Ch. 43 Sleep

Hypnotics

Class of drug that causes insensibility to pain and induces sleep.

The nurse is caring for a young adult patient on the medical-surgical unit. When doing midnight checks, she sees that the patient is awake and is doing a puzzle. What is the best explanation for the patient being awake? a. The patient was waiting to talk with the nurse. b. The patient misses his family and is lonely. c. The patient's sleep-wake cycle preference is late evening. d. The patient has been kept up with the noise on the unit.

c. The patient's sleep-wake cycle preference is late evening.

sleep apnea

cessation of breathing during sleep

insomnia

conditions characterized by chronic inability to sleep or remain asleep through the night

A single dad is discussing with the nurse the sleep needs of a preschooler. Which of the following directions would be most helpful to the parent? a. "It is important that the 5-year-old get a nap every day." b. "Preschoolers sleep soundly all night long." c. "On average, the preschooler needs to sleep 10 hours a night." d. "The preschooler may have trouble settling down after a busy day."

d. "The preschooler may have trouble settling down after a busy day."

The patient presents to the clinic with reports of irritability, being sleepy during the day, not being able to fall asleep, and being tired. Select the most appropriate nursing diagnosis. a. Anxiety b. Fatigue c. Sleep deprivation d. Insomnia

d. Insomnia

The nurse is preparing an older patient's evening medications. Which of the following does the nurse recognize as relatively safe for difficulty sleeping? a. Benadryl (diphenhydramine) b. Melatonin c. Valerian d. Lorazepam

d. Lorazepam

The patient shares with the nurse the vivid, full color dreams experienced by the patient last night. These data would indicate that the patient has reached what stage of sleep? a. Stage 1 NREM b. Stage 2 NREM c. Stage 3 NREM d. REM

d. REM

The nurse is caring for a postpartum patient. The patient's labor has lasted over 28 hours within the hospital; the patient has not slept and is disoriented to date and time. What is the most appropriate nursing diagnosis? a. Impaired parenting b. Insomnia c. Ineffective coping d. Sleep deprivation

d. Sleep deprivation

The patient has just been diagnosed with narcolepsy. The nurse provides an educational session and teaches the patient to avoid a. Antidepressant medications. b. Naps shorter than 20 minutes. c. Sitting in hot, stuffy rooms. d. Chewing gum.

c. Sitting in hot, stuffy rooms.

The older patient is visiting the clinic after a fall during the night. Which of the following data points obtained most likely would contribute to this fall? a. The patient has been taking glucosamine. b. The patient has been taking a fish oil. c. The patient has been taking Benadryl (diphenhydramine). d. The patient has been taking vitamin C.

c. The patient has been taking Benadryl (diphenhydramine).

The nurse is caring for a patient in the sleep lab. The nurse recognizes that the patient is in stage 4 NREM from which of the following assessments? a. The patient awakens easily. b. Body functions slow. c. The patient is difficult to awaken. d. Eyes rapidly move.

c. The patient is difficult to awaken.

The night nurse goes quietly into the sleeping client's room to assess him. The client wakes up as soon as the nurse is in the room. The nurse knows that the client was most likely in which stage of sleep? 1. Stage 1: NREM 2. Stage 2: NREM 3. Stage 3: NREM 4. Stage 4: NREM

1. Stage 1: NREM

An older adult client diagnosed as being in the early stage of Alzheimer's disease shares with the nurse that her sleep is interrupted by "the noises I hear all through the night." The nurse explains that the most likely reason for this problem is: 1. The client's age 2. A lack of presleep relaxation 3. The amount of noise entering into the client's environment 4. A manifestation of the disease process causing the brain disorder

1. The client's age

A 44-year-old female client shares with the nurse that she is having difficulty falling asleep at night, even though she is exhausted. The nurse knows that which of the following could be causing the sleeplessness? 1. Two cups of hot cocoa every evening 2. Vegetarian diet 3. Afternoon exercise program 4. Hot bath in the evening

1. Two cups of hot cocoa every evening

A 25-year-old client's wife complains to the nurse that he sleepwalks during the night. The nurse knows that this behavior normally occurs in which stage of sleep? 1. Stage 2: NREM 2. Stage 3: NREM 3. Stage 4: NREM 4. REM

