sleep management

Question 1

A community health nurse is providing an educational session at the senior center on
how to promote sleep. Which practices should the nurse recommend? (Select all that apply.)

Answer 1

Sleep where you sleep best.

Use sedatives as a last resort.

Decrease fluids 2 to 4 hours before sleep.

Get up if unable to fall asleep in 15 to 30 minutes.

Question 2

The patient and the nurse discuss the need for sleep. After the discussion, the patient is
able to state factors that hinder sleep. Which statements indicate that the patient has a good
understanding of sleep?

Answer 2

“Drinking coffee at 7 PM could interrupt my sleep.”

“Worry about work can disrupt my sleep.”

“Exercising 2 hours before bedtime can decrease relaxation.”

“Staying up late for a party can interrupt sleep patterns.”

Question 3

The nurse is caring for a patient in the intensive care unit who is having trouble
sleeping. The nurse explains the purpose of sleep and its benefits. What points should the nurse
include in her teaching?

Answer 3

NREM sleep contributes to body tissue restoration.

Restful sleep preserves cardiac function.

Sleep contributes to cognitive restoration.

REM sleep decreases cortical activity.

Question 4

The nurse is caring for a patient who has not been able to sleep well while in the
hospital. The nurse recognizes that lack of sleep can manifest in which of the following signs and
symptoms? (Select all that apply.)

Answer 4

Changes in physiological function such as temperature

Decreased appetite and weight loss

Anxiety, irritability, and restlessness

Impaired judgment

Question 5

The older patient is visiting the clinic after a fall during the night. Which of the
following data points obtained most likely would contribute to this fall?

Answer 5

The patient has been taking Benadryl (diphenhydramine).

Question 6

A patient has received a nursing diagnosis of sleep deprivation. Which of the following
statements by the patient would indicate that outcomes are being met?

Answer 6

“I feel rested when I wake up in the morning.”

Question 7

The nurse is evaluating outcomes for the patient with the nursing diagnosis of
Insomnia. During this process, the nurse recognizes that

Answer 7

The patient is the best evaluator of sleep.

Question 8

A young mother has been hospitalized for an irregular heartbeat (arrhythmia). The
night nurse comes in to see the patient awake. What would be the most appropriate nursing
intervention?

Answer 8

Take time to sit and talk with the patient about her inability to sleep.

Question 9

The nurse is caring for a patient on the medical-surgical unit who is experiencing an
exacerbation of asthma. Which of the following interventions would be most appropriate to help
the patient sleep?

Answer 9

Bed placed in semi-Fowler’s position

Question 10

The nurse is preparing an older patient’s evening medications. Which of the following
does the nurse recognize as relatively safe for difficulty sleeping?

Answer 10

Lorazepam

Question 11

The patient presents to the clinic with reports of irritability, being sleepy during the
day, not being able to fall asleep, and being tired. Select the most appropriate nursing diagnosis.

Answer 11

Insomnia

Question 12

The nurse is caring for a postpartum patient. The patient’s labor has lasted over 28
hours within the hospital; the patient has not slept and is disoriented to date and time. What is the
most appropriate nursing diagnosis?

Answer 12

Sleep deprivation

Question 13

The nurse assigns a nursing diagnosis of ineffective breathing pattern. Which of the
following sleep conditions would support this diagnosis?

Answer 13

Obstructive sleep apnea

Question 14

The nurse is beginning a sleep assessment on a patient. Which of the following would
be the most appropriate question to ask?

Answer 14

“How are you sleeping?”

Question 15

The nurse is completing a sleep assessment on a patient. The nurse utilizes which of
the following tools to complete the assessment?

Answer 15

Visual Analogue Scale

Question 16

The nurse is caring for a patient who has been in holding in the emergency department
for 24 hours. The nurse is concerned about the patient experiencing sleep deprivation. What would
be the best action for the nurse to take?

Answer 16

Expedite the process of obtaining a medical-surgical room for the patient.

Question 17

The patient has just been diagnosed with narcolepsy. The nurse provides an
educational session and teaches the patient to avoid

Answer 17

Sitting in hot, stuffy rooms.

Question 18

Which of the following would be most important for the nurse to monitor in a patient
who has obstructive sleep apnea?

Answer 18

Respiratory status

Question 19

The nurse is caring for an adolescent who is complaining of difficulty falling asleep.
Which intervention would be most appropriate?

Answer 19

Encourage the discontinuation of soda and chocolate nightly snack.

Question 20

The nurse is completing an assessment on an older patient who is having difficulty
falling asleep. Which factor has the potential to contribute to this difficulty?

Answer 20

Depression

Question 21

The nurse is having a conversation with an adolescent regarding the need for sleep.
The adolescent states that it is common to stay up with friends several nights a week. Which
nursing action should the nurse take?

Answer 21

Discuss with the adolescent sleep needs and the effects of excessive daytime
sleepiness.

Question 22

A single dad is discussing with the nurse the sleep needs of a preschooler. Which of the
following directions would be most helpful to the parent?

Answer 22

“The preschooler may have trouble settling down after a busy day.”

Question 23

The nurse is discussing lack of sleep with a middle-aged adult. The nurse recognizes
that insomnia in this age group is commonly due to

Answer 23

Anxiety.

Question 24

The nurse is discussing with a new mother the sleep requirements of a neonate. Which
of these comments would indicate that the patient has an understanding of the neonate’s sleeping
pattern?

Answer 24

“I will ask my mom to come after the first week, when the baby is more alert.”

Question 25

Which nursing observation of the patient in intensive care indicates that the patient is
sleeping comfortably?

Answer 25

Eyes closed, lying quietly, respirations 12, heart rate 60

Question 26

The patient shares with the nurse the vivid, full color dreams experienced by the patient
last night. These data would indicate that the patient has reached what stage of sleep?

Answer 26

REM

Question 27

The nurse is caring for a patient in the sleep lab. The nurse recognizes that the patient is
in stage 4 NREM from which of the following assessments?

Answer 27

The patient is difficult to awaken.

Question 28

The nurse is caring for a patient who is having trouble sleeping. To encourage decreased
stimulus to the reticular activating system and activation of the bulbar synchronizing region, which
actions would the nurse implement?

Answer 28

Encourage relaxed positions.

Question 29

The nurse is providing an educational session on sleep regulation for new nurses in the
Sleep Disorder Treatment Center. Which of these statements by the nurses would best indicate that
learning has occurred?

Answer 29

“If the patient has a disease process in the central nervous system, it can influence
the functions of sleep.”

Question 30

The nurse is caring for a young adult patient on the medical-surgical unit. When doing
midnight checks, she sees that the patient is awake and is doing a puzzle. What is the best
explanation for the patient being awake?

Answer 30

The patient’s sleep-wake cycle preference is late evening.