Question 1

Where are EMG leads placed to detect muscle atonia?

Accepted Answer

A)  Scalp 
B)  Intercostal 
C)  Anterior tibialis 
D)  Chin 
A)  Scalp 
B)  Intercostal 
C)  Anterior tibialis 
D)  Chin D

Question 2

Identify the usual cycle of sleep onset.

Accepted Answer

A)  NR1, NR2, NR3, NR2, REM 
B)  NR1, NR2, NR3, REM 
C)  NR1, NR2, NR3, NR1, REM 
D)  NR1, NR2, NR3, REM, NR3 
A)  NR1, NR2, NR3, NR2, REM 
B)  NR1, NR2, NR3, REM 
C)  NR1, NR2, NR3, NR1, REM 
D)  NR1, NR2, NR3, REM, NR3 A

Question 3

REM sleep comprises what percent of the sleep cycle?

Accepted Answer

A)  70% to 75% 
B)  45% to 65% 
C)  15% to 20% 
D)  20% to 25% 
A)  70% to 75% 
B)  45% to 65% 
C)  15% to 20% 
D)  20% to 25% D

Question 4

_____ is the external element that has the most significant effect on circadian rhythms.

Accepted Answer

A)  Lower body temperature 
B)  Light 
C)  Melatonin cycle 
D)  Background noise 
A)  Lower body temperature 
B)  Light 
C)  Melatonin cycle 
D)  Background noise

Question 5

The patient has been in the critical care unit for 3 weeks and has been on the intra-aortic balloon pump for the past 3 days.The patient's condition has been serious, and hourly assessments and vital signs have been necessary.The nursing staff has noted that the patient has been unable to achieve sleep for more than 30 minutes at a time.The patient has been given diazepam (Valium)prn.Which techniques may assist in assessing the patient's sleep pattern?

Accepted Answer

A)  Correlating sleep time with vital signs 
B)  Documenting sleep periods of more than 90 minutes 
C)  Assessing degree of arousal on hourly checks 
D)  Observing the length of NREM sleep periods 
A)  Correlating sleep time with vital signs 
B)  Documenting sleep periods of more than 90 minutes 
C)  Assessing degree of arousal on hourly checks 
D)  Observing the length of NREM sleep periods

Question 6

The primary determinant in the efficacy of CPAP in patients with OSA is

Accepted Answer

A)  compliance. 
B)  weight. 
C)  tonsil size. 
D)  respiratory effort. 
A)  compliance. 
B)  weight. 
C)  tonsil size. 
D)  respiratory effort.

Question 7

A patient was given the diagnosis of congestive heart failure (CHF)2 years ago.The patient complains of increased daytime sleepiness and states his support system has been complaining more and more about snoring.Central sleep apnea is suspected.Treatment depends on whether the patient has hypercapnic or nonhypercapnic central sleep apnea.The patient's primary treatment plan should include

Accepted Answer

A)  CPAP. 
B)  bilevel positive airway pressure (BiPAP). 
C)  acetazolamide and medroxyprogesterone. 
D)  modafinil and zolpidem. 
A)  CPAP. 
B)  bilevel positive airway pressure (BiPAP). 
C)  acetazolamide and medroxyprogesterone. 
D)  modafinil and zolpidem.

Question 8

Interventions to help with circadian synchronization include

Accepted Answer

A)  opening the window blinds. 
B)  encouraging the patient to take frequent naps during the day. 
C)  administering sedatives at bedtime. 
D)  keeping the patient awake during the early morning hours. 
A)  opening the window blinds. 
B)  encouraging the patient to take frequent naps during the day. 
C)  administering sedatives at bedtime. 
D)  keeping the patient awake during the early morning hours.

Question 9

What occurs physiologically during REM sleep?

Accepted Answer

A)  Growth hormone is secreted. 
B)  Metabolic needs are decreased. 
C)  Sympathetic nervous system predominates. 
D)  Heart rate and blood pressure decrease. 
A)  Growth hormone is secreted. 
B)  Metabolic needs are decreased. 
C)  Sympathetic nervous system predominates. 
D)  Heart rate and blood pressure decrease.

