Question 1

A patient needs diagnostic evaluation of sleep problems. Which test will evaluate the patient for possible sleep-related problems?

Accepted Answer

A)  Skull X-rays 
B)  Electroencephalogram (EEG) 
C)  Positron emission tomography 
D)  Single-photon emission computed tomography 
A)  Skull X-rays 
B)  Electroencephalogram (EEG) 
C)  Positron emission tomography 
D)  Single-photon emission computed tomography B

Question 2

A patient tells the nurse, "Everyone says we should sleep 8 hours a night. I can only sleep 6 hours, no matter how hard I try. Am I doing harm to my body?" Select the nurse's best response.

Accepted Answer

A)  "Tell me about strategies you have tried to increase your total sleep hours." 
B)  "Lack of sleep acts as a stressor on the body and can cause physical changes." 
C)  "If you have really tried to sleep more, maybe you should consult your health care provider." 
D)  "If you function well with 6 hours of sleep, you are a short sleeper. That's normal for some people." 
A)  "Tell me about strategies you have tried to increase your total sleep hours." 
B)  "Lack of sleep acts as a stressor on the body and can cause physical changes." 
C)  "If you have really tried to sleep more, maybe you should consult your health care provider." 
D)  "If you function well with 6 hours of sleep, you are a short sleeper. That's normal for some people." D

Question 3

A nurse counsels a patient on ways to determine the person's total sleep requirement. Which instruction would produce the most accurate results?

Accepted Answer

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 properly. Let's design ways to help you reach that goal." 
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 properly. Let's design ways to help you reach that goal." B

Question 4

A person is prescribed a selective serotonin reuptake inhibitor (SSRI). Which change in sleep is likely to be secondary to this medication?

Accepted Answer

A)  The patient will have more dreams. 
B)  The patient will have excessive sleepiness. 
C)  The patient will have less slow-wave sleep. 
D)  The patient will have less rapid eye movement (REM) sleep. 
A)  The patient will have more dreams. 
B)  The patient will have excessive sleepiness. 
C)  The patient will have less slow-wave sleep. 
D)  The patient will have less rapid eye movement (REM) sleep.

Question 5

A patient says, "It takes me about 15 minutes to go to sleep each night." Which of the following does this comment describe?

Accepted Answer

A)  Delta sleep 
B)  Parasomnia 
C)  Sleep latency 
D)  Rapid eye movement sleep 
A)  Delta sleep 
B)  Parasomnia 
C)  Sleep latency 
D)  Rapid eye movement sleep

Question 6

A person says, "I often feel like I have been dreaming just before I awake in the morning." Which rationale correctly explains the comment?

Accepted Answer

A)  Sleep architecture changes during the sleep period, resulting in increased slow-wave sleep at the end of the cycle. 
B)  Cycles of rapid eye movement sleep increase in the second half of sleep and occupy longer periods. 
C)  Dreams occur more frequently when a person is experiencing unresolved conflicts or depression. 
D)  Dream content relates directly to developmental tasks. The person is likely feeling autonomous. 
A)  Sleep architecture changes during the sleep period, resulting in increased slow-wave sleep at the end of the cycle. 
B)  Cycles of rapid eye movement sleep increase in the second half of sleep and occupy longer periods. 
C)  Dreams occur more frequently when a person is experiencing unresolved conflicts or depression. 
D)  Dream content relates directly to developmental tasks. The person is likely feeling autonomous.

Question 7

The nurse provides health education for an adult experiencing sleep deprivation. Which instruction has the highest priority?

Accepted Answer

A)  "It's important to limit your driving to short periods. Sleep deprivation increases your risks for serious accidents." 
B)  "Sleep deprivation is usually self-limiting. See your health care provider if it lasts more than a year." 
C)  "Turn the radio on with a soft volume as you prepare for bed each evening. It will help you relax." 
D)  "Three glasses of wine each evening helps many patients who suffer from sleep deprivation." 
A)  "It's important to limit your driving to short periods. Sleep deprivation increases your risks for serious accidents." 
B)  "Sleep deprivation is usually self-limiting. See your health care provider if it lasts more than a year." 
C)  "Turn the radio on with a soft volume as you prepare for bed each evening. It will help you relax." 
D)  "Three glasses of wine each evening helps many patients who suffer from sleep deprivation."

Question 8

Which season would be most associated with increased periods of wakefulness in the general population?

Accepted Answer

A)  Summer 
B)  Winter 
C)  Spring 
D)  Fall 
A)  Summer 
B)  Winter 
C)  Spring 
D)  Fall

Question 9

A 76-year-old man tells the nurse at the sleep disorder clinic, "I awaken almost nightly in the midst of violent dreams in which I am defending myself against multiple attackers. Then I realize I have been hitting and kicking my wife. She has bruises." Which health problem is most likely?

Accepted Answer

A)  Sleep paralysis 
B)  Night terror disorder 
C)  Sleep-related bruxism 
D)  Rapid eye movement (REM) sleep behaviour disorder 
A)  Sleep paralysis 
B)  Night terror disorder 
C)  Sleep-related bruxism 
D)  Rapid eye movement (REM) sleep behaviour disorder

Question 10

A nurse provides health education for an adult with sleep deprivation. It is most important for the nurse to encourage caution when the patient engages in which of the following?

