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A female client who is receiving counseling at a community health center has complained about being unable to sleep at each of the last three weekly sessions. The nurse interviews the family members to determine the effect of the client?s problem on them. Which response would the nurse most likely expect to hear?
- A. It really hasn?t seemed to be a problem for us.
- B. There?s been little change in how she gets along with other family members.
- C. The not sleeping has really had a positive effect on her and us.
- D. It?s been exhausting living with her these past few weeks.
Correct Answer: D
Rationale: Chronic insomnia can strain family dynamics, leading to exhaustion (D) due to disrupted routines or irritability. Minimal impact (A), no change in relationships (B), or positive effects (C) are less likely given insomnia?s negative effects.
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A nurse is obtaining information about a client?s sleep patterns and asks him about the total amount of sleep time compared with the amount of time spent in bed. The nurse is assessing which of the following?
- A. Sleep latency
- B. Sleep architecture
- C. Sleep efficiency
- D. Sleep-wake cycle
Correct Answer: C
Rationale: Sleep efficiency (C) is the ratio of total sleep time to time spent in bed, directly assessed by this question. Sleep latency (A) is the time to fall asleep, architecture (B) refers to sleep stages, and sleep-wake cycle (D) is broader.
The nurse is assessing the sleep patterns of a 70-year-old female client with a mental disorder. Based on the knowledge of circadian rhythms and the influence of age, which of the following would the nurse anticipate that the client would report about her sleep pattern?
- A. When I was younger, I didn?t notice any differences in how I felt in the morning or evening.
- B. Now it seems like I am sleepier at night and more alert in the morning.
- C. When I worked days, I?d always have trouble feeling sleepy in the morning.
- D. When I was younger, the amount of sleep I got didn?t seem to matter.
Correct Answer: B
Rationale: Aging shifts circadian rhythms, often leading to earlier sleepiness and morning alertness (B), a pattern known as advanced sleep phase syndrome. Options (A), (C), and (D) do not reflect typical age-related changes in circadian rhythms.
A group of nursing students is reviewing information about factors affecting the pattern and quality of sleep. The students demonstrate a need for additional review when they identify which of the following?
- A. Sleep patterns are relatively constant across the lifespan.
- B. Women report more problems with sleep than men.
- C. Working night shifts and sleeping during the day can affect sleep.
- D. Environmental influences on sleep can be internal or external.
Correct Answer: A
Rationale: Sleep patterns change across the lifespan (A), with aging affecting sleep duration and quality, indicating a need for review. Women reporting more sleep issues (B), night shifts (C), and environmental influences (D) are accurate.
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 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.