Canadian Fundamentals of Nursing, 6th Edition

Canadian Fundamentals of Nursing, 6th Edition 1. The physiological processes of sleep are complex. Which of the following statements is the most appropriate one regarding this process? a. Circadian rhythms occur in a cycle longer than 24 hours. b. Non-rapid eye movement (NREM) refers to the cycle that most people experience when in a high-stimulus environment. c. The reticular activating system is partly responsible for the level of consciousness of a person. d. The bulbar synchronizing region causes the rapid eye movement (REM) sleep in most normal adults. - ANS c. The reticular activating system is partly responsible for the level of consciousness of a person. The nurse is alert to patients who may be predisposed to obstructive sleep apnea. This includes which of the following individuals? a. Patients with heart disease. b. Patients with respiratory infections. c. Patients with nasal polyps. d. Patients who are obese.. - ANS c. Patients with nasal polyps. When a patient is deprived of sleep, the nurse might assess which of the following symptoms? a. Elevated blood pressure. b. Confusion and irritability. c. Inappropriateness and rapid respirations. d. Decreased temperature and talkativeness. - ANS b. Confusion and irritability. The parents of a newborn wonder when she should start to sleep through the night. The nurse's response should be that in infants, a nighttime pattern of sleep usually develops by which age? - ANS 6 months. The mother of a preschooler tells the nurse that the child has started crying and resisting going to sleep at the scheduled bedtime. Which of the following actions should the nurse advise the parent to take? a. Offer the child a bedtime snack. b. Eliminate one of the naps during the day. c. Allow the child to sleep longer in the mornings. d. Maintain consistency in the same bedtime ritual. - ANS d. Maintain consistency in the same bedtime ritual. An 11-year-old child in middle school is currently experiencing fatigue related to sleep deprivation during classes. Which of the following responses by the school nurse is the most appropriate one when counselling the child's parents regarding this assessment? - ANS "What are the child's usual sleep patterns?" In describing the sleep patterns of older persons, the nurse recognizes that which of the following statements is true? - ANS Older persons have a decline in slow-wave or deep sleep. A patient who is currently taking a diuretic should be informed by the nurse that he or she may experience which of the following effects? - ANS Nocturia 9. As a result of recent studies regarding infant safety during sleep, which of the following instructions does the nurse give the parents? - ANS Place the infant on his or her back. A 74-year-old patient reports having sleeping difficulties. To have a better idea of the patient's problem, how should the nurse respond? - ANS "What do you do just before going to bed?" Which of the following information provided by the patient's bed partner is most associated with sleep apnea? a. Restlessness. b. Talking during sleep. c. Sleepwalking. d. Excessive snoring. - ANS d. Excessive snoring. 12. Which of the following instructions does the nurse give the patient in teaching methods to promote positive sleep habits at home? - ANS Use the bedroom only for sleep or sexual activity. 13. The nurse is discussing sleep habits with the patient in the sleep assessment clinic. Of the following activities performed before sleeping, the nurse informs the patient that which one of the following can potentially interfere with the patient's sleep? - ANS Finishing office work. The patient needs pharmacological treatment to assist with his sleep patterns. The nurse anticipates that treatment with an anxiety-reducing, relaxation-promoting medication will include the use of which one of the following? a. Barbiturates. b. Amphetamines. c. Benzodiazepines. d. Tricyclic antidepressants. - ANS c. Benzodiazepines. 15. The nurse is completing an assessment of the patient's sleep patterns. Which of the following is a specific question that the nurse should ask to determine the potential presence of sleep apnea? a. "How easily do you fall asleep?" b. "Do you have vivid, lifelike dreams?" c. "Do you ever experience loss of muscle control or falling?" d. "Do you snore loudly or experience headaches?" - ANS d. "Do you snore loudly or experience headaches?" 16. Which of the following is an effective brief method for assessing sleep quality? - ANS Visual analogue scale. 17. Which sleep stage begins the initial period of deep sleep? - ANS Stage 3. 18. Which stage of sleep accounts for the greatest proportion of total sleep time in adults? - ANS Stage 2. 19. Which of the following is a determinant of dreams? - ANS Age 20. Which of the following sleep disorders is a parasomnia disorder of arousal? - ANS Sleepwalking. The nurse is gathering a sleep history from a patient who is being evaluated for obstructive sleep apnea (OSA). Which common symptom is the patient most likely to report? - ANS Excessive daytime sleepiness The nurse incorporates which priority nursing intervention into a plan of care to promote sleep for a hospitalized patient? - ANS Avoid awakening the patient for nonessential tasks. Older persons are cautioned about the use of nonprescription sleeping medications for which following reason? - ANS These medications lead to further sleep disruption even when they initially seemed to be effective. The patient reports having vivid dreams to the nurse. As a result of understanding the sleep cycle, the nurse recognizes that vivid dreaming occurs in which sleep phase? - ANS Rapid-eye-movement (REM) sleep The nurse teaches a patient taking phenytoin (Dilantin), an anticonvulsant, that it is one of a group of medications that cause which symptom of a sleep problem? - ANS Increased daytime sleepiness. Which intervention is appropriate to include on a care plan for improving sleep in the older adult? - ANS Decrease fluids 2 to 4 hours before sleep. Which statement made by a mother being discharged to home with her newborn infant indicates a need for further teaching? - ANS "My grandmother told me that babies sleep better on their stomachs." The nurse is developing a plan of care for a patient experiencing narcolepsy. Which intervention is appropriate to include on the plan? - ANS Encourage the patient to take one or two 20-minute naps during the day. Which nursing measure promotes sleep in school-aged children? - ANS Encouraging quiet activities before bedtime. Correct To validate the suspicion that a woman's husband has sleep apnea, what should the nurse do first? - ANS Question the partner to find out whether the patient's snoring is causing her to wake up. When analgesics are ordered for a patient with OSA after surgery, the nurse is most concerned about which of the following category of medications? - ANS Opioids The nurse finds a patient sleepwalking down the hallway. Which of the following is an appropriate intervention for the nurse to implement? - ANS Lightly tapping the patient on the shoulder and leading him or her back to bed. A patient is especially sensitive to hospital noises. On which night of admission should the nurse implement strategies to reduce noise on the unit? - ANS First Which medication is the safest to administer to adults who need assistance in falling asleep? - ANS Triazolam The nurse is providing health teaching for a patient who uses herbal compounds such as valerian for sleep. What information should the nurse include? (Select all that apply.) They can cause urinary retention. Correct They should not be used indefinitely. Correct They may cause diarrhea and anxiety. They may interfere with prescribed mediations. Correct They can lead to further sleep problems over time. Correct They are regulated by Health Canada. Correct - ANS They can cause urinary retention. They should not be used indefinitely. They may interfere with prescribed mediations. They can lead to further sleep problems over time. They are regulated by Health Canada. The nurse recognizes that a patient is experiencing insomnia when the patient reports which of the following? (Select all that apply.) Difficulty staying asleep. Correct Extended time to falling asleep. Correct Feeling tired after a night's sleep. Correct Falling asleep at inappropriate times. - ANS Difficulty staying asleep Extended time to falling asleep Feeling tired after a night's sleep The nurse teaches the mother of a newborn that in order to prevent SIDS, the best position in which to place the baby after nursing is which of the following? (Select all that apply.) - ANS Supine To assist an adult patient to sleep, the nurse recommends which of the following? (Select all that apply.) - ANS Consuming a small glass of warm milk at bedtime.