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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.
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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.
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 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.
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.
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.