Deck 11: Sleep and Activity

Question 1

The nurse needs to awaken a patient to take medication in the middle of the night.The patient has not had any sleeping medications or other preparations that would cause drowsiness.The nurse has to use vigorous stimulation to awaken the patient.What stage of sleep is this patient most likely in?

A)Stage 1,non-rapid eye movement (REM)
B)Stage 2,non-REM
C)Stage 3,non-REM
D)Stage 4,non-REM

Answer 1

Stage 4,non-REM

Question 2

An older patient reported to the clinic nurse that since a grandson moved in a few months ago,the patient has had problems sleeping.Which question by the nurse is most appropriate?

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

Answer 2

"Has your sleep pattern changed since he moved in?"

Question 3

The nurse is caring for a hospitalized patient who needs vital signs and assessments every 4 hours.The nurse last assessed the patient at midnight,and at 2 AM the nurse answers the call light and helps the patient to the bathroom.To promote good sleep,what action by the nurse is best?

A)Ask the patient if a sleeping medication is needed.
B)Assess the patient now and again at 6 AM.
C)Tell the patient you will be back in 2 hours.
D)Assess the patient at 4 AM while being very quiet.

Answer 3

Assess the patient now and again at 6 AM.

Question 4

An older patient is being admitted to an acute care unit after surgical repair of a fractured tibia.To minimize any negative factors affecting the patient's ability to sleep,the nurse's initial intervention is to:

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

Question 5

An older patient reports that sleep was being severely affected by the need to urinate frequently.The patient states 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 waking up since you cut back on fluids?"
B)"You need sufficient fluids,so don't be too restrictive."
C)"You need the same amount over 24 hours,so drink enough by dinnertime."
D)"Have you had your prostate checked by your health care provider?"

Question 6

The nurse caring for older patients would prepare to administer which medication as a short-term sleep aid?

A)Diazepam (Valium)
B)Diphenhydramine (Benadryl)
C)Chloral hydrate (Somnote)
D)The nurse would try other measures first

Question 7

A patient wants to use an herbal preparation to help with decreased sleep.What response by the nurse is best?

A)"There are no research studies on these herbal preparations."
B)"Why don't you try exercise during the day first?"
C)"Have you had a physical exam any time recently?"
D)"Why do you want to use an herbal product for insomnia?"

Question 8

A patient has chronic,severe asthma and takes many medications during the day.The patient reports difficulty falling asleep at night.What medication does the nurse ask about the patient taking?

A)Barbiturates
B)Theophylline (Theo-24)
C)Furosemide (Lasix)
D)Haloperidol (Haldol)

Question 9

A patient 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 10

The daughter of an older cognitively impaired patient 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 patients.
B)physical exercise has been proven helpful in managing anger in such patients.
C)exercise such as walking is likely to appeal to patients such as her father.
D)her father's general health and wellness will be positively affected by walking.

Question 11

The nurse is preparing to instruct a family member regarding how to appropriately assist a 76-year-old patient incorporate a healthy daily walk into the family's 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 patient appears to be having difficulty talking while walking,it is time to stop.
C)the patient 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 12

An older adult patient 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 patient'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 good 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)"Moving often causes temporary sleep disturbances,so stick to your evening routine."

Question 13

An older frail adult patient has begun displaying symptoms of sleep disturbance while being hospitalized.Since these symptoms were observed,the nurse has arranged for a bed alarm to be placed near the patient because:

A)lack of adequate sleep can result in delirium.
B)the patient has difficulty using the call light.
C)lack of sleep make the patient at risk for falls.
D)the patient will remember not to get out of bed.

Question 14

An older patient being treated for symptoms of seasonal allergies reports to the nurse that although she is careful about her caffeine intake,she has been having trouble getting to sleep at night.The nurse responds most appropriately to this patient 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;be sure to check the labels."
D)"There are many different causes of sleep disturbances besides caffeine intake."

Question 15

A confused older patient has been hospitalized for a cardiac problem that requires both antihypertensive and diuretic therapies.The nurse minimizes the patient's risk of disturbed sleep by:

A)keeping the door shut so noise from the hallway is not disruptive.
B)organizing care to minimize the number of times the patient is awakened.
C)administering medications at least 4 hours before bedtime.
D)offering to toilet the patient whenever the nurse finds the patient awake during the night.

Question 16

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

A)asking the patient about activities done for recreation.
B)showing the patient the exercise equipment available.
C)having the activity coordinator visit with the patient.
D)teaching the patient the connection between activity and memory.

Question 17

A patient reports waking up with frequent headaches and sore throat.What question by the nurse is most appropriate?

A)"Does acetaminophen (Tylenol)provide relief?"
B)"Does your partner say you snore at night?"
C)"Do you drink enough water during the day?"
D)"Do you ever wake up with night sweats?"

Question 18

A patient is discussing retirement with a nurse.What suggestion pertaining to sleep does the nurse offer?

A)Keep your same bedtime and nighttime routines.
B)If you nap during the day you can stay up later.
C)You won't need so much sleep to be rested for work.
D)Sleeping in will help revitalize your energy level.

Question 19

What is the best bedtime snack for older adult patients with failure to thrive and insomnia?

A)Ice cream in a waffle cone
B)Bowl of grapes
C)Glass of milk and a macaroon cookie
D)Cup of cream of broccoli and cheese soup

Question 20

A patient with moderate dementia has been admitted to a long-term care facility.To address the patient's need to be engaged in purposeful activity,the nurse arranges for the patient to:

A)fold some of the unit's freshly washed 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 patients when it is time for their finger sticks.

Question 21

The nurse who works with older patients explains the age-related changes in sleep to a student.Which statements are consistent with this knowledge? (Select all that apply. )

A)The amount of time spent in REM sleep increases.
B)REM sleep is interrupted more by awakening at night.
C)People spend more time in the lightest stage of sleep.
D)Stages 3 and 4 of non-REM sleep are not as deep.
E)Changes in circadian rhythm can affect sleep.

Question 22

The nurse has instituted bedtime routines for patients with dementia in a long-term care facility.What assessment findings best indicate the program is effective?

A)Patients are more alert and oriented during the day.
B)Patients fall asleep within 20 to 30 minutes of going to bed.
C)Patients appear happier and more interested in activities.
D)Patients on diuretics awake less often during the night.

Question 23

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

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