3. Stage 4: NREM

Although the most common effect of obstructive sleep apnea is a disrupted sleep pattern, the condition can cause a serious decline in arterial oxygen levels that may result in: (Select all that apply.) 1. Hypertension 2. Angina attacks 3. Alzheimer's disease 4. Cardiac dysrhythmias 5. Cerebral vascular accidents 6. Type 2 diabetes

1, 2, 4, 5

Which of the following client statements made by young adults suggest a risk factor for sleep disturbance problems? (Select all that apply.) 1. "I have a job that requires my attention 110% of the time." 2. "I really enjoy fishing; I wish we lived closer to a river or pond." 3. "My wife just found out she is pregnant for the third time in 5 years." 4. "My father recently suffered a heart attack, and Mom is so very worried about him." 5. "The kids are so active in after-school things that we never have an evening at home." 6. "Gardening always gave me such a sense of accomplishment, but I don't have much free time now."

1, 3, 4, 5

A 22-year-old male client shares with the nurse that he is always tired. In assessing the client's sleep pattern to determine the quantity of sleep the client is getting, the nurse should ask: 1. "On a scale from 0 to 10, how much sleep to you think you get each night?" 2. "What time do you usually go to bed?" 3. "What time do you usually get up?" 4. "Do you have a bedtime ritual?"

1. "On a scale from 0 to 10, how much sleep to you think you get each night?"

An 11-year-old boy in middle school is currently experiencing sleep-related fatigue during classes. Which of the following is the most appropriate response by the school nurse when counseling the child's parents regarding this assessment? 1. "What are the child's usual sleep patterns?" 2. "Establish bedtimes for the child, and withhold his allowance whenever those times are not adhered to." 3. "We need to explore other health-related problems, because sleep problems are not likely the cause of his fatigue." 4. "The bulbar synchronizing region of the child's central nervous system is causing these insomniac problems."

1. "What are the child's usual sleep patterns?"

A 74-year-old client has been having sleeping difficulties. To have a better idea of the client's problem, the nurse should respond: 1. "What do you do just before going to bed?" 2. "Let's make sure that your bedroom is completely darkened at night." 3. "Why don't you try napping more during the daytime?" 4. "Do you eat a small snack before going to bed?"

1. "What do you do just before going to bed?"

Which of the following clients is most likely to experience difficulty returning to sleep? 1. A 60-year-old with benign hypertropic prostatic disease 2. A 15-year-old with type 1 diabetes 3. A 35-year-old diagnosed with hypothyroidism 4. A 55-year-old diagnosed with hypertension

1. A 60-year-old with benign hypertropic prostatic disease

Teaching for a client who is currently taking a diuretic should include information that he or she may experience: 1. Nocturia 2. Nightmares 3. Increased daytime sleepiness 4. Reduced REM sleep

1. Nocturia

The assistive nursing personnel reports that the heart rate of the sleeping 23-year-old athlete, who is hospitalized following complications of a tonsillectomy, is 56. The assistive nursing personnel states that this is 10 beats per minute slower than when she took it earlier in the evening. The nurse knows that this is considered: 1. Normal, and they will continue to monitor the vital signs as ordered 2. Abnormally slow, and the health care provider should be notified immediately 3. Abnormally slow, and the nurse will recheck the heart rate before taking any action 4. Abnormally slow, signaling that the client may be hemorrhaging

1. Normal, and they will continue to monitor the vital signs as ordered

A 63-year-old client is discussing the recent problem the client is experiencing with falling asleep. The nurse is discussing strategies to minimize this problem. Which of the following bedtime snacks would be the most likely to induce sleep? 1. One slice of cheese on four wheat crackers and a glass of skim milk 2. Two cups of air-popped popcorn and a glass of fruit juice 3. Two fig cookies and a cup of decaffeinated tea 4. One small pear and a glass of soymilk

1. One slice of cheese on four wheat crackers and a glass of skim milk

Which of the following may improve the sleep of an older adult client? 1. Drinking an alcoholic beverage before bedtime 2. Using an over-the-counter sleeping agent 3. Eliminating naps during the day 4. Going to bed at a consistent time even if not feeling sleepy

3. Eliminating naps during the day

New research indicates that to increase safety the nurse should instruct parents to do which of the following? 1. Provide a stuffed toy for comfort. 2. Cover the infant loosely with a blanket. 3. Place the infant on his or her back. 4. Use small pillows in the crib.