Accepted Answer

A)  Using a vacuum cleaner 
B)  Cooking a meal 
C)  Driving a car 
D)  Bathing 
A)  Using a vacuum cleaner 
B)  Cooking a meal 
C)  Driving a car 
D)  Bathing

Question 11

A nurse cares for the following four patients. Which patient has the highest risk for problems with sleep physiology?

Accepted Answer

A)  Retiree who volunteers twice a week at Habitat for Humanity 
B)  Corporate accountant who travels frequently 
C)  Parent with three teenagers 
D)  Lawn care worker 
A)  Retiree who volunteers twice a week at Habitat for Humanity 
B)  Corporate accountant who travels frequently 
C)  Parent with three teenagers 
D)  Lawn care worker

Question 12

A patient reports, "The medicine prescribed to help me get to sleep worked well for about a month, but I don't have any more of those pills, and now my insomnia is worse than ever. I had nightmares the last 2 nights." Which type of medication did the health care provider most likely prescribe?

Accepted Answer

A)  Hypnotic 
B)  Tricyclic antidepressant 
C)  Conventional antipsychotic 
D)  Central nervous system stimulant 
A)  Hypnotic 
B)  Tricyclic antidepressant 
C)  Conventional antipsychotic 
D)  Central nervous system stimulant

Question 13

Which comment is most likely from a patient with chronic sleep deprivation?

Accepted Answer

A)  "I turn on the television every night to get to sleep. I set the timer so it goes off in 30 minutes." 
B)  "I have diarrhea frequently and not much energy, so I stay at home most of the time." 
C)  "I sleep only about 5 hours a night, but I know I should sleep 7 or 8 hours." 
D)  "When my alarm clock goes off every morning, it seems like I am dreaming." 
A)  "I turn on the television every night to get to sleep. I set the timer so it goes off in 30 minutes." 
B)  "I have diarrhea frequently and not much energy, so I stay at home most of the time." 
C)  "I sleep only about 5 hours a night, but I know I should sleep 7 or 8 hours." 
D)  "When my alarm clock goes off every morning, it seems like I am dreaming."

Question 14

Which neurotransmitters are most responsible for wakefulness?

Accepted Answer

A)  Gamma-aminobutyric acid (GAB
A)  
B)  Norepinephrine 
C)  Acetylcholine 
D)  Dopamine 
E)  Galanin 
A)  Gamma-aminobutyric acid (GAB
A)  
B)  Norepinephrine 
C)  Acetylcholine 
D)  Dopamine 
E)  Galanin

Question 15

A patient with rheumatoid arthritis reports, "For the past month I've been having a lot of trouble falling asleep. When I finally get to sleep, I wake up several times during the night." Which information should the nurse seek initially?

Accepted Answer

A)  "What have you done to try to improve your sleep?" 
B)  "What would be a good sleep pattern for you?" 
C)  "How much exercise are you getting?" 
D)  "Do you have pain at night?" 
A)  "What have you done to try to improve your sleep?" 
B)  "What would be a good sleep pattern for you?" 
C)  "How much exercise are you getting?" 
D)  "Do you have pain at night?"

Question 16

Normally, most people sleep at night. What is the physiological rationale?

Accepted Answer

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. 
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.

Question 17

Which person would be most likely to experience sleep fragmentation?

Accepted Answer

A)  An obese adult 
B)  A toddler who attends day care 
C)  A person diagnosed with mild osteoarthritis 
D)  An adolescent diagnosed with anorexia nervosa 
A)  An obese adult 
B)  A toddler who attends day care 
C)  A person diagnosed with mild osteoarthritis 
D)  An adolescent diagnosed with anorexia nervosa

Question 18

A young adult says to the nurse, "I go to sleep without any problem, but I often wake up during the night because it feels like there are rubber bands in my legs." Which assessment question should the nurse ask to assess for restless legs syndrome (RLS)?

Accepted Answer

A)  "What type of birth control do you use?" 
B)  "How much caffeine do you use every day?" 
C)  "How much exercise do you get in a typical day?" 
D)  "Is the sensation relieved by stretching or flexing your legs?" 
A)  "What type of birth control do you use?" 
B)  "How much caffeine do you use every day?" 
C)  "How much exercise do you get in a typical day?" 
D)  "Is the sensation relieved by stretching or flexing your legs?"

Question 19

A nurse who works night shift says, "I am exhausted most of the time. I sleep through my alarm. Sometimes my brain does not seem to work right. I am worried that I might make a practice error." Which question should the nursing supervisor ask first?

Accepted Answer

A)  "What stress are you experiencing in your life?" 
B)  "How much sleep do you get in a 24-hour period?" 
C)  "Would it help if you do some exercises just before going to bed?" 
D)  "Have you considered using a hypnotic medication to help you sleep?" 
A)  "What stress are you experiencing in your life?" 
B)  "How much sleep do you get in a 24-hour period?" 
C)  "Would it help if you do some exercises just before going to bed?" 
D)  "Have you considered using a hypnotic medication to help you sleep?"

