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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).
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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 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.
A client with insomnia is prescribed zolpidem. When describing the action of this medication to the client, the nurse would incorporate information related to the medication?s effect on which of the following?
- A. GABA
- B. Serotonin
- C. Dopamine
- D. Norepinephrine
Correct Answer: A
Rationale: Zolpidem, a non-benzodiazepine hypnotic, enhances GABA (A) activity to promote sleep. It does not primarily affect serotonin (B), dopamine (C), or norepinephrine (D).
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 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.