3. Place the infant on his or her back.

The nurse and a client are discussing the importance of an effective 24-hour sleep cycle. Which of the following responses by the client may be a direct result of an inadequate sleep pattern? (Select all that apply.) 1. Gaining weight 2. Usually feeling cold 3. Always feeling "tired" 4. A heart that beats "really fast" 5. Often feeling "blue" or depressed 6. Feeling dizzy when getting up from a chair

2, 3, 4, 5, 6

A client is discussing his recent restlessness and increased irritability. Which of the following assessment questions is likely to be most helping in determining the cause of these complaints? 1. "When did you start noticing these changes?" 2. "Has anything caused you to change your usual routine lately?" 3. "Do you have any idea what might be causing these problems?" 4. "What makes you think that you are more irritable than is normal for you?"

2. "Has anything caused you to change your usual routine lately?"

The nurse and a client are discussing possible behaviors that might be interfering with the client's ability to fall asleep. Which of the following assessment questions is most likely to identify possible problems with the client's sleep routine that possibly are contributing to the difficulty? 1. "When do you usually retire for the night?" 2. "What do you do to help yourself fall asleep?" 3. "How much time does it usually take for you to fall asleep?" 4. "Have you changed anything about your presleep ritual lately?"

2. "What do you do to help yourself fall asleep?"

Which of the following symptoms should the nurse assess with a client who is deprived of sleep? 1. Elevated blood pressure and confusion 2. Confusion and irritability 3. Inappropriateness and rapid respirations 4. Decreased temperature and talkativeness

2. Confusion and irritability

The nurse knows that which of the following habits may interfere with a client's sleep? 1. Listening to classical music 2. Finishing office work 3. Reading novels 4. Drinking warm milk

2. Finishing office work

The nurse is caring for a 35-year-old father of three young children who has experienced a compound fractured femur as a result of a work-related incident. He has expressed great concern over both his physical recovery and his long-term ability to work again. This has affected both his emotional status and his sleeping patterns. The nurse's most immediate concern is that: 1. The client needs medication to prevent depression 2. The lack of appropriate rest will affect his healing process 3. An occupational therapy consult should be ordered to help him regain his ability to return to his job 4. A psychiatric consult should be ordered to help the client deal with his various emotional concerns

2. The lack of appropriate rest will affect his healing process

A nurse caring for a patient prior to surgery should recognize which of the following factors place a client at risk for obstructive sleep apnea? (Select all that apply.) 1. Heart disease 2. Respiratory tract infections 3. Nasal polyps 4. Obesity

3, 4

The nurse is preparing to discuss the management of the sleeping disorder narcolepsy. In addition to the prescription of stimulants and antidepressants, which of the following nonpharmaceutical strategies should be included and shared with the client? (Select all that apply.) 1. Wine with meals 2. Regular use of a sauna 3. Light but high-protein meals 4. Regular use of chewing gum 5. Adoption of a regular exercise routine 6. Brief daytime naps of 20 minutes or less

3, 4, 5, 6

The nurse is discussing child care strategies with a mother of a newborn. The mother asks the nurse, "What causes sudden infant death syndrome (SIDS)?" Which of the following responses is most likely to answer the mother's question therapeutically? 1. "SIDS is a common fear for new mothers. The best advice is to put your baby to sleep on her back." 2. "We aren't sure exactly, but it may have something to do with undetected cardiac or oxygen problems." 3. "Research is inconclusive, but it's thought to be a result of a nervous system problem that occurs when the baby is asleep." 4. "Your pediatrician wants you to put your baby to sleep on her back because research has shown that more stomach sleepers are victims."

3. "Research is inconclusive, but it's thought to be a result of a nervous system problem that occurs when the baby is asleep."

The client asks the nurse, "How will I know if I'm really rested?" The nurse's most therapeutic response is: 1. "Everyone's definition of rested is different. How would you define rested?" 2. "When you aren't tired when you get up in the morning or after an afternoon nap." 3. "When you are mentally, physically, and emotionally ready to go about your daily activities." 4. "You are rested if you fall asleep easily and sleep uninterruptedly for at least 6 to 8 hours."

