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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).
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A nurse is working with a psychiatric client who was admitted to the inpatient facility and is being discharged. The client asks the nurse what he should do when he goes home to promote getting adequate sleep. Which response by the nurse would be most appropriate?
- A. Go to bed at the same time every night and watch a television show that relaxes you.
- B. Save your bedroom for sleeping; that means no work and no TV in the bedroom.
- C. Why don?t you ask your psychiatrist for a prescription for a sleeping pill?
- D. Make sure to keep the bedroom warm and toasty.
Correct Answer: B
Rationale: Reserving the bedroom for sleep (B) is a stimulus control technique that strengthens the association between the bedroom and sleep. TV watching (A) can disrupt sleep, sleeping pills (C) are not a first-line recommendation, and a warm bedroom (D) may interfere with sleep.
A nurse is working with a client diagnosed with insomnia. When developing a teaching plan for the client, which sleep promotion intervention would the nurse implement first?
- A. Encouraging the client to consider stopping smoking
- B. Instructing the client to keep regular bedtimes and rising times
- C. Encouraging the client to take frequent naps
- D. Administering prescribed sleep medications
Correct Answer: B
Rationale: Establishing regular bedtimes and rising times (B) is the first-line intervention for insomnia to stabilize circadian rhythms. Stopping smoking (A) is secondary, frequent naps (C) can worsen insomnia, and medications (D) are not first-line.
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 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.
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.