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A client has been admitted to the psychiatric unit with a diagnosis of narcolepsy. Which client statement would the nurse interpret as reflecting this condition?
- A. Sometimes when I?m falling asleep, I see and hear things that my wife doesn?t.
- B. I often have brief periods of intense excitement when going to sleep, and my legs won?t hold still.
- C. I lie there and worry all night, and it keeps me awake. I just can?t relax.
- D. I think my sleep pattern is messed up because I took sleeping pills when I was younger.
Correct Answer: A
Rationale: Hallucinations while falling asleep (A) are hypnagogic hallucinations, a hallmark of narcolepsy. Restless legs (B) suggest restless leg syndrome, worry (C) indicates insomnia, and past sleeping pill use (D) is unrelated to narcolepsy.
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A client with a mental disorder is being discharged from the inpatient unit. During the client?s stay in the hospital, the client eventually was able to get an adequate night?s sleep even though the client had experienced chronic insomnia over the years. The client?s spouse asks the nurse what the family can do in the client?s home environment to promote healthy sleep. Which response by the nurse would be most appropriate?
- A. It is basically up to your husband to focus on promoting his own sleep.
- B. You might consider a glass of wine about 30 minutes before he is ready to go to bed.
- C. Remember to keep stimulating activities at a minimum before he goes to bed.
- D. Give him a spicy snack with a warm cup of tea at night before bedtime.
Correct Answer: C
Rationale: Minimizing stimulating activities before bed (C) supports sleep hygiene by reducing arousal. Relying solely on the client (A) dismisses family support, alcohol (B) can disrupt sleep, and spicy snacks or tea (D) may cause discomfort or contain caffeine.
A nurse is preparing a presentation on sleep disorders for a community group. Which of the following would the nurse include when explaining the differences between narcolepsy and obstructive sleep apnea syndrome?
- A. Symptoms of both disorders are essentially the same, so it is difficult to differentiate between the two disorders.
- B. People with narcolepsy awaken from a nap feeling rested and replenished, but those with obstructive sleep apnea do not.
- C. People with obstructive sleep apnea syndrome can experience temporary paralysis with naps.
- D. Naps are not recommended for clients with narcolepsy because of their association with severe loss of muscle tone.
Correct Answer: B
Rationale: Narcolepsy involves refreshing naps (B), unlike obstructive sleep apnea (OSA), where naps are non-restorative due to fragmented sleep. Symptoms differ significantly (A), paralysis is specific to narcolepsy (C), and naps are beneficial for narcolepsy (D).
A client with insomnia is prescribed zolpidem. When describing the action of this medication to the client, the nurse would incorporate information related to the medication?s effect on which of the following?
- A. GABA
- B. Serotonin
- C. Dopamine
- D. Norepinephrine
Correct Answer: A
Rationale: Zolpidem, a non-benzodiazepine hypnotic, enhances GABA (A) activity to promote sleep. It does not primarily affect serotonin (B), dopamine (C), or norepinephrine (D).
A group of nursing students is reviewing the various agents used to treat insomnia. The students demonstrate an understanding of the information when they identify which agent as a melatonin receptor agonist?
- A. Trazodone
- B. Estazolam
- C. Mirtazapine
- D. Ramelteon
Correct Answer: D
Rationale: Ramelteon (D) is a melatonin receptor agonist used for insomnia. Trazodone (A) and mirtazapine (C) are antidepressants, and estazolam (B) is a benzodiazepine.
After teaching a class about circadian rhythm disorders, a nursing instructor determines that the teaching was successful when the class identifies which of the following as a subtype? Select all that apply.
- A. Delayed sleep phase
- B. Nightmare
- C. Sleep terror
- D. Jet lag
- E. Shift work
Correct Answer: A,D,E
Rationale: Circadian rhythm disorders include delayed sleep phase (A), jet lag (D), and shift work (E) disorders, which disrupt sleep-wake timing. Nightmare (B) and sleep terror (C) are parasomnias, not circadian disorders.