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college Geriatrics Quiz on chapter 20, created by nursing fairy on 10/19/2014.

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chapter 20

chapter 20

Question 1 of 24

1

The nurse is aware that the initial entry to deep sleep is:

Select one of the following:

  • stage 1 nonrapid eye movement (NREM).

  • stage 3 NREM.

  • stage 5 NREM.

  • rapid eye movement (REM) sleep.

Explanation

Question 2 of 24

1

The phenomenon of sleep walking is most likely to occur in the sleep stage of:

Select one of the following:

  • stage 1 NREM.

  • stage 2 NREM.

  • stage 4 NREM.

  • REM sleep.

Explanation

Question 3 of 24

1

The nurse explains that older adults often experience a disturbed sleep-wake cycle because of hormonal changes, which include a(n) _____ level.

Select one of the following:

  • increase in angiotensin

  • decrease in insulin

  • increase in growth hormone

  • decrease in melatonin

Explanation

Question 4 of 24

1

The older man in a long-term care facility consistently wakes at 3 AM and does not return to sleep. The nurse records this behavior as _____ insomnia.

Select one of the following:

  • sleep initiation

  • sleep maintenance

  • terminal

  • undifferentiated

Explanation

Question 5 of 24

1

The newly admitted older adult who cannot fall asleep and asks for a sedative every night is most probably experiencing a difficulty with sleep:

Select one of the following:

  • initiation related to anxiety of relocation.

  • maintenance related to unfamiliar environment.

  • initiation related to depression associated with relocation.

  • maintenance related to episodes of nocturnal movement disorders.

Explanation

Question 6 of 24

1

The home health nurse assesses that the patient is probably experiencing myoclonus when his wife says:

Select one of the following:

  • “His loud snoring and jerking awake wakes me up, too.”

  • “I am black and blue from his kicking me every night.”

  • “He wakes up at 2 AM every morning and walks around the house.”

  • “His constant leg movements tear up the covers and keep me awake.”

Explanation

Question 7 of 24

1

The nurse would question the order for lorazepam (Ativan), 5 mg at bedtime, for a
patient with:

Select one of the following:

  • chronic obstructive pulmonary disease (COPD).

  • any form of dementia.

  • hypertension.

  • sleep apnea.

Explanation

Question 8 of 24

1

In order to assist a 75-year-old male resident in a long-term care facility to decrease his problems with sleep initiation, the nurse would:

Select one of the following:

  • provide a heavy snack at bedtime.

  • reschedule the 8 PM albuterol inhalation treatment to 4 PM.

  • coach the resident in 10 minutes of exercise before bedtime.

  • provide a cola drink, strong tea, or cocoa at bedtime.

Explanation

Question 9 of 24

1

The nurse cautions the patient who has just started on the antidepressant trazodone hydrochloride to help relieve insomnia to:

Select one of the following:

  • increase fluids.

  • avoid aged cheese and red wine.

  • decrease sodium intake.

  • avoid excessive exposure to the sun.

Explanation

Question 10 of 24

1

The 80-year-old man complains that when he goes to bed and cannot fall asleep, he tosses and turns and gets so frustrated that he gets up and drinks coffee all night. The nurse suggests that when he has not fallen asleep after 30 minutes, he should:

Select one of the following:

  • take two tablets of a sedative medication.

  • get up and do a mild stretching exercise for 15 minutes.

  • remain in bed with his eyes closed.

  • get up and read until he feels sleepy and then return to bed.

Explanation

Question 11 of 24

1

The nurse clarifies that the continuous positive airway pressure (CPAP) machine decreases the incidence of episodes of sleep apnea by:

Select one of the following:

  • stimulating inspiration to be deeper.

  • taking over respiratory activity when the patient ceases to breathe.

  • sounding an alarm if respirations have ceased.

  • keeping alveoli from collapsing.

Explanation

Question 12 of 24

1

When the patient tells the home health nurse that he has flung himself out of bed three times in the course of a violent nightmare, the nurse recognizes the cardinal indicator of:

Select one of the following:

  • myoclonus.

  • restless legs syndrome.

