Chapter 9: Sleep and Sleep Disorders

Chapter 9: Sleep and Sleep Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. To assist in determining whether a patient seen in the ambulatory care setting has chronic
insomnia, the nurse will initially
a. schedule a polysomnography (PSG) study.
b. arrange for the patient to have a sleep study.
c. ask the patient to keep a 2-week sleep diary.
d. teach the patient about the use of an actigraph.
ANS: C
The diagnosis of insomnia is made on the basis of subjective complaints and an
evaluation of a 1- to 2-week sleep diary completed by the patient. Actigraphy and PSG
studies/sleep studies may be used for determining specific sleep disorders, but are not
necessary to make an initial insomnia diagnosis.
DIF: Cognitive Level: Application REF: 116
TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
2. Which instruction will the nurse include when teaching a patient with chronic insomnia
about ways to improve sleep quality?
a. Avoid aerobic exercise during the day.
b. Read in bed for a few minutes each night.
c. Keep the bedroom temperature slightly warm.
d. Try to go to bed at the same time every evening.
ANS: D
A regular evening schedule is recommended to improve sleep time and quality. Aerobic
exercise may improve sleep quality, but should occur at least 6 hours before bedtime.
Reading in bed is discouraged for patients with insomnia. The bedroom temperature
should be slightly cool.
DIF: Cognitive Level: Application REF: 116
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. After the nurse has taught a patient about the use of extended-release zolpidem (Ambien
CR) for insomnia, which patient statement indicates a need for further teaching?
a. “I will take the medication an hour before bedtime.”
b. “I should take the medication on an empty stomach.”
c. “I should not take this medication unless I can sleep for at least 6 hours.”
d. “I will schedule activities that require mental alertness for later in the day.”
ANS: A
Test Bank 9-2
Benzodiazepine receptor agonists such as zolpidem work quickly and should be taken
immediately before bedtime. The other patient statements are correct.
DIF: Cognitive Level: Application REF: 116 | 119 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity
4. Which action is best for the nurse to include in the plan of care in order to improve sleep
quality for a critically ill patient in the intensive care unit (ICU)?
a. Ask all visitors to leave the ICU for the night.
b. Lower the level of light from 8:00 PM until 7:00 AM.
c. Avoid the use of opioids for pain relief during the evening hours.
d. Schedule assessments to allow at least 4 hours of uninterrupted sleep.
ANS: B
Lowering the level of light will help mimic normal day/night patterns and maximize the
opportunity for sleep. Although frequent assessments and opioid use can disturb sleep
patterns, these actions are necessary for the care of critically ill patients. For some
patients, having a family member or friend at the bedside may decrease anxiety and
improve sleep.
DIF: Cognitive Level: Application REF: 119 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity