his role of construction worker may be disrupted by the injury/treatment, but it is not the cause of this assessment data.
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:
Sleep Pattern Disturbance related to acute pain. The client is demonstrating classic signs of sleep disturbance from the acute back and leg pain he is experiencing. Anxiety may be present but that is a symptom of his problem rather than the nursing diagnosis. He may have impaired mobility, but it is not due to RLS. Also, his role of construction worker may be disrupted by the injury/treatment, but it is not the cause of this assessment data.
Which problem is associated with obesity, heavy snoring, and shallow breathing? a) Hyperpnea b) Narcolepsy c) Hypersomnia d) Sleep apnea
Sleep apnea Explanation: Sleep apnea refers to recurrent periods of absence of breathing for 10 seconds or longer, occurring at least 5 times per hour.
When the nurse attempts to wake a client who has just closed his eyes and appears asleep, the client states he is not asleep. What stage of sleep is this client in? - Stage 3 - Stage 4 - Stage 1 - Stage 2
Stage 1 Explanation: Stage 1 is transitional stage between drowsiness and sleep, indicated by a shift from alpha waves to low-voltage, fast theta on the EEG. This stage usually lasts only a few minutes, and, if awakened, the person may say he was not asleep.
When the nurse attempts to wake a client who has just closed his eyes and appears asleep, the client states he is not asleep. What stage of sleep is this client in? a) Stage 1 b) Stage 2 c) Stage 3 d) Stage 4
Stage 1 Explanation: Stage 1 is transitional stage between drowsiness and sleep, indicated by a shift from alpha waves to low-voltage, fast theta on the EEG. This stage usually lasts only a few minutes, and, if awakened, the person may say he was not asleep.
A maternity nurse is instructing new parents on the proper sleeping position for their newborn child. In what position does the nurse instruct the parents to place the infant? a) Supine position b) High-Fowler's position c) Side-lying position d) Prone position
Supine position The nurse will teach the parents to position the infant on the back (supine). Sleeping in the prone position increases the risk for sudden infant death syndrome (SIDS).
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? a) Take immediately before going to sleep. b) Skip the bedtime dose of medication. c) Take second dose when awakening to urinate. d) Take before 6:00 PM at night.
Take before 6:00 PM at night. Explanation: The client taking a diuretic may awaken at night with a full bladder. The nurse will teach the client to take the second dose of the medication before 6:00 PM at night so that urination is accomplished before going to sleep. The other options are not appropriate for the nurse to teach the client.
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? a) Take before 6:00 PM at night. b) Take immediately before going to sleep. c) Take second dose when awakening to urinate. d) Skip the bedtime dose of medication.
Take before 6:00 PM at night. Explanation: The client taking a diuretic may awaken at night with a full bladder. The nurse will teach the client to take the second dose of the medication before 6:00 PM at night so that urination is accomplished before going to sleep. The other options are not appropriate for the nurse to teach the client.
The student nurse is providing an education program for preschool parents. The nursing student should include which intervention to improve the child's sleep? - The child should sleep with the parents. - The child should drink milk at bedtime. - The child should limit fluids after supper. - The parents should keep the child up until 10 PM.
The child should limit fluids after supper. Explanation: Parents and other caregivers can assist children in establishing the habit of voiding as part of preparing for bedtime. Drinking milk at bedtime, keeping the child up until 10 PM and sleeping with the parents will not improve the child's sleep.
The student nurse is providing an education program for preschool parents. The nursing student should include which intervention to improve the child's sleep?
The child should limit fluids after supper. Parents and other caregivers can assist children in establishing the habit of voiding as part of preparing for bedtime. Drinking milk at bedtime, keeping the child up until 10 PM and sleeping with the parents will not improve the child's sleep.
An elderly client is complaining of disturbed sleep during the night because of excessive urination. What information should the nurse address with the client as a possible cause related to the complaint?
Timing of diuretic medication The nurse should address the time that the client takes the diuretic medication because it directly causes excessive urination that is disrupting the client's sleep pattern. The other options are not direct causes of excessive urination affecting the client's sleep pattern.
Which guideline does the nurse apply to discussion of sleep patterns with older adult clients? The amount of stage 4 sleep increases as clients age. Older clients fall asleep more quickly than younger ones. Circadian rhythms become more prominent as clients age. Total sleep time decreases as the clients age.
Total sleep time decreases as the clients age. As people age, the amount of stage 4 sleep decreases significantly. Sleeping patterns may become polyphasic, with a shorter nocturnal period plus daytime naps.
Which guideline does the nurse apply to discussion of sleep patterns with older adult clients? - The amount of stage 4 sleep increases as clients age. - Older clients fall asleep more quickly than younger ones. - Total sleep time decreases as the clients age. - Circadian rhythms become more prominent as clients age.
Total sleep time decreases as the clients age. Explanation: As people age, the amount of stage 4 sleep decreases significantly. Sleeping patterns may become polyphasic, with a shorter nocturnal period plus daytime naps.
