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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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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.
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 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.
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.