Chapter 16: Normal Sleep and Sleep-Wake Disorders
Test Bank
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 arent 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
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.
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,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.
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.
5. A 10-year-old is diagnosed with somnambulism as a result of frequent episodes of
sleepwalking. Which topic should be included when considering patient and family education?
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, a. Medication therapy seldom prescribed for this disorder
b. Safety issues such as sleeping in the ground level bedroom
c. The likely connection between sleepwalking and narcolepsy
d. The need for short-term cognitive and behavioral therapy
ANS: B
Safety is a primary concern when managing sleepwalking since injury is quite likely as a result
of the patients inability to be aware of danger. Drugs that suppress stages 3 and 4 sleep, such as
benzodiazepine hypnotics, have been used for the management of this disorder. There is no
research to support a connection between this disorder and narcolepsy. This disorder is not
treated with either of these therapies.
6. Which patient statement would support a diagnosis of a circadian rhythm sleep disturbance?
a. I just started on the night shift at work.
b. My mother was seriously depressed for years.
c. I wake up gasping for breath, and it is really scary.
d. I dont think I drink any more than my buddies do.
ANS: A
The shift worktype of circadian sleep disorder is usually the result of night shift work or
frequently rotating shift work. Depression, breathing problems, and drinking indicate other types
of sleep disturbances.
7. Which physical assessment finding is supportive of a diagnosis of obstructive sleep apnea?
a. Barrel chest
b. Raccoon eyes
c. Enlarged nasal nares
d. Large neck circumference
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Test Bank
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 arent 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
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.
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,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.
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.
5. A 10-year-old is diagnosed with somnambulism as a result of frequent episodes of
sleepwalking. Which topic should be included when considering patient and family education?
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, a. Medication therapy seldom prescribed for this disorder
b. Safety issues such as sleeping in the ground level bedroom
c. The likely connection between sleepwalking and narcolepsy
d. The need for short-term cognitive and behavioral therapy
ANS: B
Safety is a primary concern when managing sleepwalking since injury is quite likely as a result
of the patients inability to be aware of danger. Drugs that suppress stages 3 and 4 sleep, such as
benzodiazepine hypnotics, have been used for the management of this disorder. There is no
research to support a connection between this disorder and narcolepsy. This disorder is not
treated with either of these therapies.
6. Which patient statement would support a diagnosis of a circadian rhythm sleep disturbance?
a. I just started on the night shift at work.
b. My mother was seriously depressed for years.
c. I wake up gasping for breath, and it is really scary.
d. I dont think I drink any more than my buddies do.
ANS: A
The shift worktype of circadian sleep disorder is usually the result of night shift work or
frequently rotating shift work. Depression, breathing problems, and drinking indicate other types
of sleep disturbances.
7. Which physical assessment finding is supportive of a diagnosis of obstructive sleep apnea?
a. Barrel chest
b. Raccoon eyes
c. Enlarged nasal nares
d. Large neck circumference
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