Chapter 08: Sleep and Sleep Disorders : Lewis’s Medical-Surgical Nursing, 12th Edition

Test Bank For Lewis's Medical-Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra Hagler Chapter 08: Sleep and Sleep Disorders : Lewis’s Medical-Surgical Nursing, 12th Edition 1. A patient reports difficulty falling asleep and daytime fatigue for the past 6 weeks. Which initial action would the nurse take in determining whether this patient has insomnia? A. Schedule a polysomnograph (PSG). B. Teach the patient about good sleep hygiene. C. Ask the patient to keep a 1-week sleep diary. D. Arrange for the patient to have a sleep study. ANS: C 2. A patient with chronic insomnia asks the nurse about ways to improve sleep quality. Which response by the nurse reflects sleep hygiene principles? A. “Avoid exercising during the day.” B. “Keep the bedroom temperature warm.” C. “Read in bed for a few minutes each night.” D. “Go to bed at the same time every evening.” ANS: D 3. Which patient statement indicates a need for further teaching about extendedrelease zolpidem (Ambien CR)? A. “I will take the medication on an empty stomach.” B. “I should take the medication 2 hours before bedtime.” C. “Ishould not take this medication unless I can sleep for at least 6 hours.” D. “I will schedule activitiesthat require mental alertness for later in the day.” ANS: B 4. The nurse cares for an unstable patient in the intensive care unit (ICU). Which intervention should the nurse include in the plan of care to improve this patient‘s sleep quality? A. Ask all visitors to leave the hospital for the night. B. Lower the level of lighting from 8:00 PM until 7:00 AM. C. Avoid the use of opioids for pain relief during the evening. D. Schedule assessments to allow 4 hours of uninterrupted sleep. ANS: B 5. Which information would the nurse plan to teach a patient who has narcolepsy? A. Driving an automobile may be possible with appropriate treatment of narcolepsy. B. Changes in sleep hygiene are ineffective in improving sleep quality in narcolepsy. C. Antidepressant drugs are prescribed to treat the depression caused by the disorder. D. Stimulant drugs should be used for less than a month because of the risk for misuse. ANS: A 6. Which action should the nurse manager promote as an evidence-based practice to support alertness for night shift nurses? A. Arrange for older staff members to work most night shifts. B. Provide a sleeping area for staff to use for napping at night. C. Post reminders about the relationship of sleep and alertness. D. Schedule nursing staff to rotate day and night shifts monthly. ANS: B 7. Which information regarding a patient‘s sleep is most important for the nurse to communicate to the health care provider? A. A 21-yr-old student takes melatonin to assist in sleeping when traveling from the United States to Europe. B. A 64-yr-old nurse works the night shift and reports drinking hot chocolate before going to bed in the morning. C. A 41-yr-old librarian who has a body mass index (BMI) of 42 kg/m2 says that the spouse complains about the patient snoring. D. A 32-yr-old accountant who is experiencing a stressful week used diphenhydramine to get to sleep for several nights. ANS: C 8. Which action would the nurse take first in addressing a patient‘s concerns about insomnia and daytime fatigue? A. Suggest that the patient decrease caffeine intake. B. Question the patient about sleep and rest patterns. C. Recommend using any prescribed sleep aids for no more than 2 weeks. D. Advise the patient to get out of bed if unable to fall asleep in 20 minutes. ANS: B 9. A patient with sleep apnea who uses a continuous positive airway pressure (CPAP) device is preparing to have inpatient surgery. Which instruction would the nurse provide to the patient? A. Schedule a preoperative sleep study. B. Take your home device to the hospital. C. Expect intubation with mechanical ventilation after surgery. D. Avoid requesting pain medication while you are hospitalized. ANS: B 10. When caring for patients with sleep disorders, which activity can the nurse appropriately delegate to assistive personnel (AP)? A. Assist a patient to choose a new CPAP mask. B. Help a patient to put on the CPAP device at bedtime. C. Interview a patient about risk factors for obstructive sleep disorders. D. Discuss the benefits of oral appliances in decreasing obstructive sleep apnea. ANS: B 11. A patient who has been in the intensive care unit for 4 days has disturbed sensory perception from sleep deprivation. Which action would the nurse include in the plan of care? A. Schedule a day-night cycle of activity and rest as much as possible. B. Administer prescribed sedatives or opioids at bedtime to promote sleep. C. Silence the alarms on the cardiac monitors to allow 30- to 40-minute naps. D. Eliminate assessments between 2200 and 0600 to allow uninterrupted sleep. ANS: B