Chapter 05: Sleep Alterations

Chapter 05: Sleep Alterations

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Which stage of NREM sleep is associated with anabolic processes?

ANS:  C

In stage N3 sleep, slow waves continue to develop until 50% of the EEG waveforms are slow wave. This stage of sleep is often referred to as slow-wave sleep. The release of other hormones, such as prolactin and testosterone, suggests that anabolism occurs during the slow-wave sleep of stage N3. N1 sleep is a transitional, lighter sleep state from which the patient can be easily aroused by light touch or by softly calling his or her name. Stage N2 sleep occupies about 45% to 55% of the night, with sleep deepening and a higher arousal threshold being required to awaken the patient. N4 sleep does not exist.

2. What occurs physiologically during REM sleep?

ANS:  C

The sympathetic nervous system predominates during REM sleep. Oxygen consumption increases, and cardiac output, blood pressure, heart rate, and respiratory rate may become erratic. NREM sleep is dominated by parasympathetic nervous system. Blood pressure, heart and respiratory rates, and the metabolic rate return to basal levels. About 80% of total daily growth stimulating hormone is released in NREM sleep.

3. Interventions to help with circadian synchronization include

ANS:  A

Nursing interventions that maintain normal rhythm of the day–night cycle, such as opening window blinds, should be encouraged.

4. The patient has been in the critical care unit for 3 weeks and has been on an intra-aortic balloon pump for the past 3 days. The patient’s condition has been serious, and hourly assessments and vital signs have been necessary. The nursing staff has noted that the patient has been unable to achieve sleep for more than 30 minutes at a time. The patient has been given diazepam (Valium) prn. The anticipated effect of diazepam on the patient’s sleep is

ANS:  D

Diazepam increases NREM stage 1 and reduces NREM stages 3 and REM. REM suppression is dose related.

5. The patient has been in the critical care unit for 3 weeks and has been on the intra-aortic balloon pump for the past 3 days. The patient’s condition has been serious, and hourly assessments and vital signs have been necessary. The nursing staff has noted that the patient has been unable to achieve sleep for more than 30 minutes at a time. The patient has been given diazepam (Valium) prn. Which techniques may assist in assessing the patient’s sleep pattern?

ANS:  B

Keeping a sleep chart for 48 to 72 hours and documenting sleep periods greater than 90 minutes, the number and length of awakenings, and the total possible sleep time can help assess sleep patterns in the critical care unit