Deck 11: Sleep and Activity

Question 1

The daughter of an older cognitively impaired client responds to the nurse's suggestion to keep her father physically active by stating, "Dad is so easily agitated it would be a major battle to take him on a walk." The nurse's initial response is based on the understanding that:

A)caregivers are often overwhelmed by the challenges of caring for such clients.
B)physical exercise has been proven helpful in managing anger in such clients.
C)exercise such as walking is likely to appeal to clients such as her father.
D)her father's general health and wellness will be positively affected by walking.

Answer 1

physical exercise has been proven helpful in managing anger in such clients.

Question 2

A 78-year-old is being admitted to an acute care unit after receiving surgical treatment for a fractured tibia.To best minimize any negative factors affecting the client's ability to sleep, the nurse's initial intervention is to:

A)be sure his postoperative pain is being well managed.
B)manipulate his environment to manage light and noise.
C)plan his care to minimize the number of times he is disturbed.
D)ask about his usual sleeping habits.

Answer 2

ask about his usual sleeping habits.

Question 3

A 73-year-old who in the early stage of Alzheimer's disease is being admitted to an assisted living facility.The admitting nurse best addresses the client's need for appropriate physical activity when:

A)asking him what he likes to do for fun.
B)showing him the various exercise equipment available.
C)having the activity coordinator visit with him.
D)sharing with him the connection between activity and memory.

Answer 3

asking him what he likes to do for fun.

Question 4

When assessing a client's report of experiencing "problems sleeping," the nurse gathers data related to which of the following? Select all that apply.

A)The client has difficulty falling asleep.
B)The client wakes up frequently during the night.
C)The client finds it difficult to stay asleep.
D)The client experiences vivid dreams while sleeping.
E)The client has a history of having taken sleeping medication in the past.

Question 5

Recognizing that food and drink can influence sleep, the nurse caring for older adult clients who has been diagnosed with failure to thrive as well as insomnia provides a bedtime snack of:

A)ice cream in a waffle cone.
B)bowl of grapes.
C)glass of milk and a macaroon cookie.
D)cup of warm cream of broccoli and cheese soup.

Question 6

An 89-year-old reported to the clinic nurse that since his grandson moved in a few months ago, he has had problems sleeping.The nurse initiates the discussion about his problem by asking:

A)"How do you feel about having a roommate?"
B)"Was it your decision to invite him to move in with you?
C)"Has your sleep pattern changed since he moved in with you?"
D)"Can you be more specific about the trouble you have sleeping?"

Question 7

A 74-year-old client with diagnoses that include moderate dementia, osteoarthritis in both hands, and type 2 diabetes has been admitted to a long-term care facility.To best address the client's need to be engaged in purposeful activity, the nurse arranges for the client to:

A)fold some of the unit's freshly laundered washcloths and towels each afternoon.
B)help decide what television programs will be on in the dayroom.
C)be responsible for changing the day calendar each morning.
D)remind other diabetic clients when it is time for their finger sticks.

Question 8

The nurse is preparing to instruct a family member regarding how to appropriately assist a 76-year-old client incorporate a healthy daily walk into their routine.The nurse includes a suggestion that:

A)a 30-minute walk after dinner is the best form of exercise for someone that age.
B)if the client appears to be having difficulty talking while walking, it is time to stop.
C)the client should be encouraged to walk a few feet farther each evening.
D)the family member selects a flat, easily accessible walking path to follow.

Question 9

An older cognitively impaired adult client has been hospitalized for the stabilization of a chronic cardiac problem that requires both antihypertensive and diuretic therapies.He is admitted into a semiprivate room near the nursing station.The nurse best minimizes the client's risk of disturbed sleep by:

A)keeping the privacy curtain drawn between his and his roommate's beds.
B)organizing his care to minimize the number of times he is awakened.
C)administering his medications at least 4 hours before bedtime.
D)offering to toilet him whenever he is awake during the night.

Question 10

An older client being treated for symptoms of seasonal allergies reports to the nurse that although she is very careful about her caffeine intake she been having trouble getting to sleep at night.The nurse responds most appropriately to this client when stating:

A)"Allergy reactions such as nasal stuffiness can cause sleep problems."
B)"If you are using over-the-counter nasal decongestants that could be the problem."
C)"Many different foods contain hidden caffeine."
D)"There are many different causes of sleep disturbances besides caffeine intake."

Question 11

An older client reports that his sleep was being severely affected by the need to urinate frequently.The client volunteered that he has begun restricting his fluid intake after 5 pm to help with the problem.The nurse responds:

A)"Have you seen a decrease in awakenings since you've starting restricting evening fluids?"
B)"You need sufficient fluids so don't be too restrictive."
C)"You need to intake sufficient fluid over 24 hours so be sure to drink enough by dinner time."
D)"Have you had your prostate checked by your health care provider?"

Question 12

An older frail adult client has begun displaying symptoms of sleep disturbance while being hospitalized for bilateral fractured ulnas.Since these symptoms were observed, the nurse has a bed alarm put in place because:

A)lack of adequate sleep can result in delirium in this cohort.
B)the client has difficulty using the call bell.
C)lack of sleep and a fractured ulna make the client at risk for falls.
D)the alarm will remind the client not to get out of bed without help.

Question 13

A 70-year-old client reports to the nurse that he seems to be sleeping less at night but now regularly requires at least two short naps a day.He expresses a concern that "something is wrong." The nurse responds that:

A)"Aging alters our sleep patterns so what you describe is really quite common."
B)"Circadian sleep rhythms are controlled by the hypothalamus, which is affected by age."
C)"Sleep patterns are affected by so many things; have you been under a lot of stress lately?"
D)"Can you be more specific about what you think is wrong with your sleep pattern?"

Question 14

An older adult client who has been seen at a neighborhood clinic for years tells the nurse that he will be moving to live with his son in a neighboring state.The nurse impacts the client's health and wellness the most therapeutically when stating:

A)"Be sure to reestablish with a health care provider as soon as you get settled."
B)"You seem to have a wonderful relationship with your son; I'm sure this will be a good move."
C)"You need to continue to be compliant with your plan of care regardless of where you live."
D)"I can provide you with a list of clinics in your new neighborhood if you like."