Mental Health Chapter 19 NCLEX Questions

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A client asks the nurse to explain what basal sleep requirement is. What is the nurse's best response? A. The basal temperature of your body needed to induce the best sleep. B. The sleep time by your body needed to repair cellular damage. C. The amount of sleep needed to be fully awake and perform well in the daytime. D. The amount of sleep needed to transition to rapid eye movement (REM) sleep.

C. The amount of sleep needed to be fully awake and perform well in the daytime. Basal sleep requirement is the amount of sleep required to feel fully awake and able to sustain normal levels of performance during the periods of wakefulness. The other options do not describe basal sleep requirement.

Which statement by a patient who was educated about the importance of acquiring adequate sleep indicates a need for further teaching? A. "I will be sure to try to get 8 hours of sleep every night, and 9 or 10 hours of sleep if I can." B. "Getting less than 6 hours of sleep at night may increase my risk for medical problems." C. "Getting enough sleep will increase my productivity at work." D. "Since I have to drive for my job, getting enough sleep will help me avoid accidents."

A. "I will be sure to try to get 8 hours of sleep every night, and 9 or 10 hours of sleep if I can." Sleeping more than 8 hours per night is associated with up to a twofold increased risk of obesity, diabetes, hypertension, incident cardiovascular disease, stroke, depression, and substance abuse. The other options are all true.

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? A. Circadian rhythm disorder B. Hypersomnolence C. REM sleep behavior disorder D. Breathing-related sleep disorder

B. Hypersomnolence The patient with hypersomnolence reports recurrent periods of sleep or unintended lapses into sleep, frequent napping, nonrefreshing nonrestorative sleep regardless of the amount of time slept, and difficulty with full alertness during the wake period. Circadian rhythm sleep disorders occur when there is a misalignment between the timing of the individual's normal circadian rhythm and external factors that affect the timing or duration of sleep. Patients with REM sleep disorder display elaborate motor activity associated with dream mentation. Breathing-related sleep disorder is characterized by frequent upper airway obstruction.

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. There is no effective medication treatment for hypersomnolence disorder. B. Medication therapy with benzodiazepines may be initiated. C. A stimulant will most likely be prescribed. D. The client will be started on an anticholinesterase inhibitor.

C. A stimulant will most likely be prescribed. Pharmacotherapy with long-acting amphetamine-based stimulants such as methylphenidate and non-amphetamine-based stimulants such as modafinil are helpful in hypersomnolence disorder. The other options are incorrect because there is effective medication treatment; benzodiazepines are sedating and addictive; and anticholinesterase inhibitors are used for the treatment of dementia.

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? A. "Don't worry! I'm sure with treatment everything will get better." B. "You are not alone. Many people who come for sleep studies are going through the same thing." C. "You seem so sad. May I ask if something else is troubling you?" D. "There is much hope for improvement through treatment. Let's talk about some strategies for your problems at work."

D. "There is much hope for improvement through treatment. Let's talk about some strategies for your problems at work." This response instills hope regarding the ability of the patient to improve and suggests positive strategies for daily functioning. The other responses are nontherapeutic.


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