Question 10

Sleep deprivation can result from which of the following?

Accepted Answer

A)  CPAP machine use 
B)  Mechanical ventilation 
C)  Use of nonbenzodiazepine short-acting hypnotics 
D)  Use of analgesic medications to control pain 
A)  CPAP machine use 
B)  Mechanical ventilation 
C)  Use of nonbenzodiazepine short-acting hypnotics 
D)  Use of analgesic medications to control pain

Question 11

Which stage of NREM sleep is associated with anabolic processes?

Accepted Answer

A)  N1 
B)  N2 
C)  N3 
D)  N4 
A)  N1 
B)  N2 
C)  N3 
D)  N4

Question 12

The patient has been in the critical care unit for 3 weeks and has been on an intra-aortic balloon pump for the past 3 days.The patient's condition has been serious, and hourly assessments and vital signs have been necessary.The nursing staff has noted that the patient has been unable to achieve sleep for more than 30 minutes at a time.The patient has been given diazepam (Valium)prn.The anticipated effect of diazepam on the patient's sleep is

Accepted Answer

A)  a decrease in NREM stage 1. 
B)  an increase in NREM stage 3. 
C)  total NREM suppression. 
D)  REM suppression in larger doses. 
A)  a decrease in NREM stage 1. 
B)  an increase in NREM stage 3. 
C)  total NREM suppression. 
D)  REM suppression in larger doses.

Question 13

A patient with mild obstructive sleep apnea (OSA)can expect treatment to consist of

Accepted Answer

A)  medical management with protriptyline. 
B)  weight loss, elimination of alcohol before bedtime, and side sleeping. 
C)  immediate use of continuous positive airway pressure (CPAP). 
D)  surgical intervention with uvulopalatopharyngoplasty (UPPP). 
A)  medical management with protriptyline. 
B)  weight loss, elimination of alcohol before bedtime, and side sleeping. 
C)  immediate use of continuous positive airway pressure (CPAP). 
D)  surgical intervention with uvulopalatopharyngoplasty (UPPP).

Question 14

A sufficient amount of sleep has been achieved when a person awakens

Accepted Answer

A)  after 8 to 10 hours of uninterrupted sleep. 
B)  with external stimuli and gets through the day without feeling sleepy. 
C)  without external stimuli and gets through the day without feeling sleepy. 
D)  feeling rested in the morning and takes a nap in the afternoon. 
A)  after 8 to 10 hours of uninterrupted sleep. 
B)  with external stimuli and gets through the day without feeling sleepy. 
C)  without external stimuli and gets through the day without feeling sleepy. 
D)  feeling rested in the morning and takes a nap in the afternoon.

Question 15

During a sleep study, which of the following groups of information are gathered?

Accepted Answer

A)  Airflow, snoring, and tonsil size 
B)  Electroencephalogram, electrocardiogram, and end-tidal carbon dioxide 
C)  Oxygen saturation, number of arousals, and airflow 
D)  Frequency of awakenings, REM speed, and apnea-hypopnea index 
A)  Airflow, snoring, and tonsil size 
B)  Electroencephalogram, electrocardiogram, and end-tidal carbon dioxide 
C)  Oxygen saturation, number of arousals, and airflow 
D)  Frequency of awakenings, REM speed, and apnea-hypopnea index

Question 16

Sleep disturbance in critically ill patients is defined as insufficient duration or stages of sleep that results in

Accepted Answer

A)  less sleep that promotes recovery. 
B)  discomfort and interferes with quality of life. 
C)  adaptation of the environment to promote sleep. 
D)  more sleep that promotes recovery. 
A)  less sleep that promotes recovery. 
B)  discomfort and interferes with quality of life. 
C)  adaptation of the environment to promote sleep. 
D)  more sleep that promotes recovery.