The nurse is providing care to a group of clients in an acute care facility. The client most likely to prefer a room that is warm as well as wearing thermal blankets is the client who is: a) aged 74 years. b) going through menopause. c) a teenager. d) 6 months' pregnant.
aged 74 years. Explanation: Older clients, such as the one aged 74 years, may prefer to have a room that is warm and being provided with thermal blankets.
The client is scheduled for a polysomnography to determine if the client has obstructive sleep apnea (OSA). The nurse instructs the client to: - take prescribed sedative before trying to sleep. - apply facial mask that will deliver positive air pressure. - insert an oral appliance prior to attempting sleep. - anticipate sleeping overnight at a health care center.
anticipate sleeping overnight at a health care center. Explanation: Polysomnography is a sleep study. The client will be scheduled for the study at a health care center and sleep overnight as part of the study. The client should avoid sedatives as this will aggravate OSA. Interventions for OSA include inserting an oral appliance or applying a facial mask for continuous positive airway pressure.
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. Polysomnography is a sleep study. The client will be scheduled for the study at a health care center and sleep overnight as part of the study. The client should avoid sedatives as this will aggravate OSA. Interventions for OSA include inserting an oral appliance or applying a facial mask for continuous positive airway pressure.
Which activity for rest break should not be incorporated into care planning for clients to aid in healing and recovery? a) stretching exercises drinking an 8 oz cup of a caffeinated beverage b) taking a short 15- to 30-minute nap c) focusing thoughts on a pleasant scene away from work d) going for a short walk
drinking an 8 oz cup of a caffeinated beverage Explanation: Drinking a caffeinated beverage is not as energizing as a short 15- to 30-minute nap, stretching exercises, or taking a short walk.
During stage 3 sleep, the client may experience: a) diaphoresis. b) enuresis. c) anxiety. d) shortness of breath.
enuresis. Explanation: Stages 3 and 4 are the stages during which snoring, sleepwalking (somnambulism), and bedwetting (enuresis) are most likely to occur.
While instructing young adults about the need for adequate sleep, the nurse instructs the group that to improve sleep quality, individuals should: - take an afternoon nap whenever possible. - stay awake until midnight consistently. - catch up on sleep on days off from work. - have a consistent time for arising.
have a consistent time for arising. Explanation: A regular time of rising is one of the most effective means of improving sleep quality and synchronizing circadian rhythms with clock time.
While instructing young adults about the need for adequate sleep, the nurse instructs the group that to improve sleep quality, individuals should: a) stay awake until midnight consistently. b) catch up on sleep on days off from work. c) have a consistent time for arising. d) take an afternoon nap whenever possible.
have a consistent time for arising. Explanation: A regular time of rising is one of the most effective means of improving sleep quality and synchronizing circadian rhythms with clock time.
The nurse is assessing a client for sleep disorders. The initial step in sleep assessment is: measure the client's weight and assess visual acuity. auscultate the lung fields and perform neuro checks. observe client's hours of sleep and review client's sleep diary. measure neck circumference and auscultate the abdomen
observe client's hours of sleep and review client's sleep diary. Observing the sleeping patterns and checking the client's sleep diary can lead the nurse to clues about the quality of the client's sleep. Neck circumference can be a factor in obstructive sleep apnea, but it is not routinely measured during assessment. Being overweight is a common finding in sleep disorder clients, but visual acuity issues are not. Auscultation of the lungs and abdomen are not pertinent to the potential disorder.
In Stage 4 sleep, the: pulse rate is slow respirations are irregular temperature increases blood pressure is elevated
pulse rate is slow Explanation: During slow-wave sleep, the muscles are relaxed, but muscle tone is maintained; respirations are even; and blood pressure, pulse, temperature, urine formation, and oxygen consumption by muscle all decrease.
In Stage 4 sleep, the: a) pulse rate is slow b) respirations are irregular c) blood pressure is elevated d) temperature increases
pulse rate is slow Explanation: During slow-wave sleep, the muscles are relaxed, but muscle tone is maintained; respirations are even; and blood pressure, pulse, temperature, urine formation, and oxygen consumption by muscle all decrease.
Which factor necessitates the need for more sleep in the adolescent population? increased nutritional needs increased life stresses rapid growth part-time employment
rapid growth The growth spurt that occurs during adolescence may necessitate the need for more sleep. However, the stresses of school, activities, and part-time employment may cause adolescents to have restless sleep, and many adolescents do not get enough sleep.
A nurse is caring for a client with insomnia. The nurse is explaining the importance of sleep to the client. Which role is sleep supposed to play? a) decrease pain tolerance b) reduce fatigue c) reduce protein synthesis d) eliminate fat accumulation
reduce fatigue Explanation: Sleep is believed to play an important role in reducing fatigue, stabilizing mood, and improving blood flow to the brain, among other things. Sleep increases, not reduces, protein synthesis. Sleep does not eliminate accumulation of fat in a person's body. Regular exercise or physical activity reduces fat accumulation. Sleep increases pain tolerance in a person, whereas sleep deprivation decreases pain tolerance.
