Sleep Disorders and Their Causes: A Comprehensive Guide, Exams of Nursing

Download Sleep Disorders and Their Causes: A Comprehensive Guide and more Exams Nursing in PDF only on Docsity! NCHP Exam 1- Sleep Assessment Questions with Answers Definite Success Which characteristics may a sleep-deprived person experience? Select all that apply. Hyperactivity Violent behavior Decreased concentration Difficulty making decisions Irritability - Correct Answers Decreased concentration Difficulty making decisions Irritability Match the central nervous system structure to its role in sleep. Relays sensory information Secretes melatonin Secretes hypocrites Processes emotions Hypothalamus Thalamus Basal forebrain Brain stem Amygdala Pineal gland - Correct Answers Relays sensory information - Thalamus Secretes melatonin - Pineal gland Secretes hypocrites - Hypothalamus Processes emotions - Amygdala Match the hormone to its role in the onset and duration of sleep. Helps maintain homeostasis Released in response to light Decreases rapid eye movement (REM) sleep when released in high levels Increases alertness when released in response to stress Cortisol Hypocrite Dopamine Norepinephrine Melatonin Adrenaline - Correct Answers Helps maintain homeostasis - Cortisol Released in response to light - Melatonin Decreases rapid eye movement (REM) sleep when released in high levels - Norepinephrine Increases alertness when released in response to stress - Adrenaline Which physiologic changes occur during sleep? Select all that apply. Heart rate decreases Respiratory rate increases Body temperature drops Blood pressure decreases Muscle tone increases - Correct Answers Heart rate decreases Body temperature drops Blood pressure decreases During which sleep stage can sleepwalking occur? Rapid eye movement (REM) No rapid eye movement (NREM) 1 NREM 2 NREM 3 - Correct Answers NREM 3 Which functions of the human body are impacted by the circadian rhythm? Select all that apply. Sleep Blood production Digestion Body temperature Endocrine function - Correct Answers Sleep Digestion Body temperature Endocrine function Recurring patterns of sleep last approximately how many minutes? Record your answer as a whole number. _________ minutes. - Correct Answers 90 Which individual would require the least amount of sleep? 2-year-old "Barbiturates increase REM sleep." - Correct Answers "Barbiturates increase REM sleep." Which nighttime snack is appropriate for a patient with a history of insomnia? Chips and salsa Chocolate ice cream Graham crackers Pizza - Correct Answers Graham crackers Which patients would most likely suffer from sleep disturbances? Select all that apply. Young adult female with marital problems Young adult male who lives alone Older adult male who recently lost his wife in death Child who is spending the summer away from home at camp Adult female caring for a family member with a chronic illness - Correct Answers Young adult female with marital problems Older adult male who recently lost his wife in death Child who is spending the summer away from home at camp Adult female caring for a family member with a chronic illness Which structures of the central nervous system are affected by a light or dark environment? Select all that apply. Basal forebrain Hypothalamus Amygdala Thalamus Pineal gland Brain stem - Correct Answers Hypothalamus Pineal gland Brain stem Sleep deprivation can lead to an increased risk for which diseases? Select all that apply. Depression Obesity Cardiovascular disease Parkinson disease Diabetes Asthma - Correct Answers Depression Obesity Cardiovascular disease Diabetes Which cues support the nursing hypothesis Impaired Sleep(quality) related to lifestyle factors and sleep apnea? Select all that apply. Daytime fatigue Excessive yawning Paranoia Dark circles around puffy eyes Nightmares - Correct Answers Daytime fatigue Excessive yawning Dark circles around puffy eyes Which patient assessment cues support a nursing hypothesis of Impaired Sleep (quantity)? Select all that apply. Sleep duration insufficient for patient age Delusions High score on the Sleep Hygiene Index Daytime drowsiness High score on the Pittsburgh Sleep Quality Index High score on the Apnea-Hypopnea Index - Correct Answers Sleep duration insufficient for patient age Delusions Daytime drowsiness High score on the Pittsburgh Sleep Quality Index Which hypothesis would the nurse select for a patient whose sleep is not progressing properly through sleep cycles? Distorted Thinking Process Fatigue Impaired Sleep (quality) Impaired Sleep (quantity) - Correct Answers Impaired Sleep (quality) Which outcome is appropriate for a patient with a nursing hypothesis of Impaired Sleep (quality)? Patient will take two 20-minute naps each day. Patient will report increased memory function. Patient will reduce score on Pittsburgh Sleep Quality Index. Patient will sleep for at least 90 minutes at a time during hospitalization. - Correct Answers Patient will sleep for at least 90 minutes at a time during hospitalization. Which outcome is appropriate for a patient with a nursing hypothesis of Fatigue? Patient will reduce score on Epworth Sleepiness Scale. Patient will report fewer episodes of hallucinations and delusions. Patient will have fewer days obtaining less than 6 hours of sleep per night. Patient will sleep for at least 90 minutes at a