Davis Edge Sleep and Rest

A client who has depression with secondary insomnia is requesting "some kind of relief" to improve his or her quality of life. What type of medication would most likely be prescribed for this client? 1. Tricyclic antidepressant 2. Selective melatonin agonist 3. Benzodiazepine 4. Barbiturate

1. Tricyclic antidepressant

In which ways can anxiety interfere with a client having a restful night's sleep? Select all that apply. 1. Tachycardia 2. Increased respirations 3. Decreased norepinephrine 4. Decreased intestinal motility 5. Increased gastric secretions

1. Tachycardia 2. Increased respirations 5. Increased gastric secretions

How many hours of sleep per day does a newborn need? 1. 16 to 20 2. 10 to 11 3. 8 to 9 4. 7 to 8

1. 16 to 20

A client with restless leg syndrome reports difficulty sleeping. Which factors may be the cause? Select all that apply. 1. Age 2. Shift work 3. Low iron levels 4. Antidepressants 5. Alcohol consumption

1. Age 3. Low iron levels 4. Antidepressants

The nurse is reviewing electroencephalograph results for a client who reports sleep difficulty. Which waves would the nurse expect to disappear when the client is asleep? 1. Alpha 2. Delta 3. Theta 4. Spindle

1. Alpha

A 38-year-old client is asking for medication for trouble falling asleep and staying asleep. The client also feels groggy and unrested during the day. What should the nurse assess for as possible etiologies? Select all that apply. 1. Watching TV while in bed 2. Sleeping with smart phone nearby 3. Caffeine consumption 4. Current medications 5. Exercise/activities

1. Watching TV while in bed 2. Sleeping with smart phone nearby 3. Caffeine consumption 4. Current medications

When assessing a client for sleep disturbances, what is an appropriate question to address the sleeping environment? 1. What room temperature do you prefer? 2. Do you have a regular sleep schedule? 3. What do you do to help you fall asleep? 4. Do you sleepwalk?

1. What room temperature do you prefer?

The nurse is developing a plan of care for a client in the intensive care unit with fluid volume overload related to congestive heart failure who is receiving diuretics. Which factors can lead to altered sleep patterns for this client? Select all that apply. 1. Uncontrolled pain 2. Diagnosis of congestive heart failure 3. Hospitalization in an intensive care unit 4. Frequent urination related to diuretic use 5. Repeated interruptions throughout the day and night

3. Hospitalization in an intensive care unit 4. Frequent urination related to diuretic use 5. Repeated interruptions throughout the day and night

A client is about to engage in a sleep study to determine sleep apnea. At which stage would an EEG show vivid dream activity? 1. NII (NREM) 2. NIII (NREM) 3. REM 4. NI (NREM)

3. REM

Which part of the brain controls circadian rhythms? 1. Thalamus 2. Cerebellum 3. Pituitary gland 4. Hypothalamus

4. Hypothalamus

The nurse is caring for a client with uncontrolled type 1 diabetes mellitus and is experiencing varying blood glucose levels. Which nursing intervention should the nurse perform that may prevent sleep and rest for the client? 1. Provide a snack every 3 to 4 hours. 2. Administer insulin as prescribed. 3. Administer 50% dextrose before bed. 4. Monitor blood glucose levels during the night.

4. Monitor blood glucose levels during the night.

Which sleep disorder involves a person suddenly waking up thrashing about and hallucinating? 1. Insomnia 2. Narcolepsy 3. Sleep apnea 4. Night terrors

4. Night terrors

Which diagnostic test involves measuring brain wave activity, oxygen and carbon dioxide levels, and vital signs? 1. Actigraph 2. Sleep study 3. Sleep diary 4. Polysomnography

4. Polysomnography

The parents of a toddler report difficulty getting their child to sleep at night. The child wants to play and not go to sleep. Which intervention suggested by the nurse would be most effective? 1. Give the toddler melatonin prior to sleep. 2. Plan sedentary activities the last hour before bed. 3. Punish the child for not listening to the rules for bedtime. 4. Feed the child a large snack 30 minutes prior to going to bed

