EXam 3 study

What are the primary functions of sleep?

Reducing fatigue, stabilizing mood, improving blood flow to the brain, increasing protein synthesis & healing, maintaining the immune system, promoting cellular growth & repair, and improving capacity for learning & memory storage.

What are the phases of sleep?

Sleep consists of REM (Rapid Eye Movement) and three stages of NREM (Non-Rapid Eye Movement).

How does sleep requirement change as a person ages?

As a person ages, the time spent in NREM decreases while the time spent in REM sleep increases.

What is the lightest stage of NREM sleep?

Stage 1 NREM is the lightest stage of sleep, lasting 1-7 minutes, characterized by a loss of awareness and easy awakeness.

Describe Stage 2 NREM sleep.

Stage 2 NREM is a deeper sleep lasting 10-25 minutes where the body's vital signs and metabolism continue to slow.

What occurs during Stage 3 NREM sleep?

Stage 3 NREM, or deep sleep, lasts 20-40 minutes and is when psychological rest and restoration occur, making it difficult to awaken.

What characterizes REM sleep?

REM sleep lasts 20-40 minutes, features vivid dreams, varying vital signs, and is crucial for cognitive restoration.

What can interfere with sleep?

Factors include physiological disorders, current life events, diet, exercise, fatigue, sleep environment, medications, substances, comorbidities, food/drink, safety, rituals, and circadian rhythms.

What is insomnia?

Insomnia is the most common sleep disorder characterized by the inability to get adequate sleep and feel rested.

What is sleep apnea?

Sleep apnea involves more than 5 breathing cessations per hour lasting longer than 10 seconds, resulting in decreased arterial O2 saturation levels.

List some common types of parasomnia.

Somnambulism (sleepwalking), nocturnal enuresis (bed-wetting), sleep talking, nightmares, and restless legs syndrome.

What is narcolepsy?

Narcolepsy is characterized by sudden, uncontrollable attacks of sleep, often accompanied by sleep paralysis and cataplexy.

What nursing measures can promote relaxation and sleep?

Help establish a bedtime routine, limit nighttime awakenings, promote a quiet environment, assist with personal hygiene before sleep, and engage in muscle relaxation.

Question: A nurse is collecting data from an older adult client regarding their sleep patterns. Which of the following findings should the nurse expect based on the client's age?

A. Increased time spent in NREM sleep
B. Decreased time spent in REM sleep
C. Increased time spent in REM sleep
D. No change in sleep cycles

Correct Answer: C

Rationale: According to the provided notes, as a person ages, the time spent in NREM sleep decreases while the time spent in REM sleep increases. This differs from neonates who typically have high REM percentages that stabilize later in life.

Question: A nurse is caring for a client who is having difficulty staying asleep. The nurse should identify that which of the following is a primary function of sleep?

A. Decreasing protein synthesis
B. Reducing blood flow to the brain
C. Stabilizing mood and reducing fatigue
D. Decreasing the immune system's response

Correct Answer: C

Rationale: The primary functions of sleep include reducing fatigue, stabilizing mood, improving blood flow to the brain, increasing protein synthesis, and maintaining the immune system.

Question: A nurse is monitoring a client in a sleep study. The client is in a stage of sleep that is very light, lasts approximately 1 to 7 minutes, and the client is easily awakened. The nurse should identify this as which stage?

A. Stage 1 NREM
B. Stage 2 NREM
C. Stage 3 NREM
D. REM sleep

Correct Answer: A

Rationale: Stage 1 NREM is the lightest stage of sleep, typically lasting 1 to 7 minutes where the person is easily aroused and loses awareness of their surroundings.

Question: Which stage of sleep is characterized by a decrease in the body's vital signs and metabolism, typically lasting 10 to 25 minutes?

A. Stage 1 NREM
B. Stage 2 NREM
C. Stage 3 NREM
D. REM sleep

Correct Answer: B

Rationale: Stage 2 NREM is a deeper sleep than Stage 1, lasting 10 to 25 minutes, during which vital signs and metabolism continue to slow down.

Question: A client reporting persistent exhaustion is encouraged to reach 'deep sleep' for psychological restoration. Which stage is the nurse referring to?

A. Stage 1 NREM
B. Stage 2 NREM
C. Stage 3 NREM
D. REM sleep

Correct Answer: C

Rationale: Stage 3 NREM, also known as deep sleep, lasts 20 to 40 minutes and is the period when psychological rest and restoration occur.

Question: A nurse is teaching a group of students about the cognitive benefits of sleep. Which stage of sleep is crucial for cognitive restoration and features vivid dreaming?

