Chapter 33 Sleep

The nurse identifies what physiological response occurs with the onset of darkness and in preparation for sleep?

a. Cortisol levels peak

b. Cortisol levels increase

c. Core body temperature increases

d. Melatonin levels increase

D

The nurse recognizes what function of the reticular activating system (RAS)?

a. Records brain waves and other variables.

b. Relays motor impulse to the hypothalamus.

c. Influences patterns of biological functioning.

d. Is affected by the light-dark cycle.

B

The nurse is educating a patient about taking measures to help avoid disruption to the circadian rhythm. Which statement by the

patient indicates a need for further education?

a. "I know the circadian rhythm influences biological functions."

b. "I know the circadian rhythm exists only in humans."

c. "I know the sleep-wake circadian rhythm is impacted by the light-dark cycle."

d. "The most familiar circadian rhythm is the day-night 24-hour cycle.

B

The nurse teaches the patient what information about polysomnograpy?

a. This is the recording of brain waves and other variables.

b. This is the relay of motor impulse to the hypothalamus.

c. This is the patterns of biological functioning.

d. This is the recording of seizure activity in the brain.

A

The nurse identifies which sequence to be the usual progression of sleep?

a. NREM 1-3 then REM, then back through NREM 1 and 2

b. REM then NREM 1-4, then back through NREM 2 and 3

c. NREM 1-3 then back through NREM 3 and 2 then REM

d. REM then NREM 1-4 then back through NREM 3

C

The nurse is providing discharge instructions to the parents of a toddler about sleeping habits. Which statement indicates further

education is needed?

a. "Sleep needs may change during growth spurts."

b. "Children sleep 12 hours a day."

c. "Toddlers will often resist going to bed."

d. "The bedtime routine can vary.

D

When the nurse is explaining cataplexy to the patient, which description should be included?

a. It is an uncontrolled desire to sleep.

b. It is falling asleep for several minutes.

c. It is loss of voluntary muscle tone.

d. It is a sleep cycle that begins with NREM

C

The nurse is providing discharge instructions to a patient who has had sleep alterations. Which statement by the patient indicates

further education is needed?

a. "I should avoid drinking caffeine too close to bedtime."

b. "I should not eat anything too close to bedtime."

c. "I should exercise regularly to help with sleeping."

d. "I can gain weight if I don't sleep enough."

B

The nurse is performing an assessment of the patient's sleep patterns. Which question by the nurse will elicit the best response?

a. "Do you feel rested when you awaken?"

b. "What is your normal eating pattern?"

c. "Do you awaken during the night?"

d. "Do you drink beverages with caffeine?"

C

A patient has Sleep deprivation. What finding by the nurse best indicates goal achievement?

a. Remains asleep for 6 to 7 hours consistently for 1 week.

b. Falls asleep within 15 minutes of going to bed.

c. Reports an ability to concentrate on tasks.

d. Verbalizes understanding of medication instructions

A

The nurse is working with a patient who has been advised to take 2 20-minute naps during the day for fatigue. After a week, the patient states the naps have not helped. What response by the nurse is best?

a. "Maybe that is too much sleep for you during the day."

b. "Why don't you try one 40-minute nap instead?"

c. "Let's explore some sleeping medications for you to try."

d. "It often takes a few weeks for napping to help.

D

The nurse wants to help a hospitalized patient get more sleep. What intervention will be most helpful?

a. Allow the patient an hour nap during the day shift.

b. Administer sleeping medication if the patient can't go to sleep after an hour.

c. Place a "do not disturb" sign on the door for the duration of the night shift.

d. Cluster cares so the patient gets at least 90 minutes of uninterrupted sleep at night.

D

The nurse is providing discharge education for a patient with narcolepsy. Which statement by the patient indicates a need for further education?

a. "Daytime naps are helpful."

b. "Taking the medication will cure it."

c. "High protein meals are helpful."

d. "I need to avoid alcohol."

B

The nurse is providing discharge education for a patient with restless leg syndrome. Which statement by the patient indicates a need for further instruction?

a. "I should avoid all caffeine."

b. "I can do leg massage and knee bends."

c. "Taking magnesium supplements may be helpful."

d. "Taking a walk regularly may be helpful."

A

Which task is inappropriate for the nurse to delegate to the unlicensed assistive personnel (UAP)?

a. Providing oral care

b. Evaluating sleep patterns

c. Providing bedtime routines

d. Documenting sleep hours

B

The nurse is providing discharge instructions for the patient with sleep pattern disturbances. Which statement by the patient indicates a need for further education?

a. "It is a good idea to have a bedtime routine."

b. "My bedtime routine can include watching TV in bed until I fall asleep."

c. "I will keep my regular sleep pattern on the weekend."

d. "If I can't fall asleep, I will get out of bed and do something relaxing."

B

The nurse knows that during rapid eye movement (REM) sleep, which activities occur? (Select all that apply.)

a. Memories are stored

b. Increase in cerebral blood flow

c. Slow rhythmic scanning eye movements

d. Release of epinephrine

e. Repair of brain cells

A, B , D

The student nurse learns that during non-rapid eye movement (NREM) sleep, which activities occur? (Select all that apply.)

a. Brain waves slow

b. Slow rhythmic scanning eye movements

c. Dreaming

d. Drop in blood pressure

e. Conservation of energy

A,D,E

The nurse recognizes which changes in sleep patterns occur in the older adult? (Select all that apply.)

a. Sleep increases to approximately 8 to 10 hours a night.

b. REM sleep is shorter.

c. Stage 4 NREM is decreased.

d. The use of medication may interfere with sleep.

e. Older adults awaken more at night

C, D, E

The nurse is providing community education on sudden infant death syndrome (SIDS). What information does the nurse include? (Select all that apply.)

a. SIDS is the second most common cause of death among infants (1 to 12 months).

b. The etiology remains largely unknown.

c. The most modifiable risk factor is sleeping supine.

d. Risk factors include being exposed to cigarette smoke.

e. It is defined as sudden unexpected death.

B, D, E

The nurse recognizes which sleeping conditions are identified as dyssomnias? (Select all that apply.)

a. Difficultly getting to sleep

b. Nocturnal enuresis'

c. Inability staying asleep

d. Being excessively sleepy

e. Falling asleep during the day

A, C, D, E

The nurse manager is concerned about nursing staff who are working the night shift. What interventions can the manager suggest to help the nurses overcome shift-related sleep disturbances? (Select all that apply.)

a. Power nap before leaving for the first night shift.

b. Get a minimum of 4 hours of sleep.

c. Wear dark glasses when driving home from work.

d. Seek exposure to bright light when waking.

e. Maintain a regular sleeping schedule when working and on nights off.

A, C, D, E

The nurse conducting a sleep workshop in the community would identify which patients to be at risk for obstructive sleep apnea (OSA)? (Select all that apply.)

a. Deviated septum

b. Recessed chin

c. Alcohol use

d. Large neck

e. Recent tonsillectomy

A, B , C ,D

The nurse is admitting a patient to the general medical-surgical unit. What should the nurse assess as part of a routine sleep assessment? (Select all that apply.)

a. Usual sleeping and waking times

b. Bedtime routines

c. Sleeping environment preferences

d. Medications used for sleep

e. Any current life events

A, B, C ,D ,E

The nurse will include which interventions to help improve sleep quality during hospitalization on all patients' care plans? (Select all that apply.)

. Maintaining sleep routines

b. Minimizing disruptions

c. Providing light snacks

d. Using sleep medications

e. Using relaxation measures

A, B, C ,E