MGRADES EXAMS
NURS 5461 Geriatric Specialty Topics
UPDATED ACTUAL Exam Questions and
CORRECT Answers
In older adults, insomnia is often comorbid with other conditions - CORRECT ANSWER -➢
Chronic illness ➢ Mood disturbance ➢ Less physical activity ➢ Physical disability
Screening Questions - CORRECT ANSWER - Is the person satisfied with his or her sleep? •
Does sleep or fatigue interfere with daytime activities? • Does the bed partner or others complain
of unusual behavior during sleep, such as snoring, interrupted breathing, or leg movements?
Polysomnography if primary sleep disorder is suspected: - CORRECT ANSWER - ➢ Sleep
apnea
➢ Narcolepsy
➢ Periodic limb movement disorder
➢ Violent or other unusual behaviors during sleep
➢ Other sleep symptoms that do not respond to treatment
Diagnostic criteria for sleep disorder - CORRECT ANSWER - Difficulty falling sleep,
difficulty staying asleep, waking too early, or sleep that is nonrestorative or poor in quality 2.
Adequate opportunity and circumstances for sleeping 3. Daytime impairment related to the sleep
complaint, such as fatigue, poor attention, mood disturbance, daytime sleepiness, or other
complaints
Insomnia A/W Psych - CORRECT ANSWER - Depression is a common cause of sleep
problems, Bereavement, anxiety, and stress can also be associated with sleep difficulties
Medical problems can contribute to sleep difficulties: - CORRECT ANSWER - ➢ Pain from
arthritis, other conditions ➢ Paresthesias ➢ Cough ➢ Dyspnea from cardiac or pulmonary
illness ➢ Gastroesophageal reflux
, MGRADES EXAMS
Central Sleep Apnea - CORRECT ANSWER - cessation of breathing without associated
respiratory effort ➢ Cheynes-Stokes pattern of sleep apnea has a crescendo-decrescendo pattern
**Initial treatment should focus on management of heart failure, if present
OSA - CORRECT ANSWER - Characterized by complete (apnea) or partial (hypopnea)
upper airway obstruction during sleep, with evidence of respiratory effort during the events •
Excessive daytime sleepiness is common • Patients may have morning headache, personality
changes, poor memory, confusion, and irritability • Bed partner may report loud snoring,
cessation of breathing, and choking sounds during sleep
OSA Risk Fcators - CORRECT ANSWER - • High body mass index (BMI) and large neck
circumference are important predictors, Other reported predictors: ➢ Falling asleep at
inappropriate times or napping ➢ Male gender • Alcoholism is an important risk factor • Some
evidence of an association with dementia
Main treatment OSA - CORRECT ANSWER - positive airway pressure (PAP) ➢ Older
adults likely to tolerate as well as younger adults ➢ Comfort-improving devices may improve
compliance ➢ Early adherence predicts long-term adherence ➢ Oral appliances may be an
option in mild cases
PLMS - CORRECT ANSWER - Repetitive, stereotypic leg movements that occur during non-
REM sleep ➢ Prevalence increases with age, IF not explained by another sleep disorder =
periodic limb movement disorder (diagnosis requires polysomnography)
RLS - CORRECT ANSWER - Characterized by an urge to move the legs, usually with an
unpleasant sensation in the legs, that occurs with inactivity, generally at night, and improves with
movement ➢ Symptoms occur while the person is awake ➢ Symptoms can also involve the
arms • Prevalence increases with age • Polysomnography not required for diagnosis • Many
patients with this condition also have PLMS
PLMS/RLS Treatement - CORRECT ANSWER - • A dopaminergic agent is the initial agent
of choice for older patients • Evening dose of a dopamine agonist (eg, pramipexole or ropinirole)
NURS 5461 Geriatric Specialty Topics
UPDATED ACTUAL Exam Questions and
CORRECT Answers
In older adults, insomnia is often comorbid with other conditions - CORRECT ANSWER -➢
Chronic illness ➢ Mood disturbance ➢ Less physical activity ➢ Physical disability
Screening Questions - CORRECT ANSWER - Is the person satisfied with his or her sleep? •
Does sleep or fatigue interfere with daytime activities? • Does the bed partner or others complain
of unusual behavior during sleep, such as snoring, interrupted breathing, or leg movements?
Polysomnography if primary sleep disorder is suspected: - CORRECT ANSWER - ➢ Sleep
apnea
➢ Narcolepsy
➢ Periodic limb movement disorder
➢ Violent or other unusual behaviors during sleep
➢ Other sleep symptoms that do not respond to treatment
Diagnostic criteria for sleep disorder - CORRECT ANSWER - Difficulty falling sleep,
difficulty staying asleep, waking too early, or sleep that is nonrestorative or poor in quality 2.
Adequate opportunity and circumstances for sleeping 3. Daytime impairment related to the sleep
complaint, such as fatigue, poor attention, mood disturbance, daytime sleepiness, or other
complaints
Insomnia A/W Psych - CORRECT ANSWER - Depression is a common cause of sleep
problems, Bereavement, anxiety, and stress can also be associated with sleep difficulties
Medical problems can contribute to sleep difficulties: - CORRECT ANSWER - ➢ Pain from
arthritis, other conditions ➢ Paresthesias ➢ Cough ➢ Dyspnea from cardiac or pulmonary
illness ➢ Gastroesophageal reflux
, MGRADES EXAMS
Central Sleep Apnea - CORRECT ANSWER - cessation of breathing without associated
respiratory effort ➢ Cheynes-Stokes pattern of sleep apnea has a crescendo-decrescendo pattern
**Initial treatment should focus on management of heart failure, if present
OSA - CORRECT ANSWER - Characterized by complete (apnea) or partial (hypopnea)
upper airway obstruction during sleep, with evidence of respiratory effort during the events •
Excessive daytime sleepiness is common • Patients may have morning headache, personality
changes, poor memory, confusion, and irritability • Bed partner may report loud snoring,
cessation of breathing, and choking sounds during sleep
OSA Risk Fcators - CORRECT ANSWER - • High body mass index (BMI) and large neck
circumference are important predictors, Other reported predictors: ➢ Falling asleep at
inappropriate times or napping ➢ Male gender • Alcoholism is an important risk factor • Some
evidence of an association with dementia
Main treatment OSA - CORRECT ANSWER - positive airway pressure (PAP) ➢ Older
adults likely to tolerate as well as younger adults ➢ Comfort-improving devices may improve
compliance ➢ Early adherence predicts long-term adherence ➢ Oral appliances may be an
option in mild cases
PLMS - CORRECT ANSWER - Repetitive, stereotypic leg movements that occur during non-
REM sleep ➢ Prevalence increases with age, IF not explained by another sleep disorder =
periodic limb movement disorder (diagnosis requires polysomnography)
RLS - CORRECT ANSWER - Characterized by an urge to move the legs, usually with an
unpleasant sensation in the legs, that occurs with inactivity, generally at night, and improves with
movement ➢ Symptoms occur while the person is awake ➢ Symptoms can also involve the
arms • Prevalence increases with age • Polysomnography not required for diagnosis • Many
patients with this condition also have PLMS
PLMS/RLS Treatement - CORRECT ANSWER - • A dopaminergic agent is the initial agent
of choice for older patients • Evening dose of a dopamine agonist (eg, pramipexole or ropinirole)