A. Stage 1 NREM
B. Stage 2 NREM
C. Stage 3 NREM
D. REM sleep

Correct Answer: D

Rationale: REM (Rapid Eye Movement) sleep is essential for cognitive restoration and is characterized by vivid dreaming and varying vital signs.

Question: A nurse is assessing a client for sleep apnea. The nurse should identify that sleep apnea is defined as having more than how many breathing cessations per hour?

A. 2
B. 5
C. 10
D. 15

Correct Answer: B

Rationale: Sleep apnea occurs when there are more than 5 breathing cessations per hour, each lasting longer than 10 seconds.

Question: A client reports suddenly falling asleep during the day and experiencing muscle weakness when laughing. Which sleep disorder should the nurse suspect?

A. Insomnia
B. Sleep apnea
C. Narcolepsy
D. Parasomnia

Correct Answer: C

Rationale: Narcolepsy is characterized by sudden, uncontrollable sleep attacks and is often accompanied by cataplexy (sudden muscle weakness) and sleep paralysis.

Question: A nurse is planning care for a client with a sleep disorder. Which of the following interventions should the nurse include to promote sleep?

A. Encourage exercise right before bedtime
B. Wake the client frequently for assessment
C. Assist with personal hygiene and a bedtime routine
D. Provide a large meal before sleep

Correct Answer: C

Rationale: Nursing measures to promote sleep include establishing a routine, providing a quiet environment, assisting with hygiene, and limiting nighttime awakenings.

Question: A nurse is educating a client on factors that interfere with sleep. Which of the following should be included? (Select all that apply)

1. Circadian rhythms

2. Current life events

3. Diet and exercise

4. Medications

5. Consistent bedtime rituals

Correct Answer: 1, 2, 3, 4

Rationale: Factors such as life events, diet, exercise, medications, and circadian rhythms can interfere with sleep. Bedtime rituals (option 5) promote sleep rather than interfere with it.

Question: True or False: Stage 3 NREM sleep is the stage where the person is most easily awakened.

Correct Answer: False

Rationale: Stage 3 NREM is deep sleep, making it difficult to awaken the individual. Stage 1 NREM is the lightest stage where awakening is easiest.

Question: True or False: Insomnia is the most common sleep disorder, characterized by an inability to feel rested.

Correct Answer: True

Rationale: Insomnia is defined as the most common sleep disorder where individuals are unable to get adequate sleep or feel rested.

Question: True or False: Somnambulism, or sleepwalking, is considered a type of parasomnia.

Correct Answer: True

Rationale: Parasomnias include somnambulism, nocturnal enuresis (bed-wetting), sleep talking, and nightmares.

Question: True or False: REM sleep typically lasts for 20 to 40 minutes per cycle.

Correct Answer: True

Rationale: Both Stage 3 NREM and REM sleep phases are documented as lasting approximately 20 to 40 minutes.

Question: True or False: During Stage 2 NREM, metabolism increases to prepare the body for the next day.

Correct Answer: False

Rationale: During Stage 2 NREM, the body's metabolism and vital signs continue to slow down or decrease.

Question: True or False: Nocturnal enuresis refers to the condition of sleep-talking.

Correct Answer: False

Rationale: Nocturnal enuresis is the medical term for bed-wetting, which is a form of parasomnia.

Question: True or False: A lack of sleep can lead to a decrease in protein synthesis and impaired healing.

Correct Answer: True

Rationale: One of the primary functions of sleep is increasing protein synthesis and healing; therefore, sleep deprivation inhibits these processes.

Question: True or False: Muscle relaxation techniques are a nursing measure that can promote sleep.

Correct Answer: True

Rationale: Engaging in muscle relaxation is a recognized nursing intervention to help clients relax and fall asleep.

Question: True or False: Caffeine and heavy exercise within 2 hours of bedtime can promote better Stage 3 sleep.

Correct Answer: False

Rationale: Diet and exercise are factors that interfere with sleep; caffeine is a stimulant and heavy exercise late in the day often disrupts the sleep cycle.

Question: True or False: Breathing cessations in sleep apnea must last longer than 10 seconds to be clinically significant.

Correct Answer: True

Rationale: The criteria for sleep apnea involves cessations longer than 10 seconds which leads to decreased arterial O_2 saturation.

Question: A nurse is caring for a client with narcolepsy. What safety precaution is most important for this client?

A. Ensuring the client has a high-carbohydrate diet
B. Teaching the client about the risks of cataplexy during activity
C. Encouraging the client to exercise before bed
D. Providing a dark environment during the day

Correct Answer: B

Rationale: Narcolepsy involves sudden sleep attacks and cataplexy (muscle weakness). It is vital to address safety because these attacks can occur during daily activities.

