Chapter 33: Sleep

Question 1

1.	The nurse knows that 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.

Answer 1

ANS: D

Question 2

2. The nurse knows 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.

Answer 2

ANS: B

Question 3

3. The nurse is educating a patient about taking measures to help avoid disruption to the circadian rhythm. The following 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.”

Answer 3

ANS: B

Question 4

4. The nurse knows that polysomnograpy is:
   a.
   the recording of brain waves and other variables.
   b.
   the relay of motor impulse to the hypothalamus.
   c.
   the patterns of biological functioning.
   d.
   the recording of seizure activity in the brain.

Answer 4

ANS: A

Question 5

5. The nurse knows the usual progression of sleep is:
   a.
   NREM 1-4 then REM, then back through NREM 1 and 2.
   b.
   REM then NREM 1-4, then back through NREM 2 and 3.
   c.
   NREM 1-4 then back through NREM 3 and 2 then REM.
   d.
   REM then NREM 1-4 then back through NREM 3.

Answer 5

ANS: C

Question 6

6. The nurse is providing discharge instructions to the parents of a toddler about sleeping habits. Which of the following statements indicates further education is needed?
   a.
   “Sleep needs may change during growth spurts.”
   b.
   “Children sleep 10 hours a day.”
   c.
   “Toddlers will often resist going to bed.”
   d.
   “The bedtime routine can vary.”

Answer 6

ANS: D

Question 7

7.	The nurse knows that cataplexy includes:
a.
an uncontrolled desire to sleep.
b.
falling asleep for several minutes.
c.
loss of voluntary muscle tone.
d.
a sleep cycle that begins with NREM.

Answer 7

ANS: C

Question 8

8. The nurse is providing discharge instructions to a patient who has had sleep alterations. The following statements by the patient indicate 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.”

Answer 8

ANS: B

Question 9

9.	The nurse is performing an assessment of the patient’s sleep patterns. Which question 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?”

Answer 9

ANS: C

Question 10

10. The nurse knows an appropriate goal for the nursing diagnosis Sleep deprivation is:
    a.
    the patient will remain asleep for 6 to 7 hours consistently for 1 week.
    b.
    the patient will fall asleep within 15 minutes of going to bed.
    c.
    the patient will report an ability to concentrate on tasks.
    d.
    the patient will repeat medication instructions on discharge.

Answer 10

ANS: A

Question 11

11. The nurse knows an appropriate goal for the nursing diagnosis Disturbed sleep pattern during hospitalization is:
    a.
    the patient will fall asleep within 15 minutes of going to bed.
    b.
    the patient will report an ability to concentrate on tasks.
    c.
    the patient will repeat medication instructions on discharge.
    d.
    the patient will be able to sleep for at least 2 hours at a time.

Answer 11

ANS: D

Question 12

12. The nurse knows an appropriate goal for the nursing diagnosis Insomnia is:
    a.
    The patient will report an ability to concentrate on tasks.
    b.
    The patient will repeat medication instructions on discharge.
    c.
    The patient will be able to sleep for at least 2 hours at a time.
    d.
    The patient will be able to fall asleep within 15 minutes.

Answer 12

ANS: D

Question 13

13.	The nurse is providing discharge education for a patient with narcolepsy. The following 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 should avoid alcohol.”

Answer 13

ANS: B

Question 14

14. The nurse is providing discharge education for a patient with restless leg syndrome. The following statement by the patient indicates a need for further education:
    a.
    “I should avoid all caffeine.”
    b.
    “I can using leg massage and knee bends.”
    c.
    “Taking magnesium supplements may be helpful.”
    d.
    “Taking a walk regularly may be helpful.”

Answer 14

ANS: A

Question 15

15.	Which of the following is inappropriate to delegate to the unlicensed assistive personnel (UAP)?
a.
Providing oral care
b.
Evaluating sleep patterns
c.
Providing bedtime routines
d.
Documenting sleep hours

Answer 15

ANS: B

Question 16

16. 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 should keep my regular sleep pattern on the weekend.”
    d.
    “If I can’t fall asleep, I should get out of bed and do something relaxing.”

Answer 16

ANS: B

Question 17

1.	The nurse knows that during rapid eye movement (REM) sleep, the following 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

Answer 17

ANS: A, B, D

Question 18

2.	The nurse knows that during non-rapid eye movement (NREM) sleep, the following occur: (Select all that apply.)
a.
Repair of brain cells
b.
Slow rhythmic scanning eye movements
c.
Dreaming
d.
Cell division in bone marrow
e.
Conservation of energy

Answer 18

ANS: A, D, E

Question 19

3. The nurse knows the following 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.

Answer 19

ANS: C, D, E

Question 20

4. The nurse knows the following information about sudden infant death syndrome (SIDS): (Select all that apply.)
   a.
   SIDS is the most common cause of death among infants (1-12 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.

Answer 20

ANS: B, D, E

Question 21

5.	The nurse knows that dyssomnias are: (Select all that apply.)
a.
difficultly getting to sleep.
b.
stages of sleep.
c.
inability staying asleep.
d.
being excessively sleepy.
e.
falling asleep during the day.

Answer 21

ANS: A, C, D, E

Question 22

6. The nurse manager is concerned about her staff who are working the night shift. What interventions can she suggest to assist nurses in overcoming 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.

Answer 22

ANS: A, C, D, E

Question 23

7.	The nurse knows the following risk factors are associated with obstructive sleep apnea (OSA): (Select all that apply.)
a.
Deviated septum
b.
Recessed chin
c.
Alcohol use
d.
Large neck
e.
Tonsillectomy

Answer 23

ANS: A, B, C, D

Question 24

8.	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

Answer 24

ANS: A, B, C, D, E

Question 25

9.	The nurse knows the following interventions will help improve sleep quality during hospitalization: (Select all that apply.)
a.
Maintaining sleep routines
b.
Minimizing disruptions
c.
Providing light snacks
d.
Using sleep medications
e.
Using relaxation measures

Answer 25

ANS: A, B, C, E