time during hospitalization. - Correct Answers Patient will reduce score on Epworth Sleepiness Scale. Which solutions would be appropriate for a patient with a nursing hypothesis of Impaired Sleep (quantity)? Select all that apply. Patient education about sleep hygiene Patient will visit with a mental health professional Patient education about sleep needs during various life stages Adjusting work schedule to allow for healthy sleep schedule Patient education about stress management - Correct Answers Patient education about sleep hygiene Patient education about sleep needs during various life stages Adjusting work schedule to allow for healthy sleep schedule Patient education about stress management Which solutions would be appropriate for a patient with a nursing hypothesis of Fatigue? Select all that apply. Patient education about sleep hygiene Patient will visit with a mental health professional Patient education about sleep needs during various life stages Adjusting work schedule to allow for healthy sleep schedule Patient education about stress management - Correct Answers Patient education about sleep hygiene Adjusting work schedule to allow for healthy sleep schedule Patient education about stress management Which sleep instrument is used to assess sleep quality and disturbance over a 1-month period? Epworth Sleepiness Scale Pittsburgh Sleep Quality Index Sleep Hygiene Index STOP-BANG questionnaire - Correct Answers Pittsburgh Sleep Quality Index Which physical signs indicate potential sleep problems? Select all that apply. Nasal polyps Thin neck Deviated septum Shortness of breath Low body mass index - Correct Answers Nasal polyps Deviated septum Shortness of breath A person suffering from mild obstructive sleep apnea (OSA) would have how many apneic or hypopnea episodes per hour? Greater than 30 15 to 30 5 to 15 Fewer than 5 - Correct Answers 5 to 15 Which components would be included in a sleep diary? Select all that apply. Meal times Bedtime routine Caffeine intake Pain level Prescription medication Naps - Correct Answers Meal times Caffeine intake Naps Which disorders are potential causes of hypersomnia? Select all that apply. Kidney disorders Diabetic ketoacidosis Heart disease Central nervous system damage Hyperthyroidism Airway collapse - Correct Answers Kidney disorders Diabetic ketoacidosis Central nervous system damage Which parasomnia may be associated with self-injury and sleep-related violence? Bruxism Sleep terrors Somnambulism Nocturnal enuresis - Correct Answers Somnambulism Which disorder is the most common type of dystonia? Insomnia Narcolepsy Hypersomnia Restless legs syndrome - Correct Answers Insomnia A patient with no known medical conditions reports constant fatigue and inability to stay awake. The patient also reports falling asleep while at work, having vivid hallucinations upon awakening, and brief episodes of paralysis at the beginning of sleep. The nurse suspects that this patient is suffering from which condition? Apnea Insomnia Narcolepsy Hypersomnia - Correct Answers Narcolepsy Which patient has the greatest risk of developing obstructive sleep apnea (OSA)? Underweight, adult male with decreased neuromuscular coordination Thin, female child with a recessed chin who has a family history of OSA Obese, older adult female who has been hospitalized several times within the past year Obese, adult male smoker with a large neck circumference - Correct Answers Obese, adult male smoker with a large neck circumference In which way are sleep deprivation and narcolepsy similar? Both carry a risk factor for obesity. Both disorders can cause hallucinations. Both are neurologic disorders. Both disorders cause a person to stop breathing during sleep. - Correct Answers Both disorders can cause hallucinations. Which factors are measured by polysomnography? Select all that apply. Eye movements Brain activity Heart rate Oxygen level Blood pressure - Correct Answers Eye movements Brain activity Heart rate Oxygen level Which question would the nurse ask when assessing for narcolepsy? Do you sleepwalk? Do you use an alarm clock? Do you fall asleep unexpectedly at random times? Do family members tell you that you snore? - Correct Answers Do you fall asleep unexpectedly at random times? Which behavioral cues may validate a sleep disturbance? Select all that apply. Ramelteon Amitriptyline Zolpidem Diphenhydramine Alprazolam Doxylamine - Correct Answers Sedative-hypnotic - Zolpidem Benzodiazepine - Alprazolam Melatonin receptor agonist - Ramelteon Antidepressant - Amitriptyline Which interventions related to sleep would the nurse recommend to the parent of a pediatric patient? Select all that apply. Give a warm bath Read a bedtime story Provide a favorite soft toy or blanket Offer a large glass of water Play soft, soothing music - Correct Answers Give a warm bath Read a bedtime story Provide a favorite soft toy or blanket Play soft, soothing music Which no pharmacologic intervention would the nurse initiate for a patient who is having difficulty falling asleep because of mild back pain? Giving the patient a massage Providing the patient with a warm cloth to wash the face Changing the patient's bed linens Asking the family to sit with the patient - Correct Answers Giving the patient a massage Which type of exercise would the nurse suggest a patient perform just before bed to