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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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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 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 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 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.
A student nurse is preparing a nursing care plan for a client who has insomnia and is experiencing sleep deprivation. Which nursing diagnosis would the nurse most likely identify as reflecting a priority care issue?
- A. Risk for Injury
- B. Ineffective Coping
- C. Deficient Knowledge
- D. Anxiety
Correct Answer: A
Rationale: Sleep deprivation increases the risk for injury (A) due to impaired coordination and cognition, making it a priority. Ineffective coping (B), deficient knowledge (C), and anxiety (D) are secondary concerns compared to safety risks.