The client being seen in the employee wellness clinic reports difficulty sleeping for the past several months. The most important assessment the nurse could make is: - reviewing the client's sleep diary for the past 2 weeks. - having client recall the number of sleep hours each night for the past week. - identifying specific foods that negatively impact sleep. - asking the client's bed partner to describe the sleep problem.
reviewing the client's sleep diary for the past 2 weeks. Explanation: A sleep diary kept for 2 weeks will provide a more detailed history of the client's sleep-wakefulness pattern than having the client identify foods that impact sleep, or having the client recall the number of hours of sleep each day for the past week. Client recall may be inaccurate. The client should describe the sleep problem, not the client's bed partner.
A 62-year-old woman informs the nurse that her mother has been anxious and disoriented in the morning, and that she sleeps 4 hours per night, while getting up from sleep to use the bathroom. What factor in the client's health regimen could interfere with healthy sleep? a) drinking iced tea in the afternoon b) not taking a nap to supplement the short sleep cycle c) sleeping with cotton socks on d) taking diuretic medicine at 10 a.m. and 10 p.m.
taking diuretic medicine at 10 a.m. and 10 p.m. Explanation: Taking a diuretic late at night will promote the need for voiding within a few hours, interrupting her sleep cycle. Tea is a weak stimulant, but should be sufficiently metabolized by bedtime. Older adults can have difficulty sleeping if they feel cold, so wearing socks to bed can promote restful sleep. Taking naps can interfere with sufficient sleep at night.
The nurse is caring for a client who is having difficulty sleeping. Which medication does the nurse anticipate will be prescribed by the healthcare provider? a) simvastatin (Zocor) b) amlodipine (Norvasc) c) furosemide (Lasix) d) temazepam (Restoril)
temazepam (Restoril) Explanation: Benzodiazepines such as temazepam (Restoril) are often used to treat difficulty sleeping. Furosemid (Lasix) is a diuretic; amlodipine (Norvasc) is a calcium-channel blocker; and simvastatin (Zocor) is a HMG CoA reductase inhibitor ("statin") used to treat high cholesterol.
The nurse is caring for a client who is having difficulty sleeping. Which medication does the nurse anticipate will be prescribed by the healthcare provider? - temazepam (Restoril) - furosemide (Lasix) - amlodipine (Norvasc) - simvastatin (Zocor)
temazepam (Restoril) Explanation: Benzodiazepines such as temazepam (Restoril) are often used to treat difficulty sleeping. Furosemid (Lasix) is a diuretic; amlodipine (Norvasc) is a calcium-channel blocker; and simvastatin (Zocor) is a HMG CoA reductase inhibitor ("statin") used to treat high cholesterol.
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 may be disoriented on awakening. - 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. Explanation: The elderly sleep less soundly for less time, and have little or no Stage IV deep sleep. It is common for them to be confused upon awakening, which could lead to injury. Napping does not alter their safety. Somnabulism is commonly seen in children. Older adults commonly take prescribed or over-the-counter sleep aids.
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 are the age group least likely to use prescribed sleep medications. they nap in the afternoon, which lessens their hours of sleep at night. they are typically prone to sleep walking. they may be disoriented on awakening.
they may be disoriented on awakening. Explanation: The elderly sleep less soundly for less time, and have little or no Stage IV deep sleep. It is common for them to be confused upon awakening, which could lead to injury. Napping does not alter their safety. Somnabulism is commonly seen in children. Older adults commonly take prescribed or over-the-counter sleep aids.
A nursing student is changing the client's bed. Which action requires intervention from the nursing instructor? removing the call light attached to the bed sheet tossing soiled linen on the floor placing the bed in high position placing the clean linen on a dry bedside table
tossing soiled linen on the floor Soiled linen should be placed directly into a pillow case or laundry hamper to prevent transferring microorganisms. Placing soiled linen on the floor requires intervention by the instructor, to prevent the unnecessary spread of microorganisms. Placing the bed in high position is appropriate as it reduces back strain. Anything attached to the linens should be removed prior to changing the bed and clean linen should be placed on a clean, dry surface, such as the bedside table or chair.
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 are 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: drink at least 1 cup of coffee with the evening meal. use caution when driving an automobile. ingest a small amount of alcohol prior to bedtime. change bedtime to later in the evening
use caution when driving an automobile. Explanation: The client is describing hypersomnia and is at increased risk for a motor vehicle accident when drowsy while driving an automobile. The client is to avoid alcohol, caffeine, and late night activities.
An 82-year-old client is newly admitted to an assistive living facility. Which intervention promotes safety at night for the client? administering diuretics at bedtime using a night light in the bathroom leaving the door open to the nursing hallway leaving a bright light on in the bathroom
using a night light in the bathroom Using night lights rather than bright room lights is preferred if an older adult arises during the night. Bright lights stimulate the brain and interfere with efforts to resume sleep. Administering a diuretic at night will cause nocturnal diuresis causing the client to be up more at night. Leaving the door open to the nursing hallway does not promote safety.