3. "When you are mentally, physically, and emotionally ready to go about your daily activities."

A new mother is concerned that her 2-week-old daughter is not sleeping through the night. The nurse should respond that infants usually develop a nighttime pattern of sleep by: 1. 1 month 2. 2 months 3. 3 months 4. 6 months

3. 3 months

It is determined that the client will need pharmacological treatment to assist with the client's sleep patterns. The nurse anticipates that treatment with an anxiety-reducing, relaxation-promoting medication will include the use of: 1. Barbiturates 2. Amphetamines 3. Benzodiazepines 4. Tricyclic antidepressants

3. Benzodiazepines

A female client describes the most elaborate dreams to the nurse. She states that she could see colors, hear music, and even had the sensation of flying. The nurse replies to the client that her dreams indicate that she must be: 1. Depressed 2. Pragmatic 3. Creative 4. Mentally ill

3. Creative

On a 2-week follow-up visit to the health care provider, a 64-year-old female postoperative client shares with the nurse that she is having difficulty sleeping and has never had a history of sleeping problems. The nurse shares with the client that: 1. Because of her age, the client should expect to begin having some problems sleeping 2. It may take a while to get used to sleeping in her bed at home after getting used to sleeping on a hospital bed 3. The medications used for anesthesia can disturb sleep cycles for several weeks following surgery 4. She may not be sleeping as well with her partner after being in a bed by herself while being hospitalized

3. The medications used for anesthesia can disturb sleep cycles for several weeks following surgery

The physiology of sleep is complex. Which of the following is the most appropriate statement in regard to this process? 1. Ultradian rhythms occur in a cycle longer than 24 hours. 2. Nonrapid eye movement (NREM) refers to the cycle that most clients experience when in a high-stimulus environment. 3. The reticular activating system is partly responsible for the level of consciousness of a person. 4. The bulbar synchronizing region (BSR) causes the rapid eye movement (REM) sleep in most normal adults.

3. The reticular activating system is partly responsible for the level of consciousness of a person.

A client hospitalized for a myocardial infarction in a cardiac critical care unit (CCU) is most likely to experience sleep deprivation as a result of: 1. A drug-disrupted circadian sleep pattern 2. Generally diminished cardiac output 3. Unfamiliar environmental stimuli 4. Increased emotional stressors

3. Unfamiliar environmental stimuli

A 70-year-old client is reporting to the nurse a concern over "taking longer to fall asleep and waking up three to four times during the night." The most therapeutic nursing response to the client's concern is: 1. "I think you need to mention your concerns to your health care provider." 2. "Older adults seem to need less sleep. Do you still feel rested in the morning?" 3. "I suggest that you plan for a nap in the afternoon to make up for that missed sleep." 4. "As we age, those kinds of problems seem more common. Does this disruption in your sleep cause you to be tired or irritable?"

4. "As we age, those kinds of problems seem more common. Does this disruption in your sleep cause you to be tired or irritable?"

A client has reported to the nurse that his sprained ankle resulted from "a careless accident. I seem so clumsy and unfocused lately." Which of the following assessment questions is most likely to reveal information regarding the cause of these symptoms? 1. "How many accidents have you had lately?" 2. "Have the accidents resulted in serious injuries?" 3. "Have there been any changes in your daily routine lately?" 4. "Do you have any idea what is responsible for this lack of focus?"

4. "Do you have any idea what is responsible for this lack of focus?"

The nurse is completing an assessment of the client's sleep patterns. A specific question that the nurse should ask to determine the potential presence of sleep apnea is: 1. "How easily do you fall asleep?" 2. "Do you have vivid, lifelike dreams?" 3. "Do you ever experience loss of muscle control or falling?" 4. "Do you snore loudly or experience headaches?"

4. "Do you snore loudly or experience headaches?"

