Sleep Flashcards
1
Q
- Which of the following processes regulates metabolism, cognition, and immune function through a 24-hour cycle?
A) Process S
B) Process C
C) Homeostatic Process
D) Circadian Process
A
Answer: D) Circadian Process
2
Q
- Chronic sleep deprivation can lead to all of the following long-term effects EXCEPT:
A) Neurocognitive dysfunction
B) Enhanced ventilatory response
C) Reduced quality of life
D) Psychiatric illness
A
Answer: B) Enhanced ventilatory response
3
Q
- What primary factor synchronizes the circadian process?
A) Nutrition
B) Physical activity
C) Exposure to light
D) Sleep duration
A
Answer: C) Exposure to light
4
Q
- Which of the following is a hallmark symptom of chronic sleep deprivation?
A) Enhanced cognitive function
B) Excessive sleepiness
C) Increased ventilatory response
D) Decreased susceptibility to infections
A
Answer: B) Excessive sleepiness
5
Q
- What is the primary goal of sleep-wake regulation (Process S and Process C)?
A) Enhance energy metabolism
B) Maintain a balanced immune response
C) Synchronize sleep patterns with environmental cues
D) Optimize cardiovascular function
A
Answer: C) Synchronize sleep patterns with environmental cues
6
Q
- A 45-year-old male with a history of obstructive sleep apnea presents with excessive daytime sleepiness and difficulty concentrating at work. He reports only sleeping 4–5 hours per night due to a demanding work schedule. What is the best initial step in managing this patient?
A) Prescribe a sedative-hypnotic for sleep initiation
B) Recommend a sleep study to rule out other conditions
C) Advise on sleep hygiene and a consistent bedtime routine
D) Refer to a neurologist for cognitive evaluation
A
Answer: C) Advise on sleep hygiene and a consistent bedtime routine
7
Q
- A 70-year-old female with a history of hypertension and Type 2 diabetes reports poor sleep quality and chronic fatigue. On examination, her BMI is 35, and her husband reports loud snoring and occasional pauses in breathing during the night. Which diagnostic test is most appropriate?
A) Polysomnography
B) Serum cortisol levels
C) Electroencephalogram
D) Overnight pulse oximetry
A
Answer: A) Polysomnography
8
Q
- Which of the following complications is least associated with chronic sleep deprivation?
A) Cognitive decline
B) Increased immune function
C) Cardiovascular disease
D) Increased risk of delirium
A
Answer: B) Increased immune function
9
Q
- What is a key nonpharmacologic strategy to prevent sleep deprivation in ICU patients?
A) Increasing night-time monitoring
B) Encouraging daytime naps
C) Clustered care to reduce interruptions
D) Avoiding natural light exposure
A
Answer: C) Clustered care to reduce interruptions
10
Q
- Which pharmacologic agent may disrupt the normal sleep-wake cycle?
A) Melatonin
B) Beta-blockers
C) Lorazepam
D) Acetaminophen
A
Answer: B) Beta-blockers
11
Q
- Disruption of circadian rhythm (Process C) is most commonly caused by:
A) Chronic illness
B) Excessive melatonin
C) Lack of light exposure
D) Acute pain
A
Answer: C) Lack of light exposure
12
Q
- Which stage of sleep is most restorative and supports physical health?
A) REM sleep
B) Stage 1 NREM
C) Stage 3 NREM (deep sleep)
D) Light sleep
A
Answer: C) Stage 3 NREM (deep sleep)
13
Q
- Which of the following complications from sleep deprivation can be life-threatening?
A) Cognitive impairment
B) Emotional distress
C) Respiratory abnormalities during mechanical ventilation
D) Decreased melatonin
A
Answer: C) Respiratory abnormalities during mechanical ventilation
14
Q
- What is the primary risk associated with poor sleep hygiene in critically ill patients?
A) Emotional dysregulation
B) Immune compromise
C) Increased delirium risk
D) Cardiovascular event
A
Answer: C) Increased delirium risk
15
Q
- Which nonpharmacologic intervention is most effective for promoting sleep in hospitalized patients?
A) Benzodiazepines
B) Sleep protocols
C) Frequent monitoring interruptions
D) Increasing light exposure at night
A
Answer: B) Sleep protocols
16
Q
- Which sleep cycle is necessary for cognitive function and memory consolidation?
