H&I chap 19 exam 3

A client reports symptomatology that supports the diagnosis of sleep paralysis. The nurse effectively assesses the client by asking which question?

"Do you ever have nightmares?"

A client tells the nurse, "I just don't sleep more than 5 hours at night." The nurse assesses the client best for individual sleep requirements by asking which question?

"Do you usually feel rested and alert when you get up?"

The nurse appropriately assesses an obese, hypertensive, Type 2 diabetic client when asking:

"How much sleep do you usually get each night?"

Which patient statement supports a diagnosis of narcolepsy?

"I have no control over when i fall asleep"

Many people allow life circumstances to dictate their amount of sleep instead of recognizing sleep as a priority. Which statement will the nurse recognize as progress in the patient's sleep hygiene program?

"I have removed the television from my bedroom."

Which statement by a patient who was educated about the importance of acquiring adequate sleep indicates a need for further teaching?

"I will be sure to try to get 8 hours of sleep every night, and 9 or 10 hours of sleep if I can."

One criterion for the diagnosis of primary insomnia is met when the client makes which statement?

"Ive actually missed work because I'm too tired to go"

A client diagnosed with a chronic sleep disorders begins to cry and states, "I can't keep going like this! I work in a bank and if I can't function correctly I'll lose my job. I just don't think I'll get better." Which statement provides a therapeutic response to the client's concerns?

"There is much hope for improvement through treatment. Let's talk about some strategies for your problems at work."

What is the usual time period that medications to treat insomnia are usually prescribed?

2 weeks

Larry is a 50-year-old man who works about 60 hours per week. He arrives at the clinic seeking assistance with a weight gain of 50 pounds over the past year. Larry admits to sleeping 4 to 5 hours a night. The nurse recognizes that the weight gain may be related to:

Dysregulation of hormones that influence appetite

A depressed client is likely to report a sleep disorder that includes which characteristics?

Frequent awakenings during the night

When providing possible interventions to promote the safety of a client reporting symptoms of somnambulism, the nurse should include which intervention?

Gating the stairways

A 38-year-old patient referred for sleep studies reports frequent daytime lethargy, unintended lapses into sleep, and never feeling rested on awakening in the morning. These symptoms support which sleep-related diagnosis?

Hypersomnolence

Light projected into the retina is believed to trigger changes in sleep patterns and quality of sleep. Therefore the nurse should suggest:

Limiting the use of electronic devices in the hour before bedtime

The stage of sleep known as rapid eye movement or REM sleep is characterized by atonia and myoclonic twitches in addition to the actual rapid movement of the eyes. Atonia is thought to be a protective mechanism as it:

Limits physical movements

A client reports insomnia and shares that a friend has recommended a nonprescription hormone product that can be purchased at the local health food store. The nurse suspects that the medication contains which component?

Melatonin

An older adult client is reporting symptomatology that suggests REM sleep behavior disorder (RSBD). Which comorbid condition should the nurse assess for?

Parkinson's disease

What non-habit-forming melatonin receptor agonist is often prescribed for insomnia?

Ramelteon (Rozerem)

A client reports to the nurse that falling asleep can often take hours. Which intervention should the nurse implement?

Teach the client how to do progressive relaxation

A client asks the nurse to explain what basal sleep requirement is. What is the nurse's best response?

The amount of sleep needed to be fully awake and perform well in the daytime.

Madelyn, a 29-year-old patient recently diagnosed with depression, comes to the mental health clinic complaining of continued difficulty sleeping. One week ago she was started on a selective serotonin reuptake inhibitor (SRRI), fluoxetine (Prozac), for her depressive symptoms. When educating Madelyn your response is guided by the knowledge that:

The neurotransmitters involved in sleep and wakefulness are the same neurotransmitters targeted by many psychiatric medications and the problem may be temporary.

Sleep disturbances are often overlooked or undiagnosed due to:

A lack of formal nurse and physician training in sleep disturbances

What is the most effective nursing intervention regarding the accurate assessment of sleep disorders?

A sleep diary

A client newly diagnosed with hypersomnolence asks about what medication will be prescribed to manage this disorder. The nurse will base his/her response based on what knowledge?

A stimulant will most likely be prescribed

What factors are consistently observed to increase the risk for sleep disturbances?

Alcohol and tobacco

Sleep deprivation is considered a safety issue that results in loss of life and property. Psychomotor impairments of sleep deprivation are similar to symptoms caused by:

Alcohol consumption

Which behaviors will the nurse encourage a patient diagnosed with insomnia disorder to adopt?

Avoiding exercising at bedtime Avoiding napping during the day Getting up at the same time each day Moving the clock so it is not visible from the bed

Which treatment is typically prescribed for primary insomnia?

Cognitive-behavioral therapy insomnia (CBT-I) Stimulus control Sleep restriction Sleep hygiene measures

A slightly obese client reports falling asleep during the daytime even though she has slept all night. Her husband says she snores, and her blood pressure is noted to be in the low hypertensive range. The nurse anticipates that the client will be scheduled for which diagnostic test?

polysomnography