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.
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A nursing instructor is describing the prevalence of obstructive sleep apnea (OSA) as being greater in individuals with mental health disorders. Which disorders would the instructor include as being associated with OSA? Select all that apply.
- A. Depression
- B. Borderline personality disorder
- C. Schizophrenia
- D. Posttraumatic stress disorder
- E. Anxiety
Correct Answer: A,D,E
Rationale: OSA is associated with depression (A), PTSD (D), and anxiety (E) due to shared physiological and psychological stressors. Borderline personality disorder (B) and schizophrenia (C) have weaker associations with OSA.
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 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 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 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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