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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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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.
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.
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 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.
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.