Question 17

_____ is a diagnostic test used to determine sleep disturbances.

Accepted Answer

A)  Electrooculography 
B)  Electromyography 
C)  Electroencephalography 
D)  Polysomnography 
A)  Electrooculography 
B)  Electromyography 
C)  Electroencephalography 
D)  Polysomnography

Question 18

Which of the following patients would the nurse most strongly suspect of having obstructive sleep apnea?

Accepted Answer

A)  A severely obese woman with diabetes 
B)  A moderately obese man who snores 
C)  A nonobese woman with hypertension 
D)  A severely obese man with renal dysfunction 
A)  A severely obese woman with diabetes 
B)  A moderately obese man who snores 
C)  A nonobese woman with hypertension 
D)  A severely obese man with renal dysfunction

Question 19

_____ is used during polysomnography to determine when the patient enters REM sleep.

Accepted Answer

A)  Electrooculography 
B)  Electromyography 
C)  Electroencephalography 
D)  Polysomnography 
A)  Electrooculography 
B)  Electromyography 
C)  Electroencephalography 
D)  Polysomnography

Question 20

Which of the following older patients demonstrates changes in sleep patterns attributable to central sleep apnea?

Accepted Answer

A)  A patient who wakes up two to three times per night and is tired during the day 
B)  A patient who reports sleeping less soundly and not feeling rested 
C)  A patient who consistently awakens at 4 AM and goes to bed at 7 PM 
D)  A patient who has irregular respiration during sleep and whose inspiratory muscles intermittently fail 
A)  A patient who wakes up two to three times per night and is tired during the day 
B)  A patient who reports sleeping less soundly and not feeling rested 
C)  A patient who consistently awakens at 4 AM and goes to bed at 7 PM 
D)  A patient who has irregular respiration during sleep and whose inspiratory muscles intermittently fail

Exam 5: Sleep Alterations

Where are EMG leads placed to detect muscle atonia?

Identify the usual cycle of sleep onset.

REM sleep comprises what percent of the sleep cycle?

_____ is the external element that has the most significant effect on circadian rhythms.

The primary determinant in the efficacy of CPAP in patients with OSA is

Interventions to help with circadian synchronization include

What occurs physiologically during REM sleep?

Sleep deprivation can result from which of the following?

Which stage of NREM sleep is associated with anabolic processes?

A patient with mild obstructive sleep apnea (OSA)can expect treatment to consist of

A sufficient amount of sleep has been achieved when a person awakens

During a sleep study, which of the following groups of information are gathered?

Sleep disturbance in critically ill patients is defined as insufficient duration or stages of sleep that results in

_____ is a diagnostic test used to determine sleep disturbances.

Which of the following patients would the nurse most strongly suspect of having obstructive sleep apnea?

_____ is used during polysomnography to determine when the patient enters REM sleep.

Which of the following older patients demonstrates changes in sleep patterns attributable to central sleep apnea?

Caring for the Critically Ill Patient

Ethical and Legal Issues

Patient and Family Education

Psychosocial and Spiritual Alterations and Management

Nutritional Alterations

Gerontological Alterations

Pain and Pain Management

Sedation, Agitation and Delirium Management

End of Life Care

Cardiovascular Clinical Assessment and Diagnostic Procedures

Cardiovascular Disorders

Cardiovascular Therapeutic Management

Pulmonary Clinical Assessment and Diagnostic Procedures

Pulmonary Disorders

Pulmonary Therapeutic Management

Neurologic Clinical Assessment and Diagnostic Procedures

Neurologic Disorders and Therapeutic Management

Kidney Clinical Assessment and Diagnostic Procedures

Kidney Disorders and Therapeutic Management

Gastrointestinal Clinical Assessment and Diagnostic Procedures

Gastrointestinal Disorders and Therapeutic Management

Endocrine Clinical Assessment and Diagnostic Procedures

Endocrine Disorders and Therapeutic Management

Trauma

Shock, Sepsis, and Multiple Organ Dysfunction Syndrome

Hematologic Disorders and Oncologic Emergencies

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