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A nurse is working with a psychiatric client who was admitted to the inpatient facility and is being discharged. The client asks the nurse what he should do when he goes home to promote getting adequate sleep. Which response by the nurse would be most appropriate?
- A. Go to bed at the same time every night and watch a television show that relaxes you.
- B. Save your bedroom for sleeping; that means no work and no TV in the bedroom.
- C. Why don?t you ask your psychiatrist for a prescription for a sleeping pill?
- D. Make sure to keep the bedroom warm and toasty.
Correct Answer: B
Rationale: Reserving the bedroom for sleep (B) is a stimulus control technique that strengthens the association between the bedroom and sleep. TV watching (A) can disrupt sleep, sleeping pills (C) are not a first-line recommendation, and a warm bedroom (D) may interfere with sleep.
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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 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 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 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.