Quiz
chapter 20
Questions in this quiz (24)
1The nurse is aware that the initial entry to deep sleep is:
- Astage 1 nonrapid eye movement (NREM).
- Bstage 3 NREM.
- Cstage 5 NREM.
- Drapid eye movement (REM) sleep.
2The phenomenon of sleep walking is most likely to occur in the sleep stage of:
- Astage 1 NREM.
- Bstage 2 NREM.
- Cstage 4 NREM.
- DREM sleep.
3The nurse explains that older adults often experience a disturbed sleep-wake cycle because of hormonal changes, which include a(n) _____ level.
- Aincrease in angiotensin
- Bdecrease in insulin
- Cincrease in growth hormone
- Ddecrease in melatonin
4The 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.
- Asleep initiation
- Bsleep maintenance
- Cterminal
- Dundifferentiated
5The newly admitted older adult who cannot fall asleep and asks for a sedative every night is most probably experiencing a difficulty with sleep:
- Ainitiation related to anxiety of relocation.
- Bmaintenance related to unfamiliar environment.
- Cinitiation related to depression associated with relocation.
- Dmaintenance related to episodes of nocturnal movement disorders.
6The home health nurse assesses that the patient is probably experiencing myoclonus when his wife says:
- A“His loud snoring and jerking awake wakes me up, too.”
- B“I am black and blue from his kicking me every night.”
- C“He wakes up at 2 AM every morning and walks around the house.”
- D“His constant leg movements tear up the covers and keep me awake.”
7The nurse would question the order for lorazepam (Ativan), 5 mg at bedtime, for a
patient with:- Achronic obstructive pulmonary disease (COPD).
- Bany form of dementia.
- Chypertension.
- Dsleep apnea.
8In 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:
- Aprovide a heavy snack at bedtime.
- Breschedule the 8 PM albuterol inhalation treatment to 4 PM.
- Ccoach the resident in 10 minutes of exercise before bedtime.
- Dprovide a cola drink, strong tea, or cocoa at bedtime.
9The nurse cautions the patient who has just started on the antidepressant trazodone hydrochloride to help relieve insomnia to:
- Aincrease fluids.
- Bavoid aged cheese and red wine.
- Cdecrease sodium intake.
- Davoid excessive exposure to the sun.
10The 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:
- Atake two tablets of a sedative medication.
- Bget up and do a mild stretching exercise for 15 minutes.
- Cremain in bed with his eyes closed.
- Dget up and read until he feels sleepy and then return to bed.
11The nurse clarifies that the continuous positive airway pressure (CPAP) machine decreases the incidence of episodes of sleep apnea by:
- Astimulating inspiration to be deeper.
- Btaking over respiratory activity when the patient ceases to breathe.
- Csounding an alarm if respirations have ceased.
- Dkeeping alveoli from collapsing.
12When 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:
- Amyoclonus.
- Brestless legs syndrome.
- Crapid eye movement (REM) sleep disorder.
- Depilepsy.
13The nurse cautions that although activity and exercise during the day are an effective sleep aid, activity and exercise should be avoided within _____ before bedtime.
- A30 minutes
- B1 hour
- C2 hours
- D3 hours
14The patient is encouraged to decrease fluid intake in the late evening to prevent interruption of sleep from:
- Aincreased digestive processes in the bowel.
- Bepisodes of nocturia.
- Cgastroesophageal reflux.
- Dchanges in body temperature.
15The nurse makes arrangements to promote normal circadian rhythm in a long-term care facility by ensuring that all rooms have:
- Abright lights during the daytime.
- Bdim lights to promote relaxation.
- Cappropriate environmental temperature.
- Dcurtains for privacy.
16The nurse is aware that an older adult’s diurnal patterns can be altered by __________. (Select all that apply.)
- Ashift work
- Btime zone changes
- Caltered nutrition
- Dillness
- Emedications
17The long-term care facility nurse takes into consideration that most residents go to sleep early and awaken early because of __________. (Select all that apply.)
- Aincreased blood pressure
- Bdrop in core temperature
- Cdiminished food intake
- Ddiminished hormone production
- Edecreased exposure to light
18The 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.)
- Aconfusion
- Burinary retention
- Chypotension
- Ddepression of respiration
- Ediarrhea
19When mild sedation has failed to solve the problem of insomnia in the older adult, the nurse suggests __________. (Select all that apply.)
- Arelaxation therapy
- Btaking a cool bath or shower before bedtime
- Clistening to relaxing music
- Darranging the sleep environment to promote sleep
- Egoing to bed at a regular time after observing routine “sleep rituals”
20The nurse explains that factors that contribute to sleep apnea include __________.
(Select all that apply.)- Aobesity
- Bdiabetes
- Chypotension
- DAfrican American heritage
- Euse of alcohol
21The wife of a patient tells the home health nurse that she suspects her husband has sleep apnea because he __________. (Select all that apply.)
- Asnores loudly
- Binterrupts snoring with several seconds of silence
- Ccomplains of daytime drowsiness
- Dfrequently is incontinent of urine
- Ehas episodes of myoclonus
22The nursing staff helps encourage sleep in long-term care facility residents by __________. (Select all that apply.)
- Ausing the minimum light necessary when making rounds
- Bmaking necessary sleep interruptions at the same time every night
- Ckeeping conversational noise at the nursing station to a minimum
- Danswering call lights promptly
- Eproviding heavy blankets for warmth
23Heavy 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- Ainability to sleep throughout the night
- Bsleeping soundly all night
- Cincrease in the number of hours asleep at night
- Ddifficulty in arousing from deep sleep
- Ewaking up early
24The nurse assesses that the resident may be experiencing changes in sleep and rest patterns when she states__________. (Select all that apply.)
- A“I don’t know why everything seems to bother me lately.”
- B“I’ve been so clumsy."
- C“I’m having trouble concentrating.”
- D“My daughter says I talk in my sleep.”
- E“I cry for no reason at all.”
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- college Geriatrics Quiz on chapter 20, created by nursing fairy on 19/10/2014.
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- nursing fairy
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