C HAPTER 19: S LEEP –W AKE D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Ed ition
MULTIPLE CHOICE
1. Which season would be most associated with increased periods of
wakefulness in the general population?
a. Summer
b. Winter
c. Spring
d. Fall
ANS: A
Circadian drive is associat ed with physiology. Light is the main
exogenous factor that drives wakefulness. Days are longest in summer.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Physiological Integrity
2. Normall y, most people sleep at night. What is the physiological rationale?
a. The master biological clock responds to darkness with sleep.
b. Darkness stimulates histamine release, which promotes sleep.
c. Cooler environmental temperatures stimulate retinal messages.
d. Stimulation of the sympathetic nervous system promotes sleep.
, ANS: A
The master biological clock in the suprachiasmatic nucleus (SCN) of
the hypothalamus regulates sleep as well as other physiological
processes. Darkness cues the clock for sleep. Light cues it for
wakefulness. Light stimulates retinal messages. Histamine release is
associated with wakefulness. Stimulation of the sympathetic nervous
s ystem promotes alertness.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Asse ssment MSC: Client Needs:
Physiological Integrity
3. A nurse counsels a client on ways to determine the person’s total sleep
requirement. Which instruction would produce the most accurate results?
a. “For 1 full week, record what you remember about your dream
content and related feelings as soon as you wake up. Bring the
record to your next appointment.”
b. “While off work for 1 week, go to bed at your usual time and wake
up without an alarm. Record how many hours you sleep and then
average the findings.”
c. “For 2 full weeks, record how much time you sleep each night and
rate your daytime alertness on a scale of 1 to 10. Calculate your
average alertness score.”
d. “All adults need 7 or 8 hours of sleep to function properl y. Let’s
design ways to help you reach that goal. ”
ANS: B
, Sleep requirements are most accuratel y determined by going to bed at
the usual time and waking up without an alarm for several nights,
ideall y on vacation. The average of these findings indicates the
estimated requirements. Two distracters relat e to dream content and
daytime alertness. Some adults are long sleepers or short sleepers with
different requirements for sleep from the general population.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Health Promotion and Maintenance
4. A home care nurse assesses a very demanding client with chronic
obstructive pulmonary disease (COPD). Afterward, the nurse talks with
the spouse who has provided this client’s care for 6 years. The spouse
says, “I don’t need much sleep anymore. I might need to help him during
the night.” What is the nurse’s most therapeutic response?
a. “It sounds like you are very devoted to your spouse.”
b. “I noticed you fell asleep while I was assessing your spouse. I’m
concerned about you.”
c. “Your spouse is lucky to have you to provide care rather than being
placed in a nursing home.”
d. “If you keep going like this, your health will be impaired also. Then
who will take care of both of you?”
ANS: B
Sleep deprivation can cause accide nts. The correct answer makes an
observation, gives important information about safet y, and
communicates care and compassion for the spouse. The distracters do
not invite further dialogue with the spouse.
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Ed ition
MULTIPLE CHOICE
1. Which season would be most associated with increased periods of
wakefulness in the general population?
a. Summer
b. Winter
c. Spring
d. Fall
ANS: A
Circadian drive is associat ed with physiology. Light is the main
exogenous factor that drives wakefulness. Days are longest in summer.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Physiological Integrity
2. Normall y, most people sleep at night. What is the physiological rationale?
a. The master biological clock responds to darkness with sleep.
b. Darkness stimulates histamine release, which promotes sleep.
c. Cooler environmental temperatures stimulate retinal messages.
d. Stimulation of the sympathetic nervous system promotes sleep.
, ANS: A
The master biological clock in the suprachiasmatic nucleus (SCN) of
the hypothalamus regulates sleep as well as other physiological
processes. Darkness cues the clock for sleep. Light cues it for
wakefulness. Light stimulates retinal messages. Histamine release is
associated with wakefulness. Stimulation of the sympathetic nervous
s ystem promotes alertness.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Asse ssment MSC: Client Needs:
Physiological Integrity
3. A nurse counsels a client on ways to determine the person’s total sleep
requirement. Which instruction would produce the most accurate results?
a. “For 1 full week, record what you remember about your dream
content and related feelings as soon as you wake up. Bring the
record to your next appointment.”
b. “While off work for 1 week, go to bed at your usual time and wake
up without an alarm. Record how many hours you sleep and then
average the findings.”
c. “For 2 full weeks, record how much time you sleep each night and
rate your daytime alertness on a scale of 1 to 10. Calculate your
average alertness score.”
d. “All adults need 7 or 8 hours of sleep to function properl y. Let’s
design ways to help you reach that goal. ”
ANS: B
, Sleep requirements are most accuratel y determined by going to bed at
the usual time and waking up without an alarm for several nights,
ideall y on vacation. The average of these findings indicates the
estimated requirements. Two distracters relat e to dream content and
daytime alertness. Some adults are long sleepers or short sleepers with
different requirements for sleep from the general population.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Health Promotion and Maintenance
4. A home care nurse assesses a very demanding client with chronic
obstructive pulmonary disease (COPD). Afterward, the nurse talks with
the spouse who has provided this client’s care for 6 years. The spouse
says, “I don’t need much sleep anymore. I might need to help him during
the night.” What is the nurse’s most therapeutic response?
a. “It sounds like you are very devoted to your spouse.”
b. “I noticed you fell asleep while I was assessing your spouse. I’m
concerned about you.”
c. “Your spouse is lucky to have you to provide care rather than being
placed in a nursing home.”
d. “If you keep going like this, your health will be impaired also. Then
who will take care of both of you?”
ANS: B
Sleep deprivation can cause accide nts. The correct answer makes an
observation, gives important information about safet y, and
communicates care and compassion for the spouse. The distracters do
not invite further dialogue with the spouse.