  • rapid eye movement (REM) sleep disorder.

  • epilepsy.

Explanation

Question 13 of 24

1

The nurse cautions that although activity and exercise during the day are an effective sleep aid, activity and exercise should be avoided within _____ before bedtime.

Select one of the following:

  • 30 minutes

  • 1 hour

  • 2 hours

  • 3 hours

Explanation

Question 14 of 24

1

The patient is encouraged to decrease fluid intake in the late evening to prevent interruption of sleep from:

Select one of the following:

  • increased digestive processes in the bowel.

  • episodes of nocturia.

  • gastroesophageal reflux.

  • changes in body temperature.

Explanation

Question 15 of 24

1

The nurse makes arrangements to promote normal circadian rhythm in a long-term care facility by ensuring that all rooms have:

Select one of the following:

  • bright lights during the daytime.

  • dim lights to promote relaxation.

  • appropriate environmental temperature.

  • curtains for privacy.

Explanation

Question 16 of 24

1

The nurse is aware that an older adult’s diurnal patterns can be altered by __________. (Select all that apply.)

Select one or more of the following:

  • shift work

  • time zone changes

  • altered nutrition

  • illness

  • medications

Explanation

Question 17 of 24

1

The long-term care facility nurse takes into consideration that most residents go to sleep early and awaken early because of __________. (Select all that apply.)

Select one or more of the following:

  • increased blood pressure

  • drop in core temperature

  • diminished food intake

  • diminished hormone production

  • decreased exposure to light

Explanation

Question 18 of 24

1

The nurse gives the antihistamine diphenhydramine (Benadryl) as a sleep aid with caution because the older adult may experience side effects, such as __________. (Select all that apply.)

Select one or more of the following:

  • confusion

  • urinary retention

  • hypotension

  • depression of respiration

  • diarrhea

Explanation

Question 19 of 24

1

When mild sedation has failed to solve the problem of insomnia in the older adult, the nurse suggests __________. (Select all that apply.)

Select one or more of the following:

  • relaxation therapy

  • taking a cool bath or shower before bedtime

  • listening to relaxing music

  • arranging the sleep environment to promote sleep

  • going to bed at a regular time after observing routine “sleep rituals”

Explanation

Question 20 of 24

1

The nurse explains that factors that contribute to sleep apnea include __________.
(Select all that apply.)

Select one or more of the following:

  • obesity

  • diabetes

  • hypotension

  • African American heritage

  • use of alcohol

Explanation

Question 21 of 24

1

The wife of a patient tells the home health nurse that she suspects her husband has sleep apnea because he __________. (Select all that apply.)

Select one or more of the following:

  • snores loudly

  • interrupts snoring with several seconds of silence

  • complains of daytime drowsiness

  • frequently is incontinent of urine

  • has episodes of myoclonus

Explanation

Question 22 of 24

1

The nursing staff helps encourage sleep in long-term care facility residents by __________. (Select all that apply.)

Select one or more of the following:

  • using the minimum light necessary when making rounds

  • making necessary sleep interruptions at the same time every night

  • keeping conversational noise at the nursing station to a minimum

  • answering call lights promptly

  • providing heavy blankets for warmth

Explanation

Question 23 of 24

1

Heavy blankets may initially feel warm to the resident but eventually make the resident uncomfortable and unable to sleep. All other options listed will help diminish sleep interruptions.
DIF: Cognitive Level: Comprehension REF: 332-333 OBJ: 7
TOP: Sleep Support KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

Select one or more of the following:

  • inability to sleep throughout the night

  • sleeping soundly all night

  • increase in the number of hours asleep at night

  • difficulty in arousing from deep sleep

  • waking up early

Explanation

Question 24 of 24

1

The nurse assesses that the resident may be experiencing changes in sleep and rest patterns when she states__________. (Select all that apply.)

Select one or more of the following:

  • “I don’t know why everything seems to bother me lately.”

  • “I’ve been so clumsy."

  • “I’m having trouble concentrating.”

  • “My daughter says I talk in my sleep.”

  • “I cry for no reason at all.”

Explanation

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