Question: A nurse explains to a student that cellular growth and repair occur primarily during which process?

A. REM Sleep
B. Exercise
C. Sleep
D. Digestion

Correct Answer: C

Rationale: Sleep is the interval where cellular growth and repair, as well as protein synthesis, are promoted for the body's maintenance.

Question: In which stage of sleep is a client most likely to experience a vivid, narrative-style dream?

A. NREM Stage 1
B. NREM Stage 2
C. NREM Stage 3
D. REM sleep

Correct Answer: D

Rationale: REM sleep is the phase associated with vivid dreaming and cognitive restoration.

Question: A client complains of a 'crawling' sensation in their legs that prevents sleep. The nurse should document this as which condition?

A. Somnambulism
B. Nocturnal enuresis
C. Restless legs syndrome
D. Sleep apnea

Correct Answer: C

Rationale: Restless legs syndrome is a type of parasomnia characterized by uncomfortable sensations in the legs and an uncontrollable urge to move them.

Question: Which of the following physiological changes occurs during sleep apnea?

A. Increased arterial O2 saturation B. Decreased arterial O2 saturation
C. Stabilized breathing patterns
D. Increased heart rate with regular rhythm

Correct Answer: B

Rationale: During sleep apnea, the cessation of breathing results in decreased arterial O_2 saturation levels.

Question: A nurse is helping a client who has insomnia. Which of the following actions should the nurse perform first?

A. Administer sleeping medication
B. Ask the client about their current life events and stress
C. Dim the lights in the hallway
D. Provide a warm snack

Correct Answer: B

Rationale: Assessment is the first step of the nursing process. Identifying factors like current life events helps determine the cause of the insomnia.

Question: How many stages of NREM sleep are identified in the provided notes?

A. 2
B. 3
C. 4
D. 5

Correct Answer: B

Rationale: The notes specify that sleep consists of REM and three stages of NREM (1, 2, and 3).

Question: A nurse is caring for a client with Stage 3 NREM deficiency. The client is at risk for which of the following?

A. Poor memory storage
B. Lack of psychological restoration
C. Increased awareness of surroundings
D. Decreased dreaming

Correct Answer: B

Rationale: Stage 3 NREM is specifically when psychological rest and restoration occur; therefore, a deficiency impacts these functions.

Question: Which statement by a client indicates an understanding of sleep hygiene?

A. 'I will drink a cup of coffee before bed to help me relax.'
B. 'I will keep my bedroom at a very warm temperature.'
C. 'I will establish a consistent bedtime routine every night.'
D. 'I will watch an action movie in bed to fall asleep faster.'

Correct Answer: C

Rationale: Establishing a consistent bedtime routine is a key nursing measure to promote relaxation and sleep.

Question: What is the duration of Stage 1 NREM sleep?

A. 1-7 minutes
B. 10-25 minutes
C. 20-40 minutes
D. 60 minutes

Correct Answer: A

Rationale: Stage 1 NREM is a short, light stage of sleep lasting only about 1 to 7 minutes.

Question: A nurse is evaluating a client's risk for sleep disturbances. Which factor refers to the body's internal 24-hour clock?

A. Comorbidities
B. Circadian rhythms
C. Rituals
D. Fatigue

Correct Answer: B

Rationale: Circadian rhythms are the internal processes that regulate the sleep-wake cycle and repeat roughly every 24 hours.

Question: A client experiences cataplexy. Which disorder is this associated with?

A. Sleep apnea
B. Narcolepsy
C. Insomnia
D. Parasomnia

Correct Answer: B

Rationale: Cataplexy, a sudden loss of muscle tone, is a classic symptom of narcolepsy.

Question: Which stage of sleep shows varying vital signs compared to the slowing vital signs in NREM?

A. Stage 1 NREM
B. Stage 2 NREM
C. Stage 3 NREM
D. REM sleep

Correct Answer: D

Rationale: REM sleep is characterized by varying vital signs, whereas NREM stages typically involve a slowing of vital signs and metabolism.

Question: A nurse is instructing a client on muscle relaxation. This is aimed at promoting which of the following?

A. Increased REM duration
B. Reduction of fatigue through protein synthesis
C. Relaxation and onset of sleep
D. Prevention of sleep apnea

Correct Answer: C

Rationale: Progressive muscle relaxation is used to help a client relax their body, making it easier to transition into the sleep cycle.

Question: What is a common nursing intervention to help a client who is being frequently disturbed by noise in the hospital?

