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The nurse is assessing the sleep patterns of a 70-year-old female client with a mental disorder. Based on the knowledge of circadian rhythms and the influence of age, which of the following would the nurse anticipate that the client would report about her sleep pattern?
- A. When I was younger, I didn?t notice any differences in how I felt in the morning or evening.
- B. Now it seems like I am sleepier at night and more alert in the morning.
- C. When I worked days, I?d always have trouble feeling sleepy in the morning.
- D. When I was younger, the amount of sleep I got didn?t seem to matter.
Correct Answer: B
Rationale: Aging shifts circadian rhythms, often leading to earlier sleepiness and morning alertness (B), a pattern known as advanced sleep phase syndrome. Options (A), (C), and (D) do not reflect typical age-related changes in circadian rhythms.
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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.
The sleep history of a client experiencing sleep problems reveals that the client ingests a significant amount of caffeine each day. When reviewing the effect of caffeine on sleep with the client, which of the following would the nurse incorporate into the discussion as a caffeine effect?
- A. Decreased sleep latency
- B. Increased total sleep time
- C. Decreased REM sleep
- D. Increased slow-wave sleep
Correct Answer: C
Rationale: Caffeine, a stimulant, decreases REM sleep (C) by increasing arousal, disrupting sleep quality. It increases sleep latency (A), decreases total sleep time (B), and does not enhance slow-wave sleep (D).
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.
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 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.