Question 20

A patient experiencing primary insomnia says she takes a nap during the day and asks the nurse, "Doesn't that make up for a lost night's sleep?" Select the nurse's best reply.

Accepted Answer

A)  "Circadian drives give daytime naps a structure different from nighttime sleep." 
B)  "The body clock operates on a 24-hour cycle, making nap effectiveness unpredictable." 
C)  "It is a matter of habit and expectation. We expect to be more refreshed from a night's sleep." 
D)  "Sleep restores homeostasis but works more efficiently when aided by melatonin secreted at night." 
A)  "Circadian drives give daytime naps a structure different from nighttime sleep." 
B)  "The body clock operates on a 24-hour cycle, making nap effectiveness unpredictable." 
C)  "It is a matter of habit and expectation. We expect to be more refreshed from a night's sleep." 
D)  "Sleep restores homeostasis but works more efficiently when aided by melatonin secreted at night."

Exam 20: Sleepwake Disorders

A patient needs diagnostic evaluation of sleep problems. Which test will evaluate the patient for possible sleep-related problems?

A patient tells the nurse, "Everyone says we should sleep 8 hours a night. I can only sleep 6 hours, no matter how hard I try. Am I doing harm to my body?" Select the nurse's best response.

A nurse counsels a patient on ways to determine the person's total sleep requirement. Which instruction would produce the most accurate results?

A person is prescribed a selective serotonin reuptake inhibitor (SSRI). Which change in sleep is likely to be secondary to this medication?

A patient says, "It takes me about 15 minutes to go to sleep each night." Which of the following does this comment describe?

A person says, "I often feel like I have been dreaming just before I awake in the morning." Which rationale correctly explains the comment?

The nurse provides health education for an adult experiencing sleep deprivation. Which instruction has the highest priority?

Which season would be most associated with increased periods of wakefulness in the general population?

A 76-year-old man tells the nurse at the sleep disorder clinic, "I awaken almost nightly in the midst of violent dreams in which I am defending myself against multiple attackers. Then I realize I have been hitting and kicking my wife. She has bruises." Which health problem is most likely?

A nurse provides health education for an adult with sleep deprivation. It is most important for the nurse to encourage caution when the patient engages in which of the following?

A nurse cares for the following four patients. Which patient has the highest risk for problems with sleep physiology?

A patient reports, "The medicine prescribed to help me get to sleep worked well for about a month, but I don't have any more of those pills, and now my insomnia is worse than ever. I had nightmares the last 2 nights." Which type of medication did the health care provider most likely prescribe?

Which comment is most likely from a patient with chronic sleep deprivation?

Which neurotransmitters are most responsible for wakefulness?

A patient with rheumatoid arthritis reports, "For the past month I've been having a lot of trouble falling asleep. When I finally get to sleep, I wake up several times during the night." Which information should the nurse seek initially?

Normally, most people sleep at night. What is the physiological rationale?

Which person would be most likely to experience sleep fragmentation?

A young adult says to the nurse, "I go to sleep without any problem, but I often wake up during the night because it feels like there are rubber bands in my legs." Which assessment question should the nurse ask to assess for restless legs syndrome (RLS)?

A nurse who works night shift says, "I am exhausted most of the time. I sleep through my alarm. Sometimes my brain does not seem to work right. I am worried that I might make a practice error." Which question should the nursing supervisor ask first?

A patient experiencing primary insomnia says she takes a nap during the day and asks the nurse, "Doesn't that make up for a lost night's sleep?" Select the nurse's best reply.

Mental Health and Mental Illness

Historical Overview of Psychiatric Mental Health Nursing

Overview of Psychiatric Mental Health Nursing Care Within Various Settings

Relevant Theories and Therapies for Nursing Practice

Understanding Responses to Stress

The Nursing Process and Standards of Care for Psychiatric Mental Health Nursing

Ethical Responsibilities and Legal Obligations for Psychiatric Mental Health Nursing Practice

Cultural Considerations for Psychiatric Mental Health Nursing

Therapeutic Relationships

Communication and the Clinical Interview

Psychotropic Drugs

Anxiety and Related Disorders

Depressive Disorders

Bipolar Disorders

Schizophrenia Spectrum and Other Psychotic Disorders

Eating and Feeding Disorders

Neurocognitive Disorders

Psychoactive Substance Use and Treatment

Personality Disorders

Crisis and Disaster

Suicide and Nonsuicidal Self-Injury

Anger, Aggression, and Violence

Interpersonal Violence: Child, Older Adult, and Intimate Partner Abuse

Sexual Assault

Sexuality and Gender

Disorders of Children and Adolescents

Psychosocial Needs of the Older Adult

Living With Recurrent and Persistent Mental Illness

Psychological Needs of Patients With Medical Conditions

Care for the Dying and for Those Who Grieve

Forensic Psychiatric Nursing

Therapeutic Groups

Family Interventions

Integrative and Complimentary Therapies

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