A) NREM
B) REM
C) Delta
D) Theta
A
Answer: B) REM
17
Q
- The circadian process (Process C) regulates:
A) Immune responses during sleep
B) Sleep-wake cycles based on light exposure
C) Homeostatic sleep drive
D) REM cycle duration
A
Answer: B) Sleep-wake cycles based on light exposure
18
Q
- Which of the following is a potential cause of chronic sleep deprivation?
A) Jet lag
B) Parasomnias
C) Insomnia due to acute stress
D) Temporary environmental changes
A
Answer: B) Parasomnias
19
Q
- How can healthcare providers support circadian rhythm in hospitalized patients?
A) Administering sedative medications during the day
B) Encouraging bright light exposure during the day
C) Avoiding mobilization during the daytime
D) Reducing all light exposure
A
Answer: B) Encouraging bright light exposure during the day
20
Q
- What is the most effective way to address sleep deprivation in critically ill patients?
A) Clustering care activities to reduce interruptions
B) Performing frequent blood draws at night
C) Increasing medication doses for sleep
D) Allowing naps throughout the day
A
Answer: A) Clustering care activities to reduce interruptions
21
Q
- Sleep deprivation contributes to which physiologic complication in acutely ill patients?
A) Enhanced cardiovascular function
B) Prolonged mechanical ventilation
C) Decreased immune system compromise
D) Improved metabolic regulation
A
Answer: B) Prolonged mechanical ventilation
22
Q
- What is a key physiologic role of sleep in critically ill patients?
A) Enhancing appetite
B) Supporting cancer surveillance mechanisms
C) Increasing melatonin production during the day
D) Decreasing cardiovascular performance
A
Answer: B) Supporting cancer surveillance mechanisms
23
Q
- Which patient is at the greatest risk for sleep deprivation?
A) A patient in a private hospital room
B) A patient with chronic insomnia
C) A patient in the ICU with constant monitoring alarms
D) A patient with mild anxiety treated with therapy
A
Answer: C) A patient in the ICU with constant monitoring alarms
24
Q
- What is the primary goal of promoting sleep in critically ill patients?
A) Reducing medication use
B) Improving patient mood
C) Preventing complications like delirium
D) Shortening hospital stay
A
Answer: C) Preventing complications like delirium
25
7. Which of the following is a common cause of sleep deprivation in hospitalized patients?
A) Proper sleep hygiene practices
B) Pain and discomfort
C) Lack of stimulation during the day
D) Controlled noise levels
Answer: B) Pain and discomfort
26
8. What is the primary goal of promoting sleep in critically ill patients?
A) Reducing medication use
B) Improving patient mood
C) Preventing complications like delirium
D) Shortening hospital stay
Answer: C) Preventing complications like delirium
27
9. Which medication used to promote sleep may increase the risk of delirium in critically ill patients?
A) Ambien (zolpidem)
B) Melatonin
C) Acetaminophen
D) Glucocorticoids
Answer: A) Ambien (zolpidem)