A client is concerned that her habit of sleeping during the day and being awake at night is not "healthy or normal." The nurse's most therapeutic response to the client's concern is: 1. "What makes you think that sleeping during the day and being up at night is unhealthy or abnormal?" 2. "Many people share your sleep habits. As long as you feel all right, I don't think there is anything to worry about." 3. "Are you interested in changing your sleep habits for any particular reason? Is sleeping during the day a problem for you?" 4. "Everyone has a different biological clock that controls his or her sleep cycle. As long as you are sleeping and functioning well, your habit isn't abnormal or unhealthy."

4. "Everyone has a different biological clock that controls his or her sleep cycle. As long as you are sleeping and functioning well, your habit isn't abnormal or unhealthy."

The nurse and the parents of a 3-year-old are discussing their child's sleep habits. They share a concern over the child's tendency to wake up several times during the night crying out loudly but not really being awake. The nurse addresses the parents' concern most therapeutically by responding: 1. "Have you ever tried reading a bedtime story before putting her to bed?" 2. "If she does that only a few times a week, I wouldn't be too overly concerned." 3. "Children her age often become poor sleepers. Have you discussed this with her pediatrician?" 4. "It is common for children to have trouble relaxing, and this behavior is the result. It's usually temporary."

4. "It is common for children to have trouble relaxing, and this behavior is the result. It's usually temporary."

A 9-year-old client asks the nurse, "Why do I need to sleep?" The nurse's most age-appropriate, informative response is: 1. "Everyone needs to sleep to feel rested." 2. "It gives your body a chance to really rest." 3. "You'll be able to do so much better in school if you're rested." 4. "Your body needs to rest in order to grow and be really healthy."

4. "Your body needs to rest in order to grow and be really healthy."

A client shares with the nurse that "My wife complains about my snoring, and I never really feel rested." Which of the following responses best attempts to explain the cause of the problem to the client? 1. "Sleep disturbances can really affect all aspects of your life. How long have you been experiencing this problem?" 2. "You need to get help to breathe more effortlessly at night so both you and your wife can get sufficient deep stage sleep." 3. "Something is interfering with your ability to breathe while you are asleep. Have you talked with your health care provider about the problem?" 4. "Your upper airway is blocked, and that is making it difficult for you to breathe effectively, so you are spending most of the night in the light sleep stage."

4. "Your upper airway is blocked, and that is making it difficult for you to breathe effectively, so you are spending most of the night in the light sleep stage."

Which of the following clients experiencing disrupted sleep patterns is most at risk for obstructive sleep apnea (OSA)? 1. A 15-year-old boy with type 1 diabetes 2. A 22-year-old diagnosed with Crohn's disease 3. A 49-year-old man who is an avid cross-county runner 4. A 58-year-old woman diagnosed with chronic depression

4. A 58-year-old woman diagnosed with chronic depression

Which of the following information provided by the client's bed partner is most associated with sleep apnea? 1. Restlessness 2. Talking during sleep 3. Somnambulism 4. Excessive snoring

4. Excessive snoring

The nurse recognizes that the sleep patterns of older adults differ and older adults generally: 1. Are more difficult to arouse 2. Require more sleep than middle-age adults 3. Take less time to fall asleep 4. Have a decline in stage 4 sleep

4. Have a decline in stage 4 sleep

The mother of a 2-year-old child is frustrated because the child does not want to go to bed at the scheduled bedtime. The nurse should suggest that the parent: 1. Offer the child a bedtime snack 2. Eliminate one of the naps during the day 3. Allow the child to sleep longer in the mornings 4. Maintain consistency in the same bedtime ritual

4. Maintain consistency in the same bedtime ritual

A 73-year-old male client who normally sleeps on his right side recently underwent a right-side hip replacement surgery and now has trouble sleeping. One of the interventions that the nurse might try with this client is to: 1. Request medication to help the client sleep while in the hospital 2. Carefully prop the client on his operative side using pillows to support the hip 3. Schedule therapy for the evening to help the client become tired so he can sleep 4. Question the client to learn more about his normal sleep pattern

4. Question the client to learn more about his normal sleep pattern

The patient and the nurse discuss the need for sleep. After the discussion, the patient is able to state factors that hinder sleep. Which statements indicate that the patient has a good understanding of sleep? (Select all that apply.) a. "Drinking coffee at 7 PM could interrupt my sleep." b. "Worry about work can disrupt my sleep." c. "Exercising 2 hours before bedtime can decrease relaxation." d. "Changing the time of day that I eat dinner can disrupt sleep." e. "Taking an antacid can decrease sleep." f. "Staying up late for a party can interrupt sleep patterns."

