Question 1

Which outcome is appropriate for an adult patient recently diagnosed with primary insomnia?

Accepted Answer

A)   Demonstrate an understanding of the cerebral stimulants prescribed.
B)   Recognize that the prescribed flurazepam (Dalmane)  can be used for up to 2 months.
C)   Demonstrate the proper use of continuous positive airway pressure (CPAP)  ventilation.
D)   Recognize physical and psychosocial stressors that exacerbate the sleep disturbance. D

Question 2

A patient with obstructive sleep apnea (OSA)is being discharged.What patient statement indicates the need for further teaching?

Accepted Answer

A)   "I hope to lose some weight."
B)   "My antidepressants seem to be helping."
C)   "I will try the oral appliance that the doctor suggested."
D)   "A glass of wine at bedtime will help relax my airways." D

Question 3

Which physical assessment finding is supportive of a diagnosis of obstructive sleep apnea?

Accepted Answer

A)   Barrel chest
B)   Raccoon eyes
C)   Enlarged nasal nares
D)   Large neck circumference D

Question 4

Which intervention will best assess a narcoleptic patient for a commonly recognized comorbid psychiatric disorder?

Accepted Answer

A)   Observing for signs of self-mutilation
B)   Observing the patient for ritualistic behaviors
C)   Asking, "Do you consider yourself to be depressed?"
D)   Asking, "Do you rely on alcohol to function socially?"

Question 5

Which suggestions would be included when educating a patient concerning the management of a circadian rhythm sleep disorder? Select all that apply.

Accepted Answer

A)   Darken the bedroom.
B)   Go to sleep at the same time each night.
C)   Keep the bedroom environment calm and serene.
D)   Initially, retire 30 minutes earlier than usual.
E)   Take a low-dose over-the-counter sleep aid.

Question 6

A patient tells the nurse,"I take herbal products like melatonin and valerian to help sleep." Which response will the nurse make to the patient?

Accepted Answer

A)   "My aunt uses them, and they help her a lot."
B)   "Studies show they are ineffective as sleep aids."
C)   "They can cause serious side effects and should be avoided."
D)   "Be aware that these products are uncontrolled, so preparations vary."

Question 7

Which patient statement would support a diagnosis of a circadian rhythm sleep disturbance?

Accepted Answer

A)   "I just started on the night shift at work."
B)   "My mother was seriously depressed for years."
C)   "I wake up gasping for breath, and it is really scary."
D)   "I don't think I drink any more than my buddies do."

Question 8

Which comorbid conditions have been associated with sleep deprivation? Select all that apply.

Accepted Answer

A)   Depression
B)   Hypertension
C)   Anxiety disorders
D)   Gastric reflux disease
E)   Coronary artery disease

Question 9

When the family of a child diagnosed with a nightmare disorder asks the nurse about prognosis,the nurse replies with the knowledge that:

Accepted Answer

A)   The disorder is frequently self-limiting in children.
B)   If the child is obese, it is likely the nightmares will continue.
C)   High doses of diazepam (Valium)  are needed to cure the disorder.
D)   With the use of antipsychotic medication, the disorder will not worsen.

Question 10

Which assessment observation would not support a diagnosis of narcolepsy?

Accepted Answer

A)   Sleep study reports excessive, loud snoring.
B)   Sleep study shows evidence of sleep paralysis.
C)   Patient reports "needing to drink pots of coffee to stay awake at work."
D)   Patient reports, "When I get sleepy I actually see things that aren't really there."

Question 11

During the assessment interview,a patient tells the nurse he has "sleep problems." Which question will assess for the use of substances that affect the quality of sleep? Select all that apply.

Accepted Answer

A)   "Do you follow a low-fat diet?"
B)   "Are you a big coffee drinker?"
C)   "Do you indulge in an evening alcoholic drink?"
D)   "Have you been prescribed an opiate-based analgesic?"
E)   "Are you currently taking antianxiety medication?"

Question 12

A 10-year-old is diagnosed with somnambulism as a result of frequent episodes of sleepwalking.Which topic should be included when considering patient and family education?

Accepted Answer

A)   Medication therapy seldom prescribed for this disorder
B)   Safety issues such as sleeping in the ground level bedroom
C)   The likely connection between sleepwalking and narcolepsy
D)   The need for short-term cognitive and behavioral therapy

Question 13

An adult patient diagnosed with narcolepsy is being educated on the medication therapy that is prescribed.Which explanation is provided for the central nervous system stimulant dextroamphetamine (Dexedrine)?

Accepted Answer

A)   The apnea will be lessened by this medication.
B)   It will help control the sporadic loss of muscle tone.
C)   This medication will minimize the daytime sleepiness.
D)   Dexedrine will manage the inflammation that causes the snoring.

Question 14

Which notations should be included in a sleep journal? Select all that apply.

Accepted Answer

A)   Any regular bedtime rituals
B)   Things that assist with sleep
C)   Time when patient went to bed
D)   Things that interfere with sleeping
E)   Foods eaten at dinner or last meal

Question 15

An adult patient diagnosed with insomnia is prescribed the antihistamine,diphenhydramine.Which side effects does the nurse educate the patient about? Select all that apply.

Accepted Answer

A)   Urinary retention
B)   Blurred vision
C)   Rhinorrhea
D)   Dry mouth
E)   Diarrhea

Question 16

Which of the statements made by the patient would be most indicative of dyssomnia?

Accepted Answer

A)   "I think I am seeing things when I wake up."
B)   "My wife says I snore and even stop breathing."
C)   "I go to sleep okay but then wake up several times at night."
D)   "My wife says I sit straight up in bed at 2 AM and then say strange things."

Question 17

Which statement indicates to the nurse that a patient requires additional education regarding appropriate sleep hygiene?

Accepted Answer

A)   "I will try to avoid daytime napping."
B)   "Relaxing music may help relax me for sleep."
C)   "Exercising before bed will make me good and tired."
D)   "I need to cut back on my four daily cups of coffee."

Question 18

A pediatric patient has been diagnosed with obstructive sleep apnea (OSA).Which statement would the nurse use as a basis for explaining the etiology of this disorder?

Accepted Answer

A)   Melatonin is not being released in sufficient quantity.
B)   This condition is often due to adenotonsillar hypertrophy.
C)   Children have a high ratio of REM sleep that can result in frequent gasping.
D)   This can be related to a sleep position which compromises chest movement.

Exam 19: Sleep Disorders: Dyssomnias and Parasomnias