A. Increase the brightness of lights
B. Promote a quiet environment and limit interruptions
C. Provide the client with high-protein snacks every hour
D. Place the client near the nurses' station for observation

Correct Answer: B

Rationale: To promote sleep, the nurse should limit nighttime awakenings and ensure a quiet environment.

Question: A client reports frequent nightmares that wake them up. This is categorized as which general type of sleep disorder?

A. Insomnia
B. Parasomnia
C. Narcolepsy
D. Apnea

Correct Answer: B

Rationale: Parasomnias are a category of sleep disorders that include abnormal movements or experiences, such as nightmares or sleepwalking.

Question: During which NREM stage does the body's metabolism first begin to slow significantly?

A. Stage 1
B. Stage 2
C. Stage 3
D. REM

Correct Answer: B

Rationale: While awareness is lost in Stage 1, Stage 2 is where vital signs and metabolism continue to slow down effectively.

Question: A person who sleeps but does not feel rested upon waking likely has which disorder?

A. Narcolepsy
B. Insomnia
C. Somnambulism
D. Sleep paralysis

Correct Answer: B

Rationale: Insomnia is specifically defined as the inability to get adequate sleep AND feel rested.

Question: True or False: REM sleep is the longest stage of the sleep cycle.

Correct Answer: False

Rationale: While REM and Stage 3 both last 20-40 minutes, they are components of a larger cycle; no single stage is labeled as the 'longest' in the provided notes, and Stage 2 is often a large portion of sleep in adults (10-25 mins per cycle, but repeats frequently).

Question: True or False: Sleep improves the capacity for learning and memory storage.

Correct Answer: True

Rationale: Improving capacity for learning and memory storage is a documented primary function of sleep.

One-word entry: What is the medical term for sleepwalking?

Correct Answer: Somnambulism

Rationale: Somnambulism is the specific term used for walking or performing other complex behaviors while asleep.

One-word entry: What is the medical term for bed-wetting during sleep?

Correct Answer: Enuresis

Rationale: Nocturnal enuresis is the term for involuntary urination during sleep, common in the parasomnia category.

One-word entry: Which specific stage of sleep provides cognitive restoration?

Correct Answer: REM

Rationale: REM (Rapid Eye Movement) sleep is unique in its role of restoring cognitive functions and processing memory.

One-word entry: How many stages of NREM sleep exist?

Correct Answer: Three

Rationale: The sleep cycle is composed of REM and three distinct stages of NREM (Stage 1, Stage 2, and Stage 3).

One-word entry: What is the most common sleep disorder?

Correct Answer: Insomnia

Rationale: Insomnia is the most prevalent sleep disorder reported in clinical settings and the provided nursing notes.

What is nutrition?

The process by which the body uses food.

Define malnutrition.

A condition resulting from a lack of proper nutrients in the diet.

What are the four components of a healthy diet?

Variety, balance, moderation, and being individually appropriate.

What is protein complementation?

Combining different protein sources to obtain all essential amino acids.

List five factors that influence nutritional needs.

Age, sex, physical activity level, health status, and socioeconomic status.

What does MyPlate emphasize about food diversity?

Focus on eating a variety of foods from all food groups.

What are the primary roles of carbohydrates?

They serve as the primary source for quick energy.

What are the health impacts of malnutrition?

It can lead to poor health outcomes, including increased risk of chronic diseases.

How can dietary fiber affect health?

It supports digestion and can help regulate blood sugar.

What is the significance of portion control in dieting?

It helps to avoid exceeding calorie limits.

Identify common problems from nutritional assessments.

Malnutrition, obesity, and deficiencies in specific vitamins or minerals.

What are the key nutrients required by older adults?

Higher protein, vitamin D, and calcium.

Describe one aspect of nutrition unique to older adults.

Increased risk for malnutrition due to loss of appetite.

What are vitamins B and C classified as?

Water-soluble vitamins.

What does vitamin D help maintain?

Normal blood concentrations of calcium and phosphorus.

State the recommended approach to meet nutrient needs.

Prioritize meeting needs through food instead of supplements.

What is the role of antioxidants like vitamin E?

They protect cells from oxidative damage.

What is the importance of folate during pregnancy?

It reduces the risk of neural tube defects.

What condition is associated with vitamin B12 deficiency?

Pernicious anemia.

What factors influence eating habits according to the notes?

Food preferences, attitudes towards nutrition, and knowledge of nutrition.

What is the primary function of calcium in the body?

To maintain bone and teeth health.

How does sodium influence hydration?

A salty meal triggers thirst and fluid consumption.

What does the current Dietary Guidelines for Americans suggest about food choices?