2. Plan sedentary activities the last hour before bed.

A 36-year-old male has been admitted to the medical-surgical floor for 24-hour observation due to exhaustion. The client reports difficultly falling asleep and then staying asleep for the past 5 months when he started a new job working nights. In addition, he states that since his 5th child was born, it is loud in his house, causing him to not get restful sleep when he gets home from work. He states he often works 12- to 14-hour shifts and only gets about 4 hours of sleep before having to return to work, and frequently dozes off on the job. He came to the hospital because he thinks he has "narcolepsy or something." Upon further assessment, he reports being very agitated at the slightest things and that he and his wife have been fighting a lot, and the nurse notices he looks very tired with dark circles underneath his eyes. What is the objective data in this scenario that help form the nursing care plan? Select all that apply. 1. Admitted for exhaustion 2. Looks tired with dark circles under the eyes 3. Reports being very agitated 4. Works 12 to 14 hours with only 4 hours of sleep 5. Difficulty falling asleep

1. Admitted for exhaustion 2. Looks tired with dark circles under the eyes

Breakfast is brought to a client who has been experiencing severe pain and thus little sleep. He or she is finally able to sleep due to analgesic therapy and is asleep when the tray is brought into the room. What should the nurse do in this situation? 1. Allow the client to sleep and have the breakfast tray brought later in the morning. 2. Leave the breakfast tray on the side table for when the client wakes up. 3. Awaken the client briefly to ask if he or she would like to go ahead and have breakfast while it is hot. 4. Wake the client to eat to keep him or her on a regular sleep cycle and provide an opportunity to rest or nap after the meal.

1. Allow the client to sleep and have the breakfast tray brought later in the morning.

The nurse is educating a client with a new diagnosis of sleep apnea regarding consistent use of the continuous positive airway pressure (CPAP) machine. Which complications should the nurse instruct the client about that can occur with untreated sleep apnea? Select all that apply. 1. Angina 2. Anemia 3. Arrhythmias 4. Hypotension 5. Evening headache

1. Angina 3. Arrhythmias

Which are causes of obstructive sleep apnea? Select all that apply. 1. Being overweight 2. Enlarged tonsils 3. Over 60-years-old 4. Deviated nasal septum 5. History of cigarette smoking

1. Being overweight 2. Enlarged tonsils 4. Deviated nasal septum

Which intervention can the nurse include in the plan of care for a client in the hospital to promote sleep and rest? 1. Clustering activities 2. Preventing daytime naps 3. Turning lights on for safety 4. Keeping visitors from staying the night

1. Clustering activities

When educating student nurses on self-care and sleep hygiene, what information should be included? Select all that apply. 1. Fatigue can cause impaired judgment and decision making. 2. If possible, take frequent breaks (e.g., every 1 to 2 hours) during the night shift. 3. Be smart about your caffeine use. 4. Use breaks and lunch hours for exercise and cardio activity. 5. Plan rest days in between consecutive work days.

1. Fatigue can cause impaired judgment and decision making. 2. If possible, take frequent breaks (e.g., every 1 to 2 hours) during the night shift. 3. Be smart about your caffeine use. 5. Plan rest days in between consecutive work days.

The physician wants to monitor a client who has been having difficulty falling and staying asleep and feels unrested during the day. What intervention could be used to do this? 1. Have the client complete a sleep diary for 14 days. 2. Plan, implement, and evaluate nursing care related to the specific nursing diagnoses addressing sleep problems. 3. Have the client remain in the hospital to undergo sleep studies. 4. Work with the client to establish goals and outcomes regarding sleep hygiene.

1. Have the client complete a sleep diary for 14 days.

A client is concerned about having narcolepsy, as he or she has sudden involuntary episodes of sleep occurring at random times during the day. What questions should the nurse ask to further investigate the client's concern? Select all that apply. 1. How have your sleeping patterns been lately? 2. Have you experienced any slurred speech or changes in your facial muscles prior to these episodes? 3. Do you feel numbness, weakness, or unusual feelings in your knees or legs? 4. Have you recently changed shifts at work? 5. Has anyone told you that you snore or grunt while you are asleep?

1. How have your sleeping patterns been lately? 2. Have you experienced any slurred speech or changes in your facial muscles prior to these episodes? 3. Do you feel numbness, weakness, or unusual feelings in your knees or legs? 4. Have you recently changed shifts at work?