A, B, C, F

The nurse is caring for a patient in the intensive care unit who is having trouble sleeping. The nurse explains the purpose of sleep and its benefits. What points should the nurse include in her teaching? (Select all that apply.) a. NREM sleep contributes to body tissue restoration. b. During NREM sleep, biological functions increase. c. Restful sleep preserves cardiac function. d. Sleep contributes to cognitive restoration. e. REM sleep decreases cortical activity. f. REM sleep assists with memory storage and learning.

A, C, D, E

A community health nurse is providing an educational session at the senior center on how to promote sleep. Which practices should the nurse recommend? (Select all that apply.) a. Take a nap in the afternoon. b. Sleep where you sleep best. c. Use sedatives as a last resort. d. Decrease fluids 2 to 4 hours before sleep. e. Watch television right before sleep. f. Get up if unable to fall asleep in 15 to 30 minutes.

B, C, D, F

The nurse is having a conversation with an adolescent regarding the need for sleep. The adolescent states that it is common to stay up with friends several nights a week. Which nursing action should the nurse take? a. Discuss with the adolescent's parent staying up with friends and the need for sleep. b. Discuss with the adolescent sleep needs and the effects of excessive daytime sleepiness. c. This is a normal occurrence for adolescents and action is not required. d. Explore the reason for staying up late with friends several nights a week.

B. Discuss with the adolescent sleep needs and the effects of excessive daytime sleepiness.

Cataplexy

Condition characterized by sudden muscular weakness and loss of muscle tone.

sleep deprivation

Condition resulting from a decrease in the amount, quality, and consistency of sleep.

Excessive daytime sleepiness (EDS)

Extreme fatigue felt during the day. Signs of this include falling asleep at inappropriate times such as while eating, talking, or driving. May indicate a sleep disorder.

Sedatives

Medications that produce a calming effect by decreasing functional activity, diminishing irritability, and allaying excitement.

circadian rhythm

Repetition of certain physiological phenomena within a 24-hour cycle.

nonrapid eye movement (NREM) sleep

Sleep that occurs during the first four stages of normal sleep.

rapid eye movement (REM) sleep

Stage of sleep in which dreaming and rapid eye movements are prominent; important for mental restoration.

sleep hygiene

The practice of following good sleep habits to sleep soundly and be alert during the day

The nurse is caring for a patient who has not been able to sleep well while in the hospital. The nurse recognizes that lack of sleep can manifest in which of the following signs and symptoms? (Select all that apply.) a. Changes in physiological function such as temperature b. Decreased appetite and weight loss c. Anxiety, irritability, and restlessness d. Impaired judgment e. Nausea, vomiting, and diarrhea f. Shortness of breath and chest pain

a, b, c, d

The nurse is providing an educational session on sleep regulation for new nurses in the Sleep Disorder Treatment Center. Which of these statements by the nurses would best indicate that learning has occurred? a. "If the patient has a disease process in the central nervous system, it can influence the functions of sleep." b. "If the patient has a disease process in the cranial nerves, it can influence the functions of sleep." c. "If the patient has an interruption in the motor pathways, it can influence the functions of sleep." d. "If the patient has an interruption in the spinal reflexes, it can influence the functions of sleep."

a. "If the patient has a disease process in the central nervous system, it can influence the functions of sleep."

The nurse is discussing lack of sleep with a middle-aged adult. The nurse recognizes that insomnia in this age group is commonly due to a. Anxiety. b. Teenagers keeping them awake. c. Caring for pets. d. Late night television.

a. Anxiety.

