A client with insomnia is taught to avoid watching television, eating, and doing work in the bedroom. Which technique is being used?
- A. Sleep restriction
- B. Relaxation training
- C. Cognitive behavior therapy
- D. Stimulus control
Correct Answer: D
Rationale: Avoiding non-sleep activities in the bedroom is a stimulus control technique (D), strengthening the bed-sleep association. Sleep restriction (A) limits time in bed, relaxation training (B) focuses on calming techniques, and cognitive behavior therapy (C) is broader.
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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.
The nurse is discussing sleep enhancing strategies with a client who is experiencing insomnia. Which of the following would be most appropriate for the nurse to suggest?
- A. Eat right before you go to bed as long as it is something rich that will make you sleepy.
- B. Try exercising a bit right before your bedtime so you will feel tired and sleepy.
- C. Drinking a warm cup of tea right before bedtime will help to relax you.
- D. Establish a regular time for going to bed and getting up in the morning.
Correct Answer: D
Rationale: Establishing a regular sleep schedule (D) promotes circadian rhythm stability, a key strategy for insomnia. Eating before bed (A) can disrupt sleep, exercise close to bedtime (B) may increase arousal, and tea (C) may contain caffeine, worsening insomnia.
A nurse is giving a presentation to a community group about sleep and its relationship to health. In explaining the relationship between REM sleep and body temperature, which statement by the nurse would be most appropriate?
- A. There is no observable relationship between REM sleep and body temperature.
- B. With higher levels of REM sleep, we also experience higher body temperatures.
- C. Our REM sleep and body temperature cycles are inversely related.
- D. The extent of our experience of REM sleep is directly proportional to a rise in body temperature.
Correct Answer: C
Rationale: Body temperature decreases during REM sleep due to reduced thermoregulation, making the cycles inversely related (C). No relationship (A) is incorrect, higher REM with higher temperatures (B) and direct proportionality (D) contradict physiological evidence.
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 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.
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