28
10. What role does Process C play in regulating sleep-wake cycles?
A) It increases the duration of wakefulness
B) It regulates homeostasis and circadian rhythm
C) It is responsible for REM sleep cycles
D) It decreases melatonin production during sleep
Answer: B) It regulates homeostasis and circadian rhythm
29
11. Which patient factor most commonly disrupts sleep in the ICU setting?
A) Pain control
B) Excessive natural light exposure
C) Environmental noise and interruptions
D) Low emotional stress levels
Answer: C) Environmental noise and interruptions
30
12. What is the primary physiologic consequence of reduced REM sleep?
A) Enhanced immune function
B) Increased restorative cycles
C) Impaired memory and cognitive function
D) Improved ventilatory tolerance
Answer: C) Impaired memory and cognitive function
31
13. Sleep-promoting medications such as melatonin are recommended for:
A) Long-term use in all critically ill patients
B) Short-term regulation of circadian rhythm
C) Preventing pain-induced insomnia
D) Reducing immune system compromise
Answer: B) Short-term regulation of circadian rhythm
32
14. Which of the following describes partial sleep deprivation?
A) Complete lack of sleep for more than 24 hours
B) Reduced sleep duration that may be self-induced
C) Acute insomnia caused by environmental factors
D) Chronic disruption of circadian rhythms
Answer: B) Reduced sleep duration that may be self-induced
33
15. The greatest impact of sleep deprivation is seen in:
A) NREM Stage 2 sleep
B) REM sleep cycles
C) Light sleep cycles
D) NREM Stage 1 sleep
Answer: B) REM sleep cycles
34
16. A patient at risk for polypharmacy is more likely to experience:
A) Enhanced sleep efficiency
B) Sleep disruption and fragmentation
C) Improved cognitive function during illness
D) Reduced incidence of delirium
Answer: B) Sleep disruption and fragmentation
35
17. What is the most effective way to promote sleep in a critically ill patient without medication?
A) Restricting physical activity during the day
B) Clustering care activities during the night
C) Providing environmental stimulation at night
D) Performing frequent blood draws
Answer: B) Clustering care activities during the night
36
19. Which of the following factors is NOT a contributor to sleep deprivation in hospitalized patients?
A) Frequent interruptions for monitoring
B) Proper medication reconciliation
C) Environmental noise
D) Anxiety related to illness
Answer: B) Proper medication reconciliation
37
20. Melatonin supplementation in critically ill patients is primarily used to:
A) Treat insomnia permanently
B) Restore circadian rhythm and reduce delirium risk
C) Decrease the need for ventilatory support
D) Increase restorative NREM sleep
Answer: B) Restore circadian rhythm and reduce delirium risk
38
6. A 70-year-old ICU patient is experiencing frequent awakenings due to environmental noise and monitoring alarms. What is the best intervention to promote sleep?
A) Increase light exposure at night
B) Administer zolpidem nightly
C) Cluster care activities during the night
D) Turn off alarms entirely
Answer: C) Cluster care activities during the night
39
7. A 50-year-old patient reports difficulty falling asleep after being admitted to a noisy hospital unit. What nonpharmacologic intervention should be prioritized?
A) Administering melatonin at bedtime
B) Offering a sedative hypnotic
C) Providing earplugs and adjusting the environment
D) Increasing physical activity during the night
Answer: C) Providing earplugs and adjusting the environment
40
8. A graduate student with a busy schedule reports sleep deprivation and poor focus during the day. Which advice is most appropriate?
A) Avoid exposure to bright light during the day
B) Limit screen use before bedtime
C) Take frequent naps during the day
D) Avoid physical activity to conserve energy
Answer: B) Limit screen use before bedtime
41
9. An 82-year-old nursing home resident complains of poor sleep and daytime fatigue. Which intervention would best address their sleep concerns?
A) Prescribe a benzodiazepine for sleep
B) Ensure exposure to natural light during the day
C) Increase their daytime caloric intake
D) Minimize daytime mobility activities
Answer: B) Ensure exposure to natural light during the day
42
10. A patient on mechanical ventilation shows signs of poor tolerance to weaning. You suspect sleep deprivation. What intervention is appropriate to improve their sleep?
A) Increase nighttime sedation
B) Introduce a sleep hygiene routine
C) Encourage daytime napping
D) Decrease respiratory support at night
Answer: B) Introduce a sleep hygiene routine
43
16. A 65-year-old ICU patient with multiple comorbidities experiences fragmented sleep and develops mild delirium. What is the best initial intervention?
A) Administer haloperidol immediately
B) Provide melatonin one hour before bedtime
C) Begin continuous sedation
D) Limit daytime light exposure to promote rest
Answer: B) Provide melatonin one hour before bedtime
44
18. A 75-year-old patient with poor sleep hygiene presents with chronic insomnia. What nonpharmacologic intervention is most appropriate?
A) Provide a detailed medication list to improve adherence
B) Suggest increased daytime activity and light exposure
C) Advise reducing water intake in the evening
D) Prescribe zolpidem for long-term use
Answer: B) Suggest increased daytime activity and light exposure
45
19. A 72-year-old ICU patient with severe malnutrition develops acute delirium. Which combination of interventions is most effective?
A) Administer haloperidol and restrict caloric intake
B) Provide a sleep hygiene plan and initiate nutrition support
C) Increase monitoring and limit sensory stimulation
D) Initiate total bedrest and avoid physical therapy
Answer: B) Provide a sleep hygiene plan and initiate nutrition support
46
20. A 50-year-old patient is recovering from opioid overdose and exhibits mild confusion and restlessness. What is the best step?
A) Administer naloxone
B) Ensure proper hydration and oxygenation
C) Begin sedation to manage confusion
D) Delay any interventions to allow recovery
Answer: B) Ensure proper hydration and oxygenation
47
18. In sleep-deprived patients on mechanical ventilation, what complication is most likely to occur?
A) Pulmonary embolism
B) Prolonged ventilator weaning
C) Increased tidal volume
D) Hypokalemia
Answer: B) Prolonged ventilator weaning
