Exam 21: Sleep–Wake Disorders

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

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

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

Which neurotransmitters are most responsible for wakefulness? Select all that apply.

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

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?

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

Which person would be most likely to experience sleep fragmentation?

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?

A home care nurse assesses a very demanding patient with chronic obstructive pulmonary disease (COPD). Afterward, the nurse talks with the spouse, who has provided this patient's care for 6 years. The spouse says, "I don't need much sleep anymore. I might need to help him during the night." Select the nurse's most therapeutic 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 new patient at the sleep disorders clinic tells the nurse, "I have not slept well in a year, so I never feel good. I do not expect things will ever improve or be any different." Which of the following interventions should the nurse consider doing? Select all that apply.

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 night shift worker reports, "I'm having trouble getting to sleep after a night's work. I have a hearty breakfast with coffee, read the paper, do my exercises, and then go to bed. However, I just lie awake until it is nearly time to get up to be with my family for dinner." What changes should the nurse suggest? Select all that apply.

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

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

A person is prescribed lorazepam (Ativan) 2 mg po bid prn for anxiety. When the person takes this medication, which change in sleep is anticipated?

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

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 patient says, "I have trouble falling asleep at night and might lie awake until 3 or 4 a.m. before falling sleep." Which medication would the nurse expect a health care provider to prescribe for this patient?