Chapter 31: Sleep

Chapter 31: Sleep

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A college student who is working in northern Alaska during the summer reports that he or she has an increase in difficulty sleeping since moving north. During a pre-employment physical, the patient asks the health care provider what could be causing this. The health care provider suspects the sleep disturbance is most likely because of which factor?

ANS:   B

Northern Alaska has extended daylight hours. Light and temperature affect all circadian rhythms, including the sleep-wake cycle. The most familiar rhythm is the 24-hour, day-night cycle known as the diurnal or circadian rhythm. When the sleep-wake cycle becomes disrupted (e. g., by working rotating shifts), other physiological functions change as well. Stress of the new job, physical demands of the new job, and a change in diet are not the issues. The patient stated that the difficulty started when he or she moved north.

PTS:    1                      DIF:    Cognitive Level: Analyzing (Analysis)

REF:    847

OBJ:    Explain the effect the 24-hour sleep-wake cycle has on biological function.

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Physiological Integrity

2. The health care provider is seeing a 16-year-old boy at the local clinic. The guardian is concerned about the patient’s lack of sleep. The guardian states that the patient “goes to school, works at a part-time job until 10 PM, and then stays up doing homework until after midnight. I am worried that he is not getting enough sleep.” What is the best response for the health care provider to give the patient and his guardian?

ANS:   C

Adolescents need between 8 and 9 hours of sleep each night; however, the typical teenager gets about 7 hours of sleep per night. At a time when sleep needs actually increase, the typical adolescent is subject to a number of changes that often reduce the time spent sleeping, such as the time when school starts, after-school social events, part-time jobs, and extracurricular activities. The shortened sleep time in adolescents often results in excessive daytime sleepiness (EDS), which can reduce performance in school, increase risk of accidents, increase the use of alcohol, and lead to behavior and mood problems. Sleep deprivation affects immune functioning, metabolism, nitrogen balance, protein catabolism, and quality of life. Saying, “I don’t get enough sleep either” or “You need to discuss this with the primary health care provider” is not focusing on the guardian’s question. Saying the boy “will be fine” is false reassurance.

PTS:    1                      DIF:    Cognitive Level: Applying (Application)

REF:    849

OBJ:    Compare and contrast the characteristics of sleep for different age groups.

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Health Promotion and Maintenance

3. During a sleep study test, the patient states, “I never dreams anymore.” The health care provider tells the patient that everyone dreams, but most people forget about them upon awakening. The health care provider tells the patient that the best way to remember dreams is to do which of the following?

ANS:   C

To remember a dream, a person must consciously think about it on awakening. People who recall dreams vividly usually awaken just after a period of rapid eye movement (REM) sleep. Personality influences the quality of dreams; for example, a creative person may have very vivid, unusual dreams, whereas a depressed person may have dreams of helplessness. Eating a large, heavy, and/or spicy meal within 3 to 4 hours of bedtime sometimes results in indigestion that interferes with sleep. Alcohol consumed in the evening has insomnia-producing and diuretic effects. Coffee, tea, cola, and chocolate contain caffeine and xanthines that cause sleeplessness as a result of central nervous system stimulation. Avoiding caffeine and becoming more creative do not increase a person’s memory for dreams.

PTS:    1                      DIF:    Cognitive Level: Applying (Application)

REF:    849                  OBJ:    Describe the normal stages of sleep.

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Health Promotion and Maintenance

4. A new mother has brought in her week-old infant to the health care provider for a 1-week well-baby checkup. She is breastfeeding and has only been sleeping a couple of hours at a time during the night between feedings. She asks the nurse, “When can I expect the baby to sleep through the night?” What is the nurse’s best response?

ANS:   B

Infants usually develop a nighttime pattern of sleep by 3 months of age. The neonate and infant up to the age of 3 months average about 16 hours of sleep a day. A symptom of anemia or depression is fatigue, but this does not focus on the question the new mother asked about the baby sleeping.

PTS:    1                      DIF:    Cognitive Level: Analyzing (Analysis)

REF:    849

OBJ:    Compare and contrast the characteristics of sleep for different age groups.

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Health Promotion and Maintenance