The nurse is caring for a patient on the medical-surgical unit who is experiencing an exacerbation of asthma. Which of the following interventions would be most appropriate to help the patient sleep? a. Bed placed in semi-Fowler's position b. Increased BNC oxygen to 5 L a minute c. A snack provided before bedtime d. Encouraging the patient to read

a. Bed placed in semi-Fowler's position

The nurse is completing an assessment on an older patient who is having difficulty falling asleep. Which factor has the potential to contribute to this difficulty? a. Depression b. Smoking c. Alcohol d. Fatigue

a. Depression

The nurse is caring for a patient who has been in holding in the emergency department for 24 hours. The nurse is concerned about the patient experiencing sleep deprivation. What would be the best action for the nurse to take? a. Expedite the process of obtaining a medical-surgical room for the patient. b. Pull the curtains shut, dim the lights, and decrease the number of visitors. c. Obtain an order for a medication to help the patient sleep. d. Ask everyone in the unit to try to be quiet so the patient can sleep.

a. Expedite the process of obtaining a medical-surgical room for the patient.

Which nursing observation of the patient in intensive care indicates that the patient is sleeping comfortably? a. Eyes closed, lying quietly, respirations 12, heart rate 60 b. Eyes closed, tossing in bed, respirations 18, heart rate 80 c. Eyes closed, mumbling to self, respirations 16, heart rate 68 d. Eyes closed, lying straight in bed, respirations 22, heart rate 66

a. Eyes closed, lying quietly, respirations 12, heart rate 60

The nurse is evaluating outcomes for the patient with the nursing diagnosis of Insomnia. During this process, the nurse recognizes that a. The patient is the best evaluator of sleep. b. Interventions will need to be adjusted. c. Medical conditions will not influence outcomes. d. Observations of the patient provide needed data.

a. The patient is the best evaluator of sleep.

The nurse is completing a sleep assessment on a patient. The nurse utilizes which of the following tools to complete the assessment? a. Visual Analogue Scale b. OUCHER scale c. FACES scale d. Glasgow Coma Scale

a. Visual Analogue Scale

The nurse is beginning a sleep assessment on a patient. Which of the following would be the most appropriate question to ask? a. "What is going on?" b. "How are you sleeping?" c. "Are you taking any medications?" d. "What did you have for dinner last night?"

b. "How are you sleeping?"

A patient has received a nursing diagnosis of sleep deprivation. Which of the following statements by the patient would indicate that outcomes are being met? a. "I wake up only once a night to go the bathroom." b. "I feel rested when I wake up in the morning." c. "I go to sleep within 30 minutes of lying down." d. "I only take a 20-minute nap during the day."

b. "I feel rested when I wake up in the morning."

The nurse is discussing with a new mother the sleep requirements of a neonate. Which of these comments would indicate that the patient has an understanding of the neonate's sleeping pattern? a. "I can't wait to get the baby home to play with the brothers and sisters." b. "I will ask my mom to come after the first week, when the baby is more alert." c. "I will get the baby on a sleeping schedule the first week while my mom is here." d. "I won't be able to nap during the day because the baby will be awake."

b. "I will ask my mom to come after the first week, when the baby is more alert."

The nurse is caring for a patient who is having trouble sleeping. To encourage decreased stimulus to the reticular activating system and activation of the bulbar synchronizing region, which actions would the nurse implement? a. Encourage television for distraction. b. Encourage relaxed positions. c. Walk with the patient. d. Provide a favorite beverage.

b. Encourage relaxed positions.

The nurse is caring for an adolescent who is complaining of difficulty falling asleep. Which intervention would be most appropriate? a. Adjust the temperature in the patient's room to 21° C (70° F). b. Ensure that the night light in the patient's room is working. c. Encourage the discontinuation of soda and chocolate nightly snack. d. Close the door to decrease noise from unit activities.

c. Encourage the discontinuation of soda and chocolate nightly snack.

Which of the following would be most important for the nurse to monitor in a patient who has obstructive sleep apnea? a. Gastrointestinal function b. Circulatory status c. Respiratory status d. Neurological function

c. Respiratory status

A young mother has been hospitalized for an irregular heartbeat (arrhythmia). The night nurse comes in to see the patient awake. What would be the most appropriate nursing intervention? a. Inform the patient that it is late and time to go to sleep. b. Ask the patient if she would like medication to help her sleep. c. Recommend the great movie that is on television tonight. d. Take time to sit and talk with the patient about her inability to sleep.

d. Take time to sit and talk with the patient about her inability to sleep.

Hypersomnolence

excessive sleepiness

polysomnogram

sleep study

Narcolepsy

syndrome characterized by recurrent uncontrollable seizures of drowsiness and sleep

nocturia

urination at night