Chapter 07: Sleep and Sleep Disorders

Chapter 07: Sleep and Sleep Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient complains of difficulty falling asleep and daytime fatigue for the past 6 weeks. What is the best initial action for the nurse to take in determining whether this patient has chronic insomnia?

a.	Schedule a polysomnograph (PSG).
b.	Teach the patient how to use an actigraph.
c.	Ask the patient to keep a 2-week sleep diary.
d.	Arrange for the patient to have a sleep study.

 

 

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 or sleep studies may be used for determining specific sleep disorders but are not necessary to make an initial insomnia diagnosis.

 

DIF:    Cognitive Level: Apply (application)           REF:               91

OBJ:   Special Questions: Prioritization      TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity

 

2. A patient with chronic insomnia asks the nurse about ways to improve sleep quality. Which response by the nurse is accurate?

a.	Avoid exercise during the day.
b.	Keep the bedroom temperature warm.
c.	Read in bed for a few minutes each night.
d.	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: Apply (application)           REF:               94

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

3. Which patient statement indicates a need for further teaching about extended-release zolpidem (Ambien CR)?

a.	“I should take the medication on an empty stomach.”
b.	“I will take the medication 1 to 2 hours before bedtime.”
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:  B

Benzodiazepine receptor agonists such as zolpidem work quickly and should be taken immediately before bedtime. The other patient statements are correct.

 

DIF:    Cognitive Level: Apply (application)           REF:               94

TOP:   Nursing Process: Evaluation            MSC:  NCLEX: Physiological Integrity

 

4. The nurse cares for an unstable patient in the intensive care unit (ICU). Which intervention should the nurse include in the plan of care to improve this patient’s sleep quality?

a.	Ask all visitors to leave the ICU for the night.
b.	Lower the level of lighting from 8:00 PM until 7:00 AM.
c.	Avoid the use of opioids for pain relief during the evening.
d.	Schedule assessments to allow 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 unstable patients. For some patients, having a family member or friend at the bedside may decrease anxiety and improve sleep.

 

DIF:    Cognitive Level: Apply (application)           REF:               96

TOP:   Nursing Process: Planning               MSC:  NCLEX: Physiological Integrity

 

5. What teaching should be included in the plan of care for a patient with narcolepsy?

a.	Driving an automobile may be possible with appropriate treatment of narcolepsy.
b.	Changes in sleep hygiene are ineffective in improving sleep quality in narcolepsy.
c.	Antidepressant drugs are prescribed to treat the depression caused by the disorder.
d.	Stimulant drugs should be used for less than a month because of the risk for abuse.

 

 

ANS:  A

The accident rate FOR patients with narcolepsy who are receiving appropriate treatment is similar to the general population. Stimulant medications are used on an ongoing basis for patients with narcolepsy. The purpose of antidepressant drugs in the treatment of narcolepsy is the management of cataplexy, not to treat depression. Changes in sleep hygiene are recommended for patients with narcolepsy to improve sleep quality.

 

DIF:    Cognitive Level: Apply (application)           REF:               98

TOP:   Nursing Process: Planning               MSC:  NCLEX: Physiological Integrity