Choose nutrient-dense foods and limit added sugars and saturated fats.

What role do minerals play in nutrition?

They are essential for various body functions, including enzyme activity and structural roles.

What types of food are sources of heme iron?

Meat, fish, and poultry.

What is one risk factor for developing iron deficiency?

Chronic blood loss or poor dietary intake of iron.

Identify the relationship between diet quality and health outcomes.

Healthy eating patterns are linked to better health and disease prevention.

Explain the impact of social isolation on nutrition for older adults.

It increases the risk of malnutrition and poor eating habits.

What is the purpose of nutritional labeling on food products?

To provide consumers with information to make informed food choices.

Define the recommended daily value of sodium for a healthy diet.

Less than 2400mg per day.

What is the role of potassium and chloride in the body?

They are major minerals and electrolytes essential for fluid balance.

Describe the effect of aging on nutrient absorption.

Aging can decrease nutrient absorption and increase dietary needs.

A nurse is performing a nutritional assessment on an older adult client who lives alone. Which finding should the nurse identify as a primary risk factor for malnutrition in this client?

A. History of occasional exercise
B. Preference for nutrient-dense foods
C. Social isolation
D. Use of vitamin supplements

Answer: C. Social isolation

Rationale: According to the notes, social isolation in older adults increases the risk of malnutrition and poor eating habits. While vitamin supplements and activity are generally positive, the lack of social interaction frequently leads to decreased motivation to prepare and consume balanced meals.

A nurse is teaching a client about the intake of sodium as part of a healthy diet. To meet the recommended daily value, the nurse should instruct the client to limit sodium to less than how many milligrams per day?

Answer: 2400\text{ mg}

Rationale: The recommended daily value for sodium to maintain a healthy diet and manage fluid balance is less than 2400\text{ mg} per day.

True or False: Vitamin B and Vitamin C are classified as fat-soluble vitamins, meaning they are stored in the body's adipose tissue.

Answer: False

Rationale: Vitamins B and C are classified as water-soluble vitamins. Unlike fat-soluble vitamins (A, D, E, and K), they are not stored in large amounts and require regular intake.

A nurse is teaching a client who is planning a pregnancy about nutrition. Which of the following nutrients should the nurse emphasize to reduce the risk of neural tube defects?

A. Vitamin E
B. Folate
C. Calcium
D. Potassium

Answer: B. Folate

Rationale: Folate (Vitamin B9) is essential during pregnancy because it significantly reduces the risk of neural tube defects in the developing fetus.

What is the primary function of carbohydrates in the human body?

Answer: Primary source for quick energy.

Rationale: Carbohydrates are the body's preferred source of fuel, especially for the brain and nervous system, providing immediate energy through glucose.

A nurse is evaluating a client's laboratory results and notes a deficiency that could lead to pernicious anemia. Which vitamin deficiency is associated with this condition?

A. Vitamin D
B. Vitamin C
C. Vitamin B12
D. Vitamin E

Answer: C. Vitamin B12

Rationale: Pernicious anemia is a specific type of macrocytic anemia that results from a deficiency in Vitamin B12, often due to a lack of intrinsic factor needed for absorption.

A nurse is caring for a client with a history of chronic blood loss. Which nutritional deficiency should the nurse prioritize in the assessment?

A. Sodium
B. Iron
C. Potassium
D. Chloride

Answer: B. Iron

Rationale: Chronic blood loss is a major risk factor for developing iron deficiency anemia, as iron is a key component of hemoglobin in red blood cells.

Which term describes the process of combining different protein sources, such as beans and rice, to obtain all essential amino acids?

A. Macronutrient balancing
B. Protein complementation
C. Nutrient densification
D. Caloric moderation

Answer: B. Protein complementation

Rationale: Protein complementation is the practice of eating two or more incomplete protein sources that together provide all the essential amino acids the body cannot produce on its own.

A nurse is educating an older adult client about bone health. Which two nutrients should the nurse recommend increasing in the diet?

A. Vitamin C and Fiber
B. Sodium and Potassium
C. Vitamin D and Calcium
D. Vitamin E and Folate

Answer: C. Vitamin D and Calcium

Rationale: Older adults require higher amounts of Vitamin D and Calcium to maintain bone and teeth health and to ensure normal blood concentrations of calcium and phosphorus.

True or False: According to MyPlate, consumers should focus on eating a variety of foods from all food groups to ensure nutritional diversity.

Answer: True

Rationale: One of the core tenets of the MyPlate guidelines is food diversity, encouraging consumers to pick various foods from all groups (fruits, vegetables, grains, protein, and dairy).