Chapter 19: Sleep Disorders: Dyssomnias and Parasomnias

Chapter 19: Sleep Disorders: Dyssomnias and Parasomnias

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which assessment observation would not support a diagnosis of narcolepsy?

a.	Sleep study reports excessive, loud snoring.
b.	Sleep study shows evidence of sleep paralysis.
c.	Patient reports “needing to drink pots of coffee to stay awake at work.”
d.	Patient reports, “When I get sleepy I actually see things that aren’t really there.”

 

ANS: A

Snoring is a characteristic obstructive sleep apnea, not narcolepsy. Classic symptoms of narcolepsy include excessive daytime sleepiness, sleep paralysis, and hallucinations

 

DIF:   Cognitive Level: Application        REF:  Page 446

TOP:  Nursing Process: Assessment

MSC: NCLEX: Patient Need: Physiological Integrity: Basic Care and Comfort: Rest and Sleep

 

2. An adult patient diagnosed with narcolepsy is being educated on the medication therapy that is prescribed. Which explanation is provided for the central nervous system stimulant dextroamphetamine (Dexedrine)?

a.	The apnea will be lessened by this medication.
b.	It will help control the sporadic loss of muscle tone.
c.	This medication will minimize the daytime sleepiness.
d.	Dexedrine will manage the inflammation that causes the snoring.

 

ANS: C

Central nervous system stimulants such as dextroamphetamine (Dexedrine, Dextrostat) may be prescribed to manage excessive daytime sleepiness. This medication has no affect on cataplexy, apnea, or snoring. Apnea and snoring are not symptoms of narcolepsy.

 

DIF:   Cognitive Level: Application        REF:  Page 451

TOP:  Nursing Process: Implementation

MSC: NCLEX: Patient Need: Physiological Integrity: Basic Care and Comfort: Rest and Sleep

 

3. A pediatric patient has been diagnosed with obstructive sleep apnea (OSA). Which statement would the nurse use as a basis for explaining the etiology of this disorder?

a.	Melatonin is not being released in sufficient quantity.
b.	This condition is often due to adenotonsillar hypertrophy.
c.	Children have a high ratio of REM sleep that can result in frequent gasping.
d.	This can be related to a sleep position which compromises chest movement.

 

ANS: B

When OSA is found in children, it is usually the result of adenotonsillar hypertrophy, craniofacial abnormalities, and neuromuscular conditions, all of which result in airway obstruction during sleep. There is no research on OSA related to melatonin insufficiency, dreaming, or a particular sleep position.

 

DIF:   Cognitive Level: Application        REF:  Page 445        TOP:  Nursing Process: Planning

MSC: NCLEX: Patient Need: Physiological Integrity: Basic Care and Comfort: Rest and Sleep

 

4. Which outcome is appropriate for an adult patient recently diagnosed with primary insomnia?

a.	Demonstrate an understanding of the cerebral stimulants prescribed.
b.	Recognize that the prescribed flurazepam (Dalmane) can be used for up to 2 months.
c.	Demonstrate the proper use of continuous positive airway pressure (CPAP) ventilation.
d.	Recognize physical and psychosocial stressors that exacerbate the sleep disturbance.

 

ANS: D

The patient should identify physical and psychosocial stressors that exacerbate the sleep disturbance in order to attempt successful self-management of the problem. Neither stimulants nor CPAP therapy are prescribed for this disorder. The duration of flurazepam therapy is considerably shorter.

 

DIF:   Cognitive Level: Application        REF:  Page 448        TOP:  Nursing Process: Planning

MSC: NCLEX: Patient Need: Physiological Integrity: Basic Care and Comfort: Rest and Sleep