What questions would best address sleep changes and problems when assessing a client's sleep history? Select all that apply. 1. How often do you experience difficulty falling asleep? 2. Do you ever experience an unpleasant creeping feeling, crawling, or tingling, relieved only by moving the legs at night? 3. Do you snore? 4. Do you grind your teeth while you sleep? 5. Do you take any sleep medications or other drugs?

1. How often do you experience difficulty falling asleep? 2. Do you ever experience an unpleasant creeping feeling, crawling, or tingling, relieved only by moving the legs at night? 3. Do you snore? 4. Do you grind your teeth while you sleep?

Which factors can affect geriatric clients' ability to obtain adequate sleep at night? Select all that apply. 1. Frequent daytime naps 2. Taking longer to fall asleep 3. Awakening for longer periods during the night 4. Nocturia interfering with sleep 5. Loneliness causing restless sleep

2. Taking longer to fall asleep 3. Awakening for longer periods during the night 4. Nocturia interfering with sleep

A 38-year-old healthy woman is being seen for her physical examination and Pap smear. During assessment, she states she lies in bed awake for hours before falling asleep and often wakes in the middle of the night and can't go back to sleep. She also states she feels exhausted in the morning and is tired all the time. She admits to feelings of irritability toward others and lack of desire to engage in social activities because she's "just too tired." What would an appropriate nursing diagnosis be for this client? 1. Insomnia 2. Sleep Deprivation 3. Altered Sleep Patterns 4. Sleep Pattern Disturbance

1. Insomnia

A client who has just changed to working third shift is concerned about getting enough sleep. What is the probable cause for this? 1. Interrupted circadian rhythm 2. Stress-related insomnia 3. Asynchronous sleeping habits 4. Insufficient melatonin production

1. Interrupted circadian rhythm

What is the benefit of the nurse providing a back massage instead of delegating it to a NAP? 1. It allows fostering of the nurse-client relationship while assessing client needs. 2. The nurse can ensure the client is responsive to treatment. 3. The identity of the client can be confirmed without question. 4. Clients are more apt to relax with the nurse than with a NAP.

1. It allows fostering of the nurse-client relationship while assessing client needs.

Which nursing interventions can help promote sleep? Select all that apply. 1. Keep the room dim or dark. 2. Change the linens daily or when soiled. 3. Hold opioid analgesics before bedtime. 4. Position the client to provide good body alignment. 5. Turn on the television set to the client's favorite show.

1. Keep the room dim or dark. 2. Change the linens daily or when soiled. 4. Position the client to provide good body alignment.

The nurse is assessing the sleep-wake pattern of a client admitted to the hospital with a gastrointestinal bleed. Which findings would require a more in-depth sleep evaluation? Select all that apply. 1. Lasts for longer than 30 days 2. Wakes up four times per night 3. Snores about one night per week 4. Smokes one pack of cigarettes daily 5. Takes more than 15 minutes to fall asleep

1. Lasts for longer than 30 days 2. Wakes up four times per night

What is the hormone that naturally controls sleep? 1. Melatonin 2. L-tryptophan 3. Progesterone 4. Testosterone

1. Melatonin

The nurse is working with a client newly diagnosed with narcolepsy. Which treatment regimen would the nurse expect to be prescribed for this client? 1. Methylphenidate (Ritalin) 2. Bilevel positive airway pressure 3. Continuous positive airway pressure 4. Set bedtime and waking time each day

1. Methylphenidate (Ritalin)

Which changes can be noted during the deepest stage of non-REM sleep? Select all that apply. 1. Muscles relax. 2. Heart rate lowers. 3. Respirations decrease. 4. Blood pressure increases. 5. Body temperature increases.

1. Muscles relax. 2. Heart rate lowers. 3. Respirations decrease.

Which is the restful phase of sleep in which physiological function is slow? 1. NREM 2. REM 3. RAS 4. CSA

1. NREM

Which sleep disorders are considered secondary and are caused by underlying health disorders? Select all that apply. 1. Pain 2. Anemia 3. Asthma 4. Depression 5. Hyperthyroidism

1. Pain 4. Depression 5. Hyperthyroidism

A preoperative client has not been sleeping well for years but is having even more difficulty lately due to worry about the procedure and concern about being able to receive Ambien while in the hospital. The client states, "I really can't sleep at all without it," and has been taking the medication for several years. Even though the client will receive opioid analgesics postoperatively, the physician still prescribes Ambien. What could be the reason behind this decision? 1. Pain can cause sleep disturbances. 2. The client needs as much sleep as possible to recover from surgery. 3. The medications will have differing effects on the client. 4. The client's age is a factor in sleep patterns that should not be disrupted during hospitalization.

