Deck 20: Sleep and Rest

Question 1

What factors can contribute to sleep apnea? (Select all that apply.)

A) Obesity
B) Diabetes
C) Hypotension
D) African American heritage
E) Use of alcohol

Answer 1

Obesity
Diabetes
African American heritage
Use of alcohol

Question 2

The patient asks how the continuous positive airway pressure (CPAP) machine decreases the incidence of sleep apnea. What is the correct response by the nurse?

A) By stimulating inspiration to be deeper
B) By taking over respiratory activity when the patient ceases to breathe
C) By sounding an alarm if respirations have ceased
D) By preventing relaxation of the tissues

Answer 2

By preventing relaxation of the tissues

Question 3

To avoid interfering with sleep, when should activity be avoided during the day?

A) 30 minutes before bedtime
B) 1 hour before bedtime
C) 2 hours before bedtime
D) 3 hours before bedtime

Answer 3

2 hours before bedtime

Question 4

What does decreasing fluid intake in the late evening prevent?

A) Increased digestive processes in the bowel
B) Episodes of nocturia
C) Gastroesophageal reflux
D) Changes in body temperature

Question 5

The wife of a patient tells the home health nurse that she suspects her husband has sleep apnea because he __________. (Select all that apply.)

A) snores loudly
B) interrupts snoring with several seconds of silence
C) complains of daytime drowsiness
D) frequently is incontinent of urine
E) has episodes of myoclonus

Question 6

What can the nurse suggest as nonpharmacological alternatives to treating insomnia? (Select all that apply.)

A) Relaxation therapy
B) Taking a cool bath or shower before bedtime
C) Listening to relaxing music
D) Arranging the sleep environment to promote sleep
E) Going to bed at a regular time after observing routine "sleep rituals"

Question 7

What are reasons that most long-term care residents go to sleep early and awaken early? (Select all that apply.)

A) Increased blood pressure
B) Drop in core temperature
C) Diminished food intake
D) Diminished hormone production
E) Decreased exposure to light

Question 8

What statement by a patient's wife would indicate that the patient is experiencing myoclonus?

A) "His loud snoring and jerking awake wakes me up, too."
B) "I am black and blue from his kicking me every night."
C) "He wakes up at 2 AM every morning and walks around the house."
D) "His constant leg movements tear up the covers and keep me awake."

Question 9

What can a nurse in a long-term care facility do to best promote normal circadian rhythm in all patient rooms?

A) Keep bright lights on during the daytime.
B) Dim lights to promote relaxation.
C) Maintain appropriate environmental temperature.
D) Pull curtains for privacy.

Question 10

What are common side effects of sleep medications? (Select all that apply.)

A) Hangover effect
B) Urinary retention
C) Hypotension
D) Dizziness
E) Diarrhea

Question 11

The 80-year-old man complains that when he goes to bed and cannot fall asleep, he becomes very upset. What would be an appropriate suggestion for when he has not fallen asleep within 30 minutes?

A) Take two tablets of a sedative medication.
B) Get up and do a mild stretching exercise for 15 minutes.
C) Remain in bed with his eyes closed.
D) Get up and read until he feels sleepy and then return to bed.

Question 12

The older man in a long-term care facility consistently wakes at 3 AM and does not return to sleep. The nurse records this behavior as _____ insomnia.

A) sleep initiation
B) sleep maintenance
C) terminal
D) undifferentiated

Question 13

What can alter an older adult's diurnal patterns? (Select all that apply.)

A) Shift work
B) Time zone changes
C) Altered nutrition
D) Illness
E) Medications

Question 14

A newly admitted older adult asks for a sedative every night and states that she cannot fall asleep. What type of sleep disorder is the patient most likely experiencing?

A) Onset related to anxiety of relocation
B) Maintenance related to unfamiliar environment
C) Initiation related to depression associated with relocation
D) Maintenance related to episodes of nocturnal movement disorders

Question 15

In what stage of sleep is sleepwalking most likely to occur?

A) Stage 1 NREM
B) Stage 2 NREM
C) Stage 4 NREM
D) REM sleep

Question 16

Which of the following can attribute to a sleep-wake cycle disturbance in the older adult?

A) Increase in angiotensin
B) Decrease in insulin
C) Increase in growth hormone
D) Decrease in melatonin

Question 17

The nurse would question the order for a sedative for a patient with which of the following diagnoses?

A) Chronic obstructive pulmonary disease (COPD)
B) Any form of dementia
C) Hypertension
D) Sleep apnea

Question 18

The patient tells the home health nurse that he has flung himself out of bed three times in the course of a violent nightmare. What sleep disorder does the nurse suspect?

A) Myoclonus
B) Restless legs syndrome
C) Rapid eye movement (REM) sleep disorder
D) Epilepsy

Question 19

What stage of sleep is the initial phase of deep sleep?

A) Stage 1 nonrapid eye movement (NREM)
B) Stage 3 NREM
C) Stage 5 NREM
D) Rapid eye movement (REM) sleep

Question 20

A 75-year-old resident in a long-term care facility has problems with sleep onset. What would be an appropriate nursing intervention to aid with sleep?

A) Provide a back rub at bedtime.
B) Provide a heavy snack at bedtime.
C) Coach the resident in 10 minutes of exercise before bedtime.
D) Provide a cola drink at bedtime.

Question 21

What statements by the resident would indicate that she may be experiencing changes in sleep and rest patterns? (Select all that apply.)

A) "I don't know why everything seems to bother me lately."
B) "I've been so clumsy."
C) "I'm having trouble concentrating."
D) "My daughter says I talk in my sleep."
E) "I cry for no reason at all."

Question 22

What changes in sleep patterns are often seen in older adults? (Select all that apply.)

A) Inability to sleep throughout the night
B) Sleeping soundly all night
C) Increase in the number of hours asleep at night
D) Difficulty in arousing from deep sleep
E) Waking up early

Question 23

How can the nursing staff encourage sleep in long-term care facility residents? (Select all that apply.)

A) Using the minimum light necessary when making rounds
B) Making necessary sleep interruptions at the same time every night
C) Keeping conversational noise at the nursing station to a minimum
D) Answering call lights promptly
E) Providing heavy blankets for warmth

Question 24

The nurse clarifies that the individual's pattern of wakefulness and sleeping is referred to as the __________ rhythm.

Question 25

The nurse encourages the long-term facility resident experiencing insomnia to drink a glass of milk with supper and again before bedtime because milk contains the sleep-inducing agent __________.

Question 26

The nurse reminds the CNAs that most older adults require a minimum of _____ hours of sleep per day.