promote sleep? Yoga Weight lifting Brisk walking Basketball - Correct Answers Yoga Which statement by the patient regarding foods that promote sleep indicates the need for further education from the nurse? "A glass of milk before bed stimulates the production of serotonin, enhancing sleep." "Coffee should be avoided prior to bed as the caffeine is a stimulant, which interferes with sleep." "I should limit my intake of fluid in the evening as it may cause the need to urinate while sleeping." "I should drink a few glasses of red wine in the evening to enhance the sleep I get overnight." - Correct Answers "I should drink a few glasses of red wine in the evening to enhance the sleep I get overnight." Which no pharmacologic intervention is most appropriate to promote rest in a patient with restless legs syndrome (RLS)? Using aromatherapy each evening Suggesting several glasses of red wine each night Encouraging deep knee bends Providing a light meal high in protein - Correct Answers Encouraging deep knee bends Which pharmacologic interventions would the nurse suggest for a patient with chronic insomnia who prefers to use supplements over medications? Select all that apply. Melatonin Valerian Amitriptyline Diphenhydramine Doxylamine - Correct Answers Melatonin Valerian Which statement made by a patient after education regarding the safe administration of common sleep medications indicates a need for further teaching? "I must read the warnings to help me understand the potential severe allergic reactions and dangerous sleep behaviors, such as sleep-driving." "I understand that long-term use of benzodiazepine medications may actually cause additional sleep problems." "Since I am an older adult, I will take the medicine with care so as to lessen my risk of side effects." "Maybe I should take a higher dose of antidepressants since it is my first time taking them for my sleep problems." - Correct Answers "Maybe I should take a higher dose of antidepressants since it is my first time taking them for my sleep problems." Which statements made by the patient would indicate a sleep medication was ineffective? Select all that apply. "It took a lot longer to fall asleep than normal." "I am a lot less tired today than yesterday." "I slept several more hours last night than I usually do." "I woke up more frequently in the night." "My mind was very active last night after taking the medication." - Correct Answers "It took a lot longer to fall asleep than normal." "I woke up more frequently in the night." "My mind was very active last night after taking the medication." 1. A nurse is developing a plan for a patient who was diagnosed with narcolepsy. Which interventions should the nurse include on the plan? (Select all that apply.) 1. Take brief, 20-minute naps no more than twice a day. 2. Drink a glass of wine with dinner. 3. Eat a large meal at lunch rather than dinner. 4. Establish a regular exercise program. 5. Teach the patient about the side effects of modafinil. - Correct Answers 1. Take brief, 20-minute naps no more than twice a day. 4. Establish a regular exercise program. 5. Teach the patient about the side effects of modafinil. 2. Which statements from a patient indicate an understanding of behaviors that will promote sleep? (Select all that apply.) 1. "I will not watch television in bed." 2. "I will not drink caffeine later in the day." 3. "A short nap late in the evening will lead to a more restful night of sleep." 1. Mrs. Dodd, 46 years old, was admitted 3 days ago following a motor vehicle accident. She is in balanced skeletal traction for a fractured left femur. She is having difficulty falling asleep. 4. Mrs. Dodd is taking her pain medication every 4 hours as ordered and rates her pain as 2 out of 10. Last night she was still awake at 0100. She states that she is comfortable but just can't fall asleep. Her vital signs are BP 124/76, P 78, R 12 and T 37.1°C (98.8°F). 3. "I'm calling to ask if you would order a hypnotic such as zolpidem to use on a pen basis." 8. Which statement made by a mother being discharged to home with her newborn infant indicates that she understands the discharge teaching related to best sleep practices? 1. "I'll give the baby a bottle to help her fall asleep." 2. "We'll place the baby on her back to sleep." 3. "We put the baby's stuffed animals in the crib to make her feel safe." 4. "I know the baby will not need to be fed until morning." - Correct Answers 2. "We'll place the baby on her back to sleep." 9. A nurse is taking a sleep history from a patient. Which statement made by the patient needs further follow-up? 1. "I feel refreshed when I wake up in the morning." 2. "I use soft music at night to help me relax." 3. "It takes me about 45 to 60 minutes to fall asleep." 4. "I take the pain medication for my leg pain about 30 minutes before I go to bed." - Correct Answers 3. "It takes me about 45 to 60 minutes to fall asleep." 10. Which sleep-hygiene actions at bedtime can the nurse delegate to assistive personnel? (Select all that apply.) 1. Giving the patient a back rub 2. Turning on quiet music 3. Dimming the lights in the patient's room 4. Giving a patient a cup of coffee 5. Monitoring for the effect of the sleeping medication that was given - Correct Answers 1. Giving the patient a back rub 2. Turning on quiet music 3. Dimming the lights in the patient's room