1. Pain can cause sleep disturbances.

What priority nursing intervention does the nurse incorporate into a plan of care to promote sleep for a hospitalized client? 1. Schedule nursing care to avoid interrupting sleep. 2. Promote good body alignment to facilitate relaxation. 3. Control the temperature of the room and provide good ventilation. 4. Offer cool cloths or a back massage.

1. Schedule nursing care to avoid interrupting sleep.

An adolescent reports constant fatigue and an inability to stay awake in school. Which factors should the nurse assess for that could be interfering with sleep? Select all that apply. 1. Smart phone use 2. Drug and alcohol use 3. Caffeine consumption 4. Hectic work schedules 5. School work and studying 6. Depression, anxiety, and tension

1. Smart phone use 2. Drug and alcohol use 3. Caffeine consumption 5. School work and studying

What is a nursing consideration for arousing a client during the (NREM) stage of sleep? 1. Temperature, heart rate, and blood pressure are slightly decreased. 2. Skeletal muscles are very relaxed. 3. Metabolism, temperature, pulse, and blood pressure increase. 4. If awakened, the client will react normally.

1. Temperature, heart rate, and blood pressure are slightly decreased.

The nurse is discussing sleep patterns with a client who reports sleep disturbances. Which questions should the nurse ask the client to determine the cause of the sleep problem? Select all that apply. 1. "What do you do for employment?" 2. "Do you include exercise in your daily life?" 3. "What is a typical 24-hour food intake for you?" 4. "When does your spouse normally go to sleep?" 5. "How many caffeinated beverages do you drink each day?"

2. "Do you include exercise in your daily life?" 3. "What is a typical 24-hour food intake for you?" 5. "How many caffeinated beverages do you drink each day?"

A client presents to the clinic requesting medication to help him or her sleep. The health-care provider diagnoses the client with insomnia. Which criteria would the nurse expect to be present related to this diagnosis? Select all that apply. 1. Happens three times a night 2. Happens three days per week 3. Happens for at least three months 4. Happens when unable to sleep for three hours 5. Happens from three causes: caffeine, smoking, or alcohol

2. Happens three days per week 3. Happens for at least three months

A nurse caring for a client with peripheral neuropathy secondary to uncontrolled diabetes suggests acupuncture because the client has trouble sleeping and is showing signs of daytime drowsiness, irritability, and restlessness. The client does not want to take medication for pain but is willing to try alternative therapies. What component of the PICOT model addresses acupuncture in this situation? 1. P 2. I 3. C 4. O 5. T

2. I

In which sleep stage would a client's EEG show beta waves? 1. Drowsy stage 2. In periods of wakefulness 3. Earlier phase of NREM 4. When transitioning to deep sleep

2. In periods of wakefulness

The nurse is educating a group of teenagers regarding obtaining sufficient amounts of sleep. Which consequences of sleep deprivation should the nurse include in the presentation? Select all that apply. 1. Decreases risk for strokes 2. Increases sensitivity to pain 3. Intensifies insulin resistance 4. Strengthens the immune system 5. Increases the appetite and intake

2. Increases sensitivity to pain 3. Intensifies insulin resistance 5. Increases the appetite and intake

Which statement best describes parasomnia? 1. Parasomnia is when a client has difficulty falling asleep. 2. Parasomnias include sleep apnea and narcolepsy. 3. Parasomnia is a pattern of waking behavior that involves sleepwalking. 4. Parasomnia is an umbrella term that includes restless leg syndrome as a cause.

3. Parasomnia is a pattern of waking behavior that involves sleepwalking.

Which neurotransmitters are related to excitatory and inhibitory sleep mechanisms? Select all that apply. 1. Glycine 2. Aspartate 3. Serotonin 4. Histamine 5. Prostaglandins 6. Acetylcholine

3. Serotonin 4. Histamine 5. Prostaglandins 6. Acetylcholine

Which high-amplitude brain waves found during sleep are common in children but rare in adults? 1. Beta 2. Alpha 3